401k Plan data: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN plan

ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN
Plan identification number	001

ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Plan covering Self-Employed individuals.
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

ALBERT & MACKENZIE, LLP has sponsored the creation of one or more 401k plans.

Company Name: ALBERT & MACKENZIE, LLP

Employer identification number (EIN): 821962454

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 ADRIANA WENDLAND 2023-10-11
001 2021-01-01 ADRIANA WENDLAND 2022-10-17
001 2020-01-01 ADRIANA WENDLAND 2021-10-15
001 2019-01-01
001 2018-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	ADRIANA WENDLAND	2023-10-11
001	2021-01-01	ADRIANA WENDLAND	2022-10-17
001	2020-01-01	ADRIANA WENDLAND	2021-10-15
001	2019-01-01
001	2018-01-01

Plan Statistics for ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 288
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 225
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 84
Total of all active and inactive participants 2022-01-01 309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 309
Number of participants with account balances 2022-01-01 289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 20
2021: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 210
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 67
Total of all active and inactive participants 2021-01-01 278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 278
Number of participants with account balances 2021-01-01 242
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 17
2020: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 89
Number of retired or separated participants receiving benefits 2020-01-01 5
Number of other retired or separated participants entitled to future benefits 2020-01-01 45
Total of all active and inactive participants 2020-01-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 139
Number of participants with account balances 2020-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1

Measure	Date	Value
2022: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	288
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	225
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	84
Total of all active and inactive participants	2022-01-01	309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	309
Number of participants with account balances	2022-01-01	289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	20
2021: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	210
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	67
Total of all active and inactive participants	2021-01-01	278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	278
Number of participants with account balances	2021-01-01	242
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	17
2020: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	89
Number of retired or separated participants receiving benefits	2020-01-01	5
Number of other retired or separated participants entitled to future benefits	2020-01-01	45
Total of all active and inactive participants	2020-01-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	139
Number of participants with account balances	2020-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1

Financial Data on ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2022 : ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$114,660
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$770,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$612,579
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$3,154,280
Value of total assets at end of year	2022-12-31	$16,502,643
Value of total assets at beginning of year	2022-12-31	$17,157,997
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$157,435
Total interest from all sources	2022-12-31	$3,596
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$830,145
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$830,145
Administrative expenses professional fees incurred	2022-12-31	$1,935
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,544,987
Participant contributions at end of year	2022-12-31	$90,272
Participant contributions at beginning of year	2022-12-31	$24,246
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$568,540
Other income not declared elsewhere	2022-12-31	$3,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-655,354
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$16,502,643
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$17,157,997
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$47,150
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$15,944,995
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$16,729,986
Interest on participant loans	2022-12-31	$2,922
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$467,376
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$403,765
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$403,765
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$674
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,876,880
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$1,040,753
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$612,579
Contract administrator fees	2022-12-31	$108,350
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MELONI HRIBAL TRATNER LLP
Accountancy firm EIN	2022-12-31	954649521
2021 : ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$7,369,551
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,208,940
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$370,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$310,098
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$970,991
Value of total assets at end of year	2021-12-31	$17,157,997
Value of total assets at beginning of year	2021-12-31	$7,949,928
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$60,324
Total interest from all sources	2021-12-31	$775
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$775,228
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$775,228
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$435,628
Participant contributions at end of year	2021-12-31	$24,246
Participant contributions at beginning of year	2021-12-31	$14,593
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$53,005
Other income not declared elsewhere	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,838,518
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$17,157,997
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,949,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$60,324
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$16,729,986
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,878,032
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$5,905,798
Interest on participant loans	2021-12-31	$749
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$403,765
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$26,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$26,971
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$26
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$124,534
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$461,946
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$482,358
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$310,098
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MELONI HIRBAL TRATNER LLP
Accountancy firm EIN	2021-12-31	954649521
2020 : ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,196,089
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$119,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$117,228
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,270,243
Value of total assets at end of year	2020-12-31	$7,949,928
Value of total assets at beginning of year	2020-12-31	$5,873,146
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,079
Total interest from all sources	2020-12-31	$2,163
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$328,266
Participant contributions at end of year	2020-12-31	$14,593
Participant contributions at beginning of year	2020-12-31	$19,394
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$589,923
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,076,782
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,949,928
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$5,873,146
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$2,079
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$1,878,032
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,575,734
Value of interest in pooled separate accounts at end of year	2020-12-31	$5,905,798
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,167,435
Interest on participant loans	2020-12-31	$888
Interest earned on other investments	2020-12-31	$1,275
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$26,971
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$124,534
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$110,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$163,044
Net investment gain/loss from pooled separate accounts	2020-12-31	$760,639
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$352,054
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$117,228
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MELONI HIRBAL TRATNER LLP
Accountancy firm EIN	2020-12-31	954649521

Form 5500 Responses for ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN

2022: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ALBERT & MACKENZIE, LLP 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1264193-01

Policy instance

Insurance contract or identification number	1264193-01
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INSURANCE AGENT OR BROKER
Insurance broker organization code?	0

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1264193-01

Policy instance

Insurance contract or identification number	1264193-01
Number of Individuals Covered	110
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,100
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,100
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INSURANCE AGENT OR BROKER
Insurance broker organization code?	0

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Company Name:	ALBERT & MACKENZIE, LLP
Employer identification number (EIN):	821962454
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers