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LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameLAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN
Plan identification number 002

LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

LAKE CHARLES ANESTHESIOLOGY APMC has sponsored the creation of one or more 401k plans.

Company Name:LAKE CHARLES ANESTHESIOLOGY APMC
Employer identification number (EIN):720732206
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01DWIGHT R. LEMOINE, M.D.
0022017-01-01DWIGHT R. LEMOINE, M.D.
0022016-01-01DWIGHT R. LEMOINE, M.D.
0022015-01-01DWIGHT R. LEMOINE, M.D.
0022014-01-01DWIGHT R. LEMOINE, M.D.
0022013-01-01DWIGHT R. LEMOINE, M.D.
0022012-01-01DWIGHT R. LEMOINE, M.D.
0022011-01-01DWIGHT R. LEMOINE, M.D.
0022010-01-01DWIGHT R. LEMOINE, M.D.
0022009-01-01DWIGHT R. LEMOINE, M.D.

Plan Statistics for LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN

Measure Date Value
2022: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0150
Total number of active participants reported on line 7a of the Form 55002022-01-0139
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-019
Total of all active and inactive participants2022-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0149
Number of participants with account balances2022-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0146
Total number of active participants reported on line 7a of the Form 55002021-01-0139
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0110
Total of all active and inactive participants2021-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0149
Number of participants with account balances2021-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0143
Total number of active participants reported on line 7a of the Form 55002020-01-0138
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-018
Total of all active and inactive participants2020-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0146
Number of participants with account balances2020-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0133
Total number of active participants reported on line 7a of the Form 55002019-01-0135
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-012
Total of all active and inactive participants2019-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0137
Number of participants with account balances2019-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0131
Total number of active participants reported on line 7a of the Form 55002018-01-0129
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-014
Total of all active and inactive participants2018-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0133
Number of participants with account balances2018-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0130
Total number of active participants reported on line 7a of the Form 55002017-01-0128
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0131
Number of participants with account balances2017-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0126
Total number of active participants reported on line 7a of the Form 55002016-01-0127
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0130
Number of participants with account balances2016-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0124
Total number of active participants reported on line 7a of the Form 55002015-01-0126
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0126
Number of participants with account balances2015-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0124
Total number of active participants reported on line 7a of the Form 55002014-01-0124
Total of all active and inactive participants2014-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0124
Number of participants with account balances2014-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0127
Total number of active participants reported on line 7a of the Form 55002013-01-0124
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0125
Number of participants with account balances2013-01-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0129
Total number of active participants reported on line 7a of the Form 55002012-01-0125
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0127
Number of participants with account balances2012-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0130
Total number of active participants reported on line 7a of the Form 55002011-01-0127
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0129
Number of participants with account balances2011-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0128
Total number of active participants reported on line 7a of the Form 55002010-01-0129
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-011
Total of all active and inactive participants2010-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0130
Number of participants with account balances2010-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0129
Total number of active participants reported on line 7a of the Form 55002009-01-0127
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0128
Number of participants with account balances2009-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN

Measure Date Value
2022 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$-5,495,491
Expenses. Total of all expenses incurred2022-12-31$1,267,014
Benefits paid (including direct rollovers)2022-12-31$1,243,876
Total plan assets at end of year2022-12-31$27,607,346
Total plan assets at beginning of year2022-12-31$34,369,851
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$625,622
Other income received2022-12-31$-7,305,034
Net income (gross income less expenses)2022-12-31$-6,762,505
Net plan assets at end of year (total assets less liabilities)2022-12-31$27,607,346
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$34,369,851
Assets. Value of participant loans2022-12-31$437,759
Assets. Value of assets in partnership/joint-venture interests2022-12-31$112,828
Total contributions received or receivable from employer(s)2022-12-31$1,183,921
Value of corrective distributions2022-12-31$1,799
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$21,339
2021 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources2021-12-31$4,837,581
Expenses. Total of all expenses incurred2021-12-31$655,803
Benefits paid (including direct rollovers)2021-12-31$655,803
Total plan assets at end of year2021-12-31$34,369,851
Total plan assets at beginning of year2021-12-31$30,188,073
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$556,202
Contributions received from other sources (not participants or employers)2021-12-31$373,573
Other income received2021-12-31$2,795,643
Net income (gross income less expenses)2021-12-31$4,181,778
Net plan assets at end of year (total assets less liabilities)2021-12-31$34,369,851
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$30,188,073
Assets. Value of participant loans2021-12-31$387,926
Assets. Value of assets in partnership/joint-venture interests2021-12-31$85,070
Total contributions received or receivable from employer(s)2021-12-31$1,112,163
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$6,451,363
Expenses. Total of all expenses incurred2020-12-31$4,290,341
Benefits paid (including direct rollovers)2020-12-31$4,290,341
Total plan assets at end of year2020-12-31$30,188,073
Total plan assets at beginning of year2020-12-31$28,027,051
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$493,850
Contributions received from other sources (not participants or employers)2020-12-31$63,087
Other income received2020-12-31$4,884,864
Net income (gross income less expenses)2020-12-31$2,161,022
Net plan assets at end of year (total assets less liabilities)2020-12-31$30,188,073
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$28,027,051
Assets. Value of participant loans2020-12-31$407,388
Assets. Value of assets in partnership/joint-venture interests2020-12-31$70,080
Total contributions received or receivable from employer(s)2020-12-31$1,009,562
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$6,444,825
Expenses. Total of all expenses incurred2019-12-31$539,459
Benefits paid (including direct rollovers)2019-12-31$534,540
Total plan assets at end of year2019-12-31$28,027,051
Total plan assets at beginning of year2019-12-31$22,121,685
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$414,962
Other income received2019-12-31$5,199,404
Net income (gross income less expenses)2019-12-31$5,905,366
Net plan assets at end of year (total assets less liabilities)2019-12-31$28,027,051
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$22,121,685
Assets. Value of participant loans2019-12-31$203,109
Assets. Value of assets in partnership/joint-venture interests2019-12-31$114,450
Total contributions received or receivable from employer(s)2019-12-31$830,459
Value of corrective distributions2019-12-31$568
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$4,351
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$-617,462
Expenses. Total of all expenses incurred2018-12-31$1,329,476
Benefits paid (including direct rollovers)2018-12-31$1,329,476
Total plan assets at end of year2018-12-31$22,121,685
Total plan assets at beginning of year2018-12-31$24,068,623
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$336,908
Contributions received from other sources (not participants or employers)2018-12-31$1,913
Other income received2018-12-31$-1,649,645
Net income (gross income less expenses)2018-12-31$-1,946,938
Net plan assets at end of year (total assets less liabilities)2018-12-31$22,121,685
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$24,068,623
Assets. Value of participant loans2018-12-31$187,835
Assets. Value of assets in partnership/joint-venture interests2018-12-31$44,630
Total contributions received or receivable from employer(s)2018-12-31$693,362
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$4,689,443
Expenses. Total of all expenses incurred2017-12-31$141,970
Benefits paid (including direct rollovers)2017-12-31$140,594
Total plan assets at end of year2017-12-31$24,068,623
Total plan assets at beginning of year2017-12-31$19,521,150
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$294,023
Contributions received from other sources (not participants or employers)2017-12-31$4,007
Other income received2017-12-31$3,754,725
Net income (gross income less expenses)2017-12-31$4,547,473
Net plan assets at end of year (total assets less liabilities)2017-12-31$24,068,623
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$19,521,150
Assets. Value of participant loans2017-12-31$196,620
Assets. Value of assets in partnership/joint-venture interests2017-12-31$61,237
Total contributions received or receivable from employer(s)2017-12-31$636,688
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$1,376
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$2,344,762
Expenses. Total of all expenses incurred2016-12-31$584,901
Benefits paid (including direct rollovers)2016-12-31$568,419
Total plan assets at end of year2016-12-31$19,521,150
Total plan assets at beginning of year2016-12-31$17,761,289
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$293,128
Other income received2016-12-31$1,449,917
Net income (gross income less expenses)2016-12-31$1,759,861
Net plan assets at end of year (total assets less liabilities)2016-12-31$19,521,150
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$17,761,289
Assets. Value of participant loans2016-12-31$208,264
Assets. Value of assets in partnership/joint-venture interests2016-12-31$43,027
Total contributions received or receivable from employer(s)2016-12-31$601,717
Value of certain deemed distributions of participant loans2016-12-31$16,482
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$803,517
Expenses. Total of all expenses incurred2015-12-31$1,405,633
Benefits paid (including direct rollovers)2015-12-31$1,407,078
Total plan assets at end of year2015-12-31$17,761,289
Total plan assets at beginning of year2015-12-31$18,363,405
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$270,657
Expenses. Other expenses not covered elsewhere2015-12-31$566
Other income received2015-12-31$-44,279
Net income (gross income less expenses)2015-12-31$-602,116
Net plan assets at end of year (total assets less liabilities)2015-12-31$17,761,289
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$18,363,405
Assets. Value of participant loans2015-12-31$241,277
Assets. Value of assets in partnership/joint-venture interests2015-12-31$51,855
Total contributions received or receivable from employer(s)2015-12-31$577,139
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$-2,011
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$1,551,508
Expenses. Total of all expenses incurred2014-12-31$135,816
Benefits paid (including direct rollovers)2014-12-31$138,994
Total plan assets at end of year2014-12-31$18,363,405
Total plan assets at beginning of year2014-12-31$16,947,713
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$242,996
Expenses. Other expenses not covered elsewhere2014-12-31$311
Other income received2014-12-31$752,476
Net income (gross income less expenses)2014-12-31$1,415,692
Net plan assets at end of year (total assets less liabilities)2014-12-31$18,363,405
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$16,947,713
Assets. Value of participant loans2014-12-31$217,764
Assets. Value of assets in partnership/joint-venture interests2014-12-31$75,793
Total contributions received or receivable from employer(s)2014-12-31$556,036
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$-3,489
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$3,540,850
Expenses. Total of all expenses incurred2013-12-31$1,371,311
Benefits paid (including direct rollovers)2013-12-31$1,370,733
Total plan assets at end of year2013-12-31$16,947,713
Total plan assets at beginning of year2013-12-31$14,778,174
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$228,468
Expenses. Other expenses not covered elsewhere2013-12-31$152
Other income received2013-12-31$2,759,080
Net income (gross income less expenses)2013-12-31$2,169,539
Net plan assets at end of year (total assets less liabilities)2013-12-31$16,947,713
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$14,778,174
Assets. Value of participant loans2013-12-31$248,154
Assets. Value of assets in partnership/joint-venture interests2013-12-31$122,348
Total contributions received or receivable from employer(s)2013-12-31$553,302
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$426
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$754
Total income from all sources2012-12-31$2,513,790
Expenses. Total of all expenses incurred2012-12-31$108,127
Benefits paid (including direct rollovers)2012-12-31$92,114
Total plan assets at end of year2012-12-31$14,778,174
Total plan assets at beginning of year2012-12-31$12,373,265
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$247,598
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$1,660,351
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$2,405,663
Net plan assets at end of year (total assets less liabilities)2012-12-31$14,778,174
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$12,372,511
Assets. Value of participant loans2012-12-31$261,991
Assets. Value of assets in partnership/joint-venture interests2012-12-31$84,000
Total contributions received or receivable from employer(s)2012-12-31$605,841
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$16,013
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$754
Total plan liabilities at beginning of year2011-12-31$2,445
Total income from all sources2011-12-31$661,259
Expenses. Total of all expenses incurred2011-12-31$2,236,080
Benefits paid (including direct rollovers)2011-12-31$2,161,697
Total plan assets at end of year2011-12-31$12,373,265
Total plan assets at beginning of year2011-12-31$13,949,777
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$257,112
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-243,316
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-1,574,821
Net plan assets at end of year (total assets less liabilities)2011-12-31$12,372,511
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$13,947,332
Assets. Value of participant loans2011-12-31$295,923
Assets. Value of assets in partnership/joint-venture interests2011-12-31$89,734
Total contributions received or receivable from employer(s)2011-12-31$647,463
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$754
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$73,629
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$2,445
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$2,566,517
Expenses. Total of all expenses incurred2010-12-31$176,365
Benefits paid (including direct rollovers)2010-12-31$133,898
Total plan assets at end of year2010-12-31$13,949,777
Total plan assets at beginning of year2010-12-31$11,557,180
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$306,989
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$1,558,620
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$2,390,152
Net plan assets at end of year (total assets less liabilities)2010-12-31$13,947,332
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$11,557,180
Assets. Value of participant loans2010-12-31$340,187
Assets. Value of assets in partnership/joint-venture interests2010-12-31$56,109
Total contributions received or receivable from employer(s)2010-12-31$700,908
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$2,445
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$40,022
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN

2022: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING 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: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING 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: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LAKE CHARLES ANESTHESIOLOGY APMC 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered13
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered12
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered12
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $10,292
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,719
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered11
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $7,225
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,780
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,449
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,337
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered8
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,501
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,217
Insurance broker organization code?3
Insurance broker nameJAMES GUILBEAUX
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered8
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,800
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,800
Insurance broker organization code?3
Insurance broker nameERIC STEVENS
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,331
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,331
Insurance broker organization code?3
Insurance broker nameERIC STEVENS
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number335450-01
Policy instance 1
Insurance contract or identification number335450-01
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,874
Total amount of fees paid to insurance companyUSD $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 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 $2,874
Insurance broker organization code?3
Insurance broker nameERIC STEVENS
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57748
Policy instance 1
Insurance contract or identification number57748
Number of Individuals Covered27
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $77,843
Total amount of fees paid to insurance companyUSD $1,564
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $77,843
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerREDEMPTION FEE
Insurance broker nameEMPLOYEE PLAN COMPLIANCE CO.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57748
Policy instance 1
Insurance contract or identification number57748
Number of Individuals Covered29
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $74,059
Total amount of fees paid to insurance companyUSD $156
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57748
Policy instance 1
Insurance contract or identification number57748
Number of Individuals Covered30
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $48,478
Total amount of fees paid to insurance companyUSD $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 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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $48,478
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGT

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