PRIMARY CARE NORTHWEST, PLLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN
| Measure | Date | Value |
|---|
| 2022: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 36 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 36 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 36 |
| Number of participants with account balances | 2022-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 0 |
| 2021: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 47 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 37 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 37 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 37 |
| Number of participants with account balances | 2021-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 0 |
| 2020: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 46 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 15 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 32 |
| Total of all active and inactive participants | 2020-01-01 | 47 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 47 |
| Number of participants with account balances | 2020-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 0 |
| 2019: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 47 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 32 |
| Total of all active and inactive participants | 2019-01-01 | 46 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 46 |
| Number of participants with account balances | 2019-01-01 | 46 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 1 |
| 2018: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 51 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 33 |
| Total of all active and inactive participants | 2018-01-01 | 47 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 47 |
| Number of participants with account balances | 2018-01-01 | 47 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 1 |
| 2017: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 52 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 37 |
| Total of all active and inactive participants | 2017-01-01 | 51 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 51 |
| Number of participants with account balances | 2017-01-01 | 51 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 3 |
| 2016: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 50 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 25 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 27 |
| Total of all active and inactive participants | 2016-01-01 | 52 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 52 |
| Number of participants with account balances | 2016-01-01 | 52 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 2 |
| 2015: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 53 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 25 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 25 |
| Total of all active and inactive participants | 2015-01-01 | 50 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 50 |
| Number of participants with account balances | 2015-01-01 | 50 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 1 |
| 2014: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 57 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 26 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 27 |
| Total of all active and inactive participants | 2014-01-01 | 53 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 53 |
| Number of participants with account balances | 2014-01-01 | 53 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 2 |
| 2013: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 29 |
| Total of all active and inactive participants | 2013-01-01 | 57 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 57 |
| Number of participants with account balances | 2013-01-01 | 57 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 2 |
| 2012: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 56 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 27 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 31 |
| Total of all active and inactive participants | 2012-01-01 | 58 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 58 |
| Number of participants with account balances | 2012-01-01 | 58 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 5 |
| 2011: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 51 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 33 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 23 |
| Total of all active and inactive participants | 2011-01-01 | 56 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 56 |
| Number of participants with account balances | 2011-01-01 | 56 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 2 |
| Measure | Date | Value |
|---|
| 2022 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2022 401k financial data |
|---|
| Total plan liabilities at end of year | 2022-12-31 | $0 |
| Total plan liabilities at beginning of year | 2022-12-31 | $20,968 |
| Total income from all sources | 2022-12-31 | $-261,732 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $2,376,160 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $2,358,509 |
| Total plan assets at end of year | 2022-12-31 | $1,574,316 |
| Total plan assets at beginning of year | 2022-12-31 | $4,233,176 |
| Value of fidelity bond covering the plan | 2022-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $41,500 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $0 |
| Other income received | 2022-12-31 | $-303,232 |
| Net income (gross income less expenses) | 2022-12-31 | $-2,637,892 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $1,574,316 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $4,212,208 |
| Assets. Value of participant loans | 2022-12-31 | $10,760 |
| Assets. Value of real-estate (other than employer real property) | 2022-12-31 | $945,500 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $17,651 |
| 2021 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2021 401k financial data |
|---|
| Transfers to/from the plan | 2021-12-31 | $0 |
| Total plan liabilities at end of year | 2021-12-31 | $20,968 |
| Total plan liabilities at beginning of year | 2021-12-31 | $0 |
| Total income from all sources | 2021-12-31 | $630,009 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $2,849,298 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $2,836,711 |
| Total plan assets at end of year | 2021-12-31 | $4,233,176 |
| Total plan assets at beginning of year | 2021-12-31 | $6,431,497 |
| Value of fidelity bond covering the plan | 2021-12-31 | $450,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $54,940 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2021-12-31 | $0 |
| Other income received | 2021-12-31 | $545,892 |
| Noncash contributions received | 2021-12-31 | $0 |
| Net income (gross income less expenses) | 2021-12-31 | $-2,219,289 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $4,212,208 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $6,431,497 |
| Assets. Value of participant loans | 2021-12-31 | $10,354 |
| Assets. Value of real-estate (other than employer real property) | 2021-12-31 | $945,500 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $29,177 |
| Value of certain deemed distributions of participant loans | 2021-12-31 | $0 |
| Value of corrective distributions | 2021-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $12,587 |
| 2020 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2020 401k financial data |
|---|
| Transfers to/from the plan | 2020-12-31 | $0 |
| Total plan liabilities at end of year | 2020-12-31 | $0 |
| Total plan liabilities at beginning of year | 2020-12-31 | $0 |
| Total income from all sources | 2020-12-31 | $671,059 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $128,782 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $122,544 |
| Total plan assets at end of year | 2020-12-31 | $6,431,497 |
| Total plan assets at beginning of year | 2020-12-31 | $5,889,220 |
| Value of fidelity bond covering the plan | 2020-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $63,621 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $0 |
| Other income received | 2020-12-31 | $516,278 |
| Noncash contributions received | 2020-12-31 | $0 |
| Net income (gross income less expenses) | 2020-12-31 | $542,277 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $6,431,497 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $5,889,220 |
| Assets. Value of participant loans | 2020-12-31 | $20,208 |
| Assets. Value of real-estate (other than employer real property) | 2020-12-31 | $794,100 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $91,160 |
| Value of certain deemed distributions of participant loans | 2020-12-31 | $0 |
| Value of corrective distributions | 2020-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $6,238 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| 2019 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $933,968 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $573,691 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $537,245 |
| Total plan assets at end of year | 2019-12-31 | $5,889,220 |
| Total plan assets at beginning of year | 2019-12-31 | $5,528,943 |
| Value of fidelity bond covering the plan | 2019-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $75,120 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $19,887 |
| Other income received | 2019-12-31 | $743,312 |
| Net income (gross income less expenses) | 2019-12-31 | $360,277 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $5,889,220 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $5,528,943 |
| Assets. Value of participant loans | 2019-12-31 | $34,301 |
| Assets. Value of real-estate (other than employer real property) | 2019-12-31 | $737,300 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $115,536 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $16,559 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-31 | $0 |
| 2018 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $85,361 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $189,027 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $148,372 |
| Total plan assets at end of year | 2018-12-31 | $5,528,943 |
| Total plan assets at beginning of year | 2018-12-31 | $5,632,609 |
| Value of fidelity bond covering the plan | 2018-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $75,970 |
| Other income received | 2018-12-31 | $-100,609 |
| Net income (gross income less expenses) | 2018-12-31 | $-103,666 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $5,528,943 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $5,632,609 |
| Assets. Value of participant loans | 2018-12-31 | $32,700 |
| Assets. Value of real-estate (other than employer real property) | 2018-12-31 | $679,600 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $110,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $40,655 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $752,984 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $346,629 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $307,172 |
| Total plan assets at end of year | 2017-12-31 | $5,632,609 |
| Total plan assets at beginning of year | 2017-12-31 | $5,226,254 |
| Value of fidelity bond covering the plan | 2017-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $96,158 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $16,960 |
| Other income received | 2017-12-31 | $526,487 |
| Net income (gross income less expenses) | 2017-12-31 | $406,355 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $5,632,609 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $5,226,254 |
| Assets. Value of participant loans | 2017-12-31 | $29,992 |
| Assets. Value of real-estate (other than employer real property) | 2017-12-31 | $741,422 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $130,339 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $22,497 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $659,419 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $159,931 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $49,106 |
| Total plan assets at end of year | 2016-12-31 | $5,226,254 |
| Total plan assets at beginning of year | 2016-12-31 | $4,726,766 |
| Value of fidelity bond covering the plan | 2016-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $127,570 |
| Other income received | 2016-12-31 | $472,235 |
| Net income (gross income less expenses) | 2016-12-31 | $499,488 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $5,226,254 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $4,726,766 |
| Assets. Value of participant loans | 2016-12-31 | $75,940 |
| Assets. Value of real-estate (other than employer real property) | 2016-12-31 | $681,922 |
| Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102 | 2016-12-31 | $38,667 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $59,614 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $110,825 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $257,017 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $193,948 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $102,946 |
| Total plan assets at end of year | 2015-12-31 | $4,703,729 |
| Total plan assets at beginning of year | 2015-12-31 | $4,640,660 |
| Value of fidelity bond covering the plan | 2015-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $128,730 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $75,918 |
| Other income received | 2015-12-31 | $-34,681 |
| Net income (gross income less expenses) | 2015-12-31 | $63,069 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $4,703,729 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $4,640,660 |
| Assets. Value of participant loans | 2015-12-31 | $15,761 |
| Assets. Value of real-estate (other than employer real property) | 2015-12-31 | $379,294 |
| Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102 | 2015-12-31 | $38,667 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $162,968 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $15,084 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $544,336 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $593,427 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $587,025 |
| Total plan assets at end of year | 2014-12-31 | $4,640,660 |
| Total plan assets at beginning of year | 2014-12-31 | $4,689,751 |
| Value of fidelity bond covering the plan | 2014-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $130,841 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $5,210 |
| Other income received | 2014-12-31 | $218,447 |
| Net income (gross income less expenses) | 2014-12-31 | $-49,091 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $4,640,660 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $4,689,751 |
| Assets. Value of real-estate (other than employer real property) | 2014-12-31 | $366,194 |
| Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102 | 2014-12-31 | $42,313 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $195,048 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $1,192 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2013 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $827,261 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $38,620 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $35,567 |
| Total plan assets at end of year | 2013-12-31 | $4,689,751 |
| Total plan assets at beginning of year | 2013-12-31 | $3,901,110 |
| Value of fidelity bond covering the plan | 2013-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $134,694 |
| Other income received | 2013-12-31 | $498,385 |
| Net income (gross income less expenses) | 2013-12-31 | $788,641 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $4,689,751 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $3,901,110 |
| Assets. Value of real-estate (other than employer real property) | 2013-12-31 | $114,994 |
| Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102 | 2013-12-31 | $26,704 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $194,182 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $3,053 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-12-31 | $307 |
| Total plan liabilities at beginning of year | 2012-12-31 | $465 |
| Total income from all sources | 2012-12-31 | $695,144 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $1,504 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $1,122 |
| Total plan assets at end of year | 2012-12-31 | $3,901,110 |
| Total plan assets at beginning of year | 2012-12-31 | $3,207,628 |
| Value of fidelity bond covering the plan | 2012-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $143,753 |
| Other income received | 2012-12-31 | $347,031 |
| Net income (gross income less expenses) | 2012-12-31 | $693,640 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $3,900,803 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $3,207,163 |
| Assets. Value of participant loans | 2012-12-31 | $14,034 |
| Assets. Value of real-estate (other than employer real property) | 2012-12-31 | $114,994 |
| Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102 | 2012-12-31 | $26,704 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $204,360 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $382 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-12-31 | $465 |
| Total income from all sources | 2011-12-31 | $449,497 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $3,158 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $2,368 |
| Total plan assets at end of year | 2011-12-31 | $3,207,628 |
| Total plan assets at beginning of year | 2011-12-31 | $2,760,824 |
| Value of fidelity bond covering the plan | 2011-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $145,693 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $146,781 |
| Other income received | 2011-12-31 | $-33,452 |
| Net income (gross income less expenses) | 2011-12-31 | $446,339 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $3,207,163 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $2,760,824 |
| Assets. Value of participant loans | 2011-12-31 | $19,665 |
| Assets. Value of real-estate (other than employer real property) | 2011-12-31 | $117,525 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $190,475 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $790 |
| 2022: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: PRIMARY CARE NORTHWEST, PLLC 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | |
| Policy instance | 1 |
| Total amount of commissions paid to insurance broker | USD $19,266 | | Total amount of fees paid to insurance company | USD $2,026 | | Commission paid to Insurance Broker | USD $12,175 | | Amount paid for insurance broker fees | 2026 | | Insurance broker organization code? | 5 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | |
| Policy instance | 1 |
| Total amount of commissions paid to insurance broker | USD $14,374 | | Total amount of fees paid to insurance company | USD $6,450 | | Commission paid to Insurance Broker | USD $14,374 | | Insurance broker organization code? | 7 | | Amount paid for insurance broker fees | 6425 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 5 | | Total amount of commissions paid to insurance broker | USD $23,103 | | Total amount of fees paid to insurance company | USD $4,751 | | Commission paid to Insurance Broker | USD $16,628 | | Insurance broker organization code? | 7 | | Amount paid for insurance broker fees | 4751 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 5 | | Total amount of commissions paid to insurance broker | USD $4,681 | | Total amount of fees paid to insurance company | USD $16,584 | | Amount paid for insurance broker fees | 16384 | | Insurance broker organization code? | 7 | | Commission paid to Insurance Broker | USD $4,681 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 6 | | Total amount of commissions paid to insurance broker | USD $21,322 | | Total amount of fees paid to insurance company | USD $17,526 | | Commission paid to Insurance Broker | USD $16,584 | | Amount paid for insurance broker fees | 642 | | Additional information about fees paid to insurance broker | RECORDKEEPING | | Insurance broker organization code? | 6 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $20,635 | | Total amount of fees paid to insurance company | USD $6,300 | | 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? | No | | 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 $15,538 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GREAT WEST LIFE & ANNUITY COMPANY |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $17,916 | | Total amount of fees paid to insurance company | USD $912 | | 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 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? | No | | 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 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $22,512 | | Total amount of fees paid to insurance company | USD $780 | | 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 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? | No | | 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 $17,072 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 780 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker name | GREAT WEST LIFE & ANNUITY COMPANY |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $13,995 | | 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 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? | No | | 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 | 13273 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GREAT WEST LIFE & ANNUITY COMPANY |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $10,295 | | Total amount of fees paid to insurance company | USD $1,664 | | 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 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? | No | | 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 $7,151 | | Amount paid for insurance broker fees | 1010 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GREAT WEST LIFE & ANNUITY COMPANY |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 331843-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 331843-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,225 | | Total amount of fees paid to insurance company | USD $12,981 | | 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 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? | No | | 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 |
|
