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SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameSECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN
Plan identification number 001

SECURITY STATE BANK OF WEWOKA 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.
  • 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

SECURITY STATE BANK OF WEWOKA has sponsored the creation of one or more 401k plans.

Company Name:SECURITY STATE BANK OF WEWOKA
Employer identification number (EIN):730440430
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KEITH CLAYBROOK2023-07-27
0012021-01-01KEITH CLAYBROOK2022-07-18
0012020-01-01KEITH CLAYBROOK2021-10-13
0012019-01-01KEITH CLAYBROOK2020-10-09
0012018-01-01KEITH CLAYBROOK2019-09-27
0012017-01-01KEITH CLAYBROOK2018-10-12
0012016-01-01
0012015-01-01
0012014-01-01KEITH CLAYBROOK
0012013-01-01KEITH CLAYBROOK
0012012-01-01KEITH CLAYBROOK
0012011-01-01KEITH CLAYBROOK
0012010-01-01KEITH CLAYBROOK
0012009-01-01KEITH CLAYBROOK

Plan Statistics for SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN

401k plan membership statisitcs for SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN

Measure Date Value
2016: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0166
Total number of active participants reported on line 7a of the Form 55002016-01-0159
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-0110
Total of all active and inactive participants2016-01-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0170
Number of participants with account balances2016-01-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0152
Total number of active participants reported on line 7a of the Form 55002015-01-0158
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-019
Total of all active and inactive participants2015-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0167
Number of participants with account balances2015-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0146
Total number of active participants reported on line 7a of the Form 55002014-01-0145
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-017
Total of all active and inactive participants2014-01-0152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0152
Number of participants with account balances2014-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013
2013: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0133
Total number of active participants reported on line 7a of the Form 55002013-01-0144
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0148
Number of participants with account balances2013-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0131
Total number of active participants reported on line 7a of the Form 55002012-01-0131
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 participants2012-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0133
Number of participants with account balances2012-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: SECURITY STATE BANK OF WEWOKA 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 55002011-01-0128
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0131
Number of participants with account balances2011-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0132
Total number of active participants reported on line 7a of the Form 55002010-01-0128
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-012
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 balances2010-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0132
Total number of active participants reported on line 7a of the Form 55002009-01-0130
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0132
Number of participants with account balances2009-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN

Measure Date Value
2016 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$103,646
Total income from all sources2016-12-31$341,741
Expenses. Total of all expenses incurred2016-12-31$103,936
Benefits paid (including direct rollovers)2016-12-31$94,142
Total plan assets at end of year2016-12-31$2,413,628
Total plan assets at beginning of year2016-12-31$2,072,177
Value of fidelity bond covering the plan2016-12-31$825,000
Total contributions received or receivable from participants2016-12-31$119,566
Other income received2016-12-31$165,526
Net income (gross income less expenses)2016-12-31$237,805
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,413,628
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,072,177
Assets. Value of participant loans2016-12-31$3,524
Total contributions received or receivable from employer(s)2016-12-31$56,649
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$9,794
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$1,014,912
Expenses. Total of all expenses incurred2015-12-31$7,031
Benefits paid (including direct rollovers)2015-12-31$1,223
Total plan assets at end of year2015-12-31$2,072,177
Total plan assets at beginning of year2015-12-31$1,064,296
Value of fidelity bond covering the plan2015-12-31$825,000
Total contributions received or receivable from participants2015-12-31$110,431
Contributions received from other sources (not participants or employers)2015-12-31$932,320
Other income received2015-12-31$-74,133
Net income (gross income less expenses)2015-12-31$1,007,881
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,072,177
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,064,296
Assets. Value of participant loans2015-12-31$3,584
Total contributions received or receivable from employer(s)2015-12-31$46,294
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$5,808
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$173,564
Expenses. Total of all expenses incurred2014-12-31$51,993
Benefits paid (including direct rollovers)2014-12-31$47,276
Total plan assets at end of year2014-12-31$1,064,296
Total plan assets at beginning of year2014-12-31$942,725
Value of fidelity bond covering the plan2014-12-31$1,000,000
Total contributions received or receivable from participants2014-12-31$89,812
Other income received2014-12-31$42,435
Net income (gross income less expenses)2014-12-31$121,571
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,064,296
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$942,725
Assets. Value of participant loans2014-12-31$5,434
Total contributions received or receivable from employer(s)2014-12-31$41,317
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$4,717
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$169,709
Expenses. Total of all expenses incurred2013-12-31$2,533
Benefits paid (including direct rollovers)2013-12-31$437
Total plan assets at end of year2013-12-31$942,725
Total plan assets at beginning of year2013-12-31$775,549
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$68,669
Other income received2013-12-31$71,928
Net income (gross income less expenses)2013-12-31$167,176
Net plan assets at end of year (total assets less liabilities)2013-12-31$942,725
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$775,549
Assets. Value of participant loans2013-12-31$4,446
Total contributions received or receivable from employer(s)2013-12-31$29,112
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$2,096
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$160,332
Expenses. Total of all expenses incurred2012-12-31$2,735
Benefits paid (including direct rollovers)2012-12-31$2,698
Total plan assets at end of year2012-12-31$775,549
Total plan assets at beginning of year2012-12-31$617,952
Value of fidelity bond covering the plan2012-12-31$825,000
Total contributions received or receivable from participants2012-12-31$59,847
Expenses. Other expenses not covered elsewhere2012-12-31$37
Other income received2012-12-31$71,772
Net income (gross income less expenses)2012-12-31$157,597
Net plan assets at end of year (total assets less liabilities)2012-12-31$775,549
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$617,952
Assets. Value of participant loans2012-12-31$6,431
Total contributions received or receivable from employer(s)2012-12-31$28,713
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$72,548
Expenses. Total of all expenses incurred2011-12-31$54,107
Benefits paid (including direct rollovers)2011-12-31$54,107
Total plan assets at end of year2011-12-31$617,952
Total plan assets at beginning of year2011-12-31$599,511
Value of fidelity bond covering the plan2011-12-31$825,000
Total contributions received or receivable from participants2011-12-31$60,809
Other income received2011-12-31$-15,596
Net income (gross income less expenses)2011-12-31$18,441
Net plan assets at end of year (total assets less liabilities)2011-12-31$617,952
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$599,511
Assets. Value of participant loans2011-12-31$6,730
Total contributions received or receivable from employer(s)2011-12-31$27,335
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$254,328
Expenses. Total of all expenses incurred2010-12-31$174,159
Benefits paid (including direct rollovers)2010-12-31$174,159
Total plan assets at end of year2010-12-31$599,511
Total plan assets at beginning of year2010-12-31$519,342
Value of fidelity bond covering the plan2010-12-31$825,000
Total contributions received or receivable from participants2010-12-31$56,608
Contributions received from other sources (not participants or employers)2010-12-31$2,064
Other income received2010-12-31$171,588
Net income (gross income less expenses)2010-12-31$80,169
Net plan assets at end of year (total assets less liabilities)2010-12-31$599,511
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$519,342
Total contributions received or receivable from employer(s)2010-12-31$24,068
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : SECURITY STATE BANK OF WEWOKA 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 SECURITY STATE BANK OF WEWOKA 401K PROFIT SHARING PLAN

2016: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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: SECURITY STATE BANK OF WEWOKA 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 number944440-01
Policy instance 2
Insurance contract or identification number944440-01
Number of Individuals Covered5
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameROBERT KNOWLES
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered6
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNFP SECURITIES, INC.
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered6
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNFP SECURITIES, INC.
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944440-01
Policy instance 2
Insurance contract or identification number944440-01
Number of Individuals Covered38
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameROBERT KNOWLES
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered6
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNFP SECURITIES, INC.
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944440-01
Policy instance 2
Insurance contract or identification number944440-01
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2
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 $2
Insurance broker organization code?3
Insurance broker nameROBERT KNOWLES
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered6
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameNFP SECURITIES, INC.
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944440-01
Policy instance 2
Insurance contract or identification number944440-01
Number of Individuals Covered28
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,862
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?Yes
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?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,862
Insurance broker organization code?3
Insurance broker nameROBERT KNOWLES
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered6
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,048
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?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
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 number944440-01
Policy instance 2
Insurance contract or identification number944440-01
Number of Individuals Covered24
Insurance policy start date2011-04-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,617
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?Yes
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?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )
Policy contract numberGP 2799
Policy instance 1
Insurance contract or identification numberGP 2799
Number of Individuals Covered27
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,123
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?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,829
Insurance broker organization code?3
Insurance broker nameNFP SECURITIES INC.

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