BEDFORD COMMONS OB-GYN, P.A. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN
401k plan membership statisitcs for BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN
| Measure | Date | Value |
|---|
| 2017: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 82 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 54 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 26 |
| Total of all active and inactive participants | 2017-07-01 | 82 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-07-01 | 0 |
| Total participants | 2017-07-01 | 82 |
| Number of participants with account balances | 2017-07-01 | 82 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-07-01 | 1 |
| 2016: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 52 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 28 |
| Total of all active and inactive participants | 2016-07-01 | 80 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-07-01 | 0 |
| Total participants | 2016-07-01 | 80 |
| Number of participants with account balances | 2016-07-01 | 80 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-07-01 | 4 |
| 2015: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 50 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 47 |
| Total of all active and inactive participants | 2015-07-01 | 97 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-07-01 | 0 |
| Total participants | 2015-07-01 | 97 |
| Number of participants with account balances | 2015-07-01 | 97 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-07-01 | 5 |
| 2014: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 88 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 43 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 41 |
| Total of all active and inactive participants | 2014-07-01 | 86 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-07-01 | 0 |
| Total participants | 2014-07-01 | 86 |
| Number of participants with account balances | 2014-07-01 | 86 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-07-01 | 5 |
| 2013: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 48 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 36 |
| Total of all active and inactive participants | 2013-07-01 | 85 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
| Total participants | 2013-07-01 | 85 |
| Number of participants with account balances | 2013-07-01 | 84 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-07-01 | 4 |
| 2012: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 81 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 45 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 34 |
| Total of all active and inactive participants | 2012-07-01 | 81 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
| Total participants | 2012-07-01 | 81 |
| Number of participants with account balances | 2012-07-01 | 81 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-07-01 | 2 |
| 2007: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-07-01 | 61 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-07-01 | 39 |
| Number of retired or separated participants receiving benefits | 2007-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-07-01 | 32 |
| Total of all active and inactive participants | 2007-07-01 | 71 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2007-07-01 | 0 |
| Total participants | 2007-07-01 | 71 |
| Number of participants with account balances | 2007-07-01 | 71 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2007-07-01 | 6 |
| Measure | Date | Value |
|---|
| 2018 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-06-30 | $2,805,270 |
| Expenses. Total of all expenses incurred | 2018-06-30 | $3,975,133 |
| Benefits paid (including direct rollovers) | 2018-06-30 | $3,973,695 |
| Total plan assets at end of year | 2018-06-30 | $14,150,123 |
| Total plan assets at beginning of year | 2018-06-30 | $15,319,986 |
| Value of fidelity bond covering the plan | 2018-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2018-06-30 | $299,706 |
| Contributions received from other sources (not participants or employers) | 2018-06-30 | $14,201 |
| Other income received | 2018-06-30 | $2,087,311 |
| Net income (gross income less expenses) | 2018-06-30 | $-1,169,863 |
| Net plan assets at end of year (total assets less liabilities) | 2018-06-30 | $14,150,123 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-06-30 | $15,319,986 |
| Assets. Value of participant loans | 2018-06-30 | $89,229 |
| Total contributions received or receivable from employer(s) | 2018-06-30 | $404,052 |
| Value of certain deemed distributions of participant loans | 2018-06-30 | $1,438 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-06-30 | $0 |
| 2017 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-06-30 | $2,577,621 |
| Expenses. Total of all expenses incurred | 2017-06-30 | $43,813 |
| Benefits paid (including direct rollovers) | 2017-06-30 | $43,813 |
| Total plan assets at end of year | 2017-06-30 | $15,319,986 |
| Total plan assets at beginning of year | 2017-06-30 | $12,786,178 |
| Value of fidelity bond covering the plan | 2017-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2017-06-30 | $298,146 |
| Other income received | 2017-06-30 | $1,913,852 |
| Net income (gross income less expenses) | 2017-06-30 | $2,533,808 |
| Net plan assets at end of year (total assets less liabilities) | 2017-06-30 | $15,319,986 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-06-30 | $12,786,178 |
| Assets. Value of participant loans | 2017-06-30 | $92,085 |
| Total contributions received or receivable from employer(s) | 2017-06-30 | $365,623 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-06-30 | $0 |
| 2016 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-06-30 | $756,288 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $16,369 |
| Benefits paid (including direct rollovers) | 2016-06-30 | $15,882 |
| Total plan assets at end of year | 2016-06-30 | $12,786,178 |
| Total plan assets at beginning of year | 2016-06-30 | $12,046,259 |
| Value of fidelity bond covering the plan | 2016-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2016-06-30 | $264,842 |
| Other income received | 2016-06-30 | $140,360 |
| Net income (gross income less expenses) | 2016-06-30 | $739,919 |
| Net plan assets at end of year (total assets less liabilities) | 2016-06-30 | $12,786,178 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-06-30 | $12,046,259 |
| Assets. Value of participant loans | 2016-06-30 | $54,340 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $351,086 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-06-30 | $487 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-06-30 | $0 |
| 2015 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-06-30 | $1,138,223 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $112,103 |
| Benefits paid (including direct rollovers) | 2015-06-30 | $111,263 |
| Total plan assets at end of year | 2015-06-30 | $12,046,259 |
| Total plan assets at beginning of year | 2015-06-30 | $11,020,139 |
| Value of fidelity bond covering the plan | 2015-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2015-06-30 | $240,122 |
| Contributions received from other sources (not participants or employers) | 2015-06-30 | $21,849 |
| Other income received | 2015-06-30 | $567,573 |
| Net income (gross income less expenses) | 2015-06-30 | $1,026,120 |
| Net plan assets at end of year (total assets less liabilities) | 2015-06-30 | $12,046,259 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-06-30 | $11,020,139 |
| Assets. Value of participant loans | 2015-06-30 | $54,872 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $308,679 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-06-30 | $840 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-06-30 | $0 |
| 2014 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-06-30 | $2,401,850 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $197,784 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $196,759 |
| Total plan assets at end of year | 2014-06-30 | $11,020,139 |
| Total plan assets at beginning of year | 2014-06-30 | $8,816,073 |
| Value of fidelity bond covering the plan | 2014-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2014-06-30 | $261,723 |
| Expenses. Other expenses not covered elsewhere | 2014-06-30 | $0 |
| Contributions received from other sources (not participants or employers) | 2014-06-30 | $0 |
| Other income received | 2014-06-30 | $1,830,211 |
| Net income (gross income less expenses) | 2014-06-30 | $2,204,066 |
| Net plan assets at end of year (total assets less liabilities) | 2014-06-30 | $11,020,139 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-06-30 | $8,816,073 |
| Assets. Value of participant loans | 2014-06-30 | $56,330 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $309,916 |
| Value of certain deemed distributions of participant loans | 2014-06-30 | $0 |
| Value of corrective distributions | 2014-06-30 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-06-30 | $1,025 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-06-30 | $0 |
| 2013 : BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-06-30 | $1,729,217 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $116,520 |
| Benefits paid (including direct rollovers) | 2013-06-30 | $104,653 |
| Total plan assets at end of year | 2013-06-30 | $8,816,073 |
| Total plan assets at beginning of year | 2013-06-30 | $7,203,376 |
| Value of fidelity bond covering the plan | 2013-06-30 | $1,000,000 |
| Total contributions received or receivable from participants | 2013-06-30 | $222,958 |
| Contributions received from other sources (not participants or employers) | 2013-06-30 | $27,008 |
| Other income received | 2013-06-30 | $1,191,743 |
| Net income (gross income less expenses) | 2013-06-30 | $1,612,697 |
| Net plan assets at end of year (total assets less liabilities) | 2013-06-30 | $8,816,073 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-06-30 | $7,203,376 |
| Assets. Value of participant loans | 2013-06-30 | $15,085 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $287,508 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-06-30 | $11,867 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-06-30 | $0 |
| 2017: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – Trust | Yes |
| 2017-07-01 | Plan benefit arrangement - Trust | Yes |
| 2016: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – Trust | Yes |
| 2016-07-01 | Plan benefit arrangement - Trust | Yes |
| 2015: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – Trust | Yes |
| 2015-07-01 | Plan benefit arrangement - Trust | Yes |
| 2014: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – Trust | Yes |
| 2014-07-01 | Plan benefit arrangement - Trust | Yes |
| 2013: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – Trust | Yes |
| 2013-07-01 | Plan benefit arrangement - Trust | Yes |
| 2012: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – Trust | Yes |
| 2012-07-01 | Plan benefit arrangement - Trust | Yes |
| 2007: BEDFORD COMMONS OB-GYN, P.A. 401(K) RETIREMENT PLAN 2007 form 5500 responses |
|---|
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | Submission has been amended | No |
| 2007-07-01 | This submission is the final filing | No |
| 2007-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-07-01 | Plan is a collectively bargained plan | No |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan funding arrangement – Trust | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-07-01 | Plan benefit arrangement - Trust | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 3652186 |
| Policy instance | 2 |
| Insurance contract or identification number | 3652186 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2017-07-03 | | Are there contracts with allocated funds for individual policies? | 1 | | 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 | 332998-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 332998-01 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $470 | | 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 $235 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHAEL KENNEDY |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 3652186 |
| Policy instance | 2 |
| Insurance contract or identification number | 3652186 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $70 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 $70 | | Insurance broker organization code? | 3 | | Insurance broker name | PENFACS FINANCIAL SERVICES, INC. |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 332998-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 332998-01 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $48 | | Total amount of fees paid to insurance company | USD $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 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 $24 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHAEL KENNEDY |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 3652186 |
| Policy instance | 2 |
| Insurance contract or identification number | 3652186 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $70 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 $70 | | Insurance broker organization code? | 3 | | Insurance broker name | PENFACS FINANCIAL SERVICES, INC. |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 332998-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 332998-01 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $138 | | Total amount of fees paid to insurance company | USD $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 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 $69 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHAEL KENNEDY |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 3652186 |
| Policy instance | 2 |
| Insurance contract or identification number | 3652186 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 | 332998-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 332998-01 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $20 | | Total amount of fees paid to insurance company | USD $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 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 $10 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHAEL KENNEDY |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 3652186 |
| Policy instance | 2 |
| Insurance contract or identification number | 3652186 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 | 332998-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 332998-01 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $28 | | Total amount of fees paid to insurance company | USD $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 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 $14 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHAEL KENNEDY |
|
