401k Plan data: APOLLO ENDOSURGERY 401(K) PLAN plan

APOLLO ENDOSURGERY 401(K) PLAN 401k Plan overview

Plan Name	APOLLO ENDOSURGERY 401(K) PLAN
Plan identification number	001

APOLLO ENDOSURGERY 401(K) 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.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

APOLLO ENDOSURGERY, INC. has sponsored the creation of one or more 401k plans.

Company Name: APOLLO ENDOSURGERY, INC.

Employer identification number (EIN): 203412701

NAIC Classification: 339110

Additional information about APOLLO ENDOSURGERY, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4009847

More information about APOLLO ENDOSURGERY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan APOLLO ENDOSURGERY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 STEFANIE CAVANAUGH
001 2016-01-01 STEFANIE CAVANAUGH
001 2015-01-01 STEFANIE CAVANAUGH 2016-04-21
001 2014-01-01 STEFANIE CAVANAUGH 2015-07-02
001 2013-01-01 DENNIS MCWILLIAMS 2014-06-18
001 2012-01-01 DENNIS MCWILLIAMS 2013-08-12
001 2011-01-01 DENNIS MCWILLIAMS 2012-07-26
001 2010-01-01 DENNIS MCWILLIAMS 2011-08-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	STEFANIE CAVANAUGH
001	2016-01-01	STEFANIE CAVANAUGH
001	2015-01-01	STEFANIE CAVANAUGH	2016-04-21
001	2014-01-01	STEFANIE CAVANAUGH	2015-07-02
001	2013-01-01	DENNIS MCWILLIAMS	2014-06-18
001	2012-01-01	DENNIS MCWILLIAMS	2013-08-12
001	2011-01-01	DENNIS MCWILLIAMS	2012-07-26
001	2010-01-01	DENNIS MCWILLIAMS	2011-08-11

Plan Statistics for APOLLO ENDOSURGERY 401(K) PLAN

401k plan membership statisitcs for APOLLO ENDOSURGERY 401(K) PLAN

Measure Date Value
2022: APOLLO ENDOSURGERY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 132
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 33
Total of all active and inactive participants 2022-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 165
Number of participants with account balances 2022-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: APOLLO ENDOSURGERY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 95
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 33
Total of all active and inactive participants 2021-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 128
Number of participants with account balances 2021-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: APOLLO ENDOSURGERY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 75
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 42
Total of all active and inactive participants 2020-01-01 117
Total participants 2020-01-01 117
Number of participants with account balances 2020-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: APOLLO ENDOSURGERY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 107
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 34
Total of all active and inactive participants 2019-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 142
Number of participants with account balances 2019-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: APOLLO ENDOSURGERY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 116
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 23
Total of all active and inactive participants 2018-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 141
Number of participants with account balances 2018-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: APOLLO ENDOSURGERY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 114
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 17
Total of all active and inactive participants 2017-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 132
Number of participants with account balances 2017-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: APOLLO ENDOSURGERY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 104
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 12
Total of all active and inactive participants 2016-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 117
Number of participants with account balances 2016-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2022: APOLLO ENDOSURGERY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	132
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	33
Total of all active and inactive participants	2022-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	165
Number of participants with account balances	2022-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: APOLLO ENDOSURGERY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	95
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	33
Total of all active and inactive participants	2021-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	128
Number of participants with account balances	2021-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: APOLLO ENDOSURGERY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	75
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	42
Total of all active and inactive participants	2020-01-01	117
Total participants	2020-01-01	117
Number of participants with account balances	2020-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: APOLLO ENDOSURGERY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	107
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	34
Total of all active and inactive participants	2019-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	142
Number of participants with account balances	2019-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: APOLLO ENDOSURGERY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	116
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	23
Total of all active and inactive participants	2018-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	141
Number of participants with account balances	2018-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: APOLLO ENDOSURGERY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	114
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	17
Total of all active and inactive participants	2017-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	132
Number of participants with account balances	2017-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: APOLLO ENDOSURGERY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	104
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	12
Total of all active and inactive participants	2016-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	117
Number of participants with account balances	2016-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on APOLLO ENDOSURGERY 401(K) PLAN

Measure	Date	Value
2022 : APOLLO ENDOSURGERY 401(K) PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-287,408
Total of all expenses incurred	2022-12-31	$684,551
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$625,151
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,172,562
Value of total assets at end of year	2022-12-31	$11,727,151
Value of total assets at beginning of year	2022-12-31	$12,699,110
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$59,400
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
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	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$50,000
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	$1,507,018
Participant contributions at end of year	2022-12-31	$95,333
Participant contributions at beginning of year	2022-12-31	$69,950
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$39,830
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$-971,959
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$11,727,151
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,699,110
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$11,631,818
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$12,626,787
Interest on participant loans	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,459,970
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	$625,714
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$2,373
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$625,151
Contract administrator fees	2022-12-31	$59,400
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	BAUER & COMPANY, LLC
Accountancy firm EIN	2022-12-31	471743368
2021 : APOLLO ENDOSURGERY 401(K) PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$3,338,758
Total of all expenses incurred	2021-12-31	$1,298,880
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,244,516
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,701,835
Value of total assets at end of year	2021-12-31	$12,699,110
Value of total assets at beginning of year	2021-12-31	$10,659,232
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$54,364
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
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	$0
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	$994,524
Participant contributions at end of year	2021-12-31	$69,950
Participant contributions at beginning of year	2021-12-31	$49,375
Participant contributions at end of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$288,742
Value of other receiveables (less allowance for doubtful accounts) at end of year	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	$2,039,878
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,699,110
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$10,659,232
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$12,626,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$10,569,770
Interest on participant loans	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$36,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$36,915
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,636,923
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	$418,569
Employer contributions (assets) at end of year	2021-12-31	$2,373
Employer contributions (assets) at beginning of year	2021-12-31	$3,172
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,244,516
Contract administrator fees	2021-12-31	$54,364
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	BAUER & COMPANY, LLC
Accountancy firm EIN	2021-12-31	471743368
2020 : APOLLO ENDOSURGERY 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$3,175,105
Total of all expenses incurred	2020-12-31	$1,766,597
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,722,531
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,324,004
Value of total assets at end of year	2020-12-31	$10,659,232
Value of total assets at beginning of year	2020-12-31	$9,250,724
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$44,066
Total interest from all sources	2020-12-31	$3,096
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
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$769,826
Participant contributions at end of year	2020-12-31	$49,375
Participant contributions at beginning of year	2020-12-31	$44,119
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$232,751
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$1,408,508
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$10,659,232
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,250,724
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$10,569,770
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,057,673
Interest on participant loans	2020-12-31	$1,687
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$36,915
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$148,932
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$148,932
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$1,409
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,848,005
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	No
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	$321,427
Employer contributions (assets) at end of year	2020-12-31	$3,172
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,722,531
Contract administrator fees	2020-12-31	$44,066
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	BAUER & COMPANY LLC
Accountancy firm EIN	2020-12-31	471743368
2019 : APOLLO ENDOSURGERY 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$3,423,186
Total of all expenses incurred	2019-12-31	$1,604,296
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,543,699
Expenses. Certain deemed distributions of participant loans	2019-12-31	$17,175
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,552,228
Value of total assets at end of year	2019-12-31	$9,250,724
Value of total assets at beginning of year	2019-12-31	$7,431,834
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$43,422
Total interest from all sources	2019-12-31	$4,223
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,089,990
Participant contributions at end of year	2019-12-31	$44,119
Participant contributions at beginning of year	2019-12-31	$83,837
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$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	2019-12-31	No
Value of net income/loss	2019-12-31	$1,818,890
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,250,724
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,431,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,057,673
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,155,087
Interest on participant loans	2019-12-31	$2,322
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$148,932
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$192,910
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$192,910
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$1,901
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,866,735
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$462,238
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,543,699
Contract administrator fees	2019-12-31	$43,422
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BAUER & COMPANY LLC
Accountancy firm EIN	2019-12-31	471743368
2018 : APOLLO ENDOSURGERY 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$1,452,408
Total of all expenses incurred	2018-12-31	$616,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$523,445
Expenses. Certain deemed distributions of participant loans	2018-12-31	$51,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,918,560
Value of total assets at end of year	2018-12-31	$7,431,834
Value of total assets at beginning of year	2018-12-31	$6,596,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$41,872
Total interest from all sources	2018-12-31	$5,734
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,138,414
Participant contributions at end of year	2018-12-31	$83,837
Participant contributions at beginning of year	2018-12-31	$124,054
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$291,092
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$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	2018-12-31	No
Value of net income/loss	2018-12-31	$835,447
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$7,431,834
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$6,596,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$7,155,087
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,450,596
Interest on participant loans	2018-12-31	$5,235
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$192,910
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$21,736
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$21,736
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$499
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-471,886
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$489,054
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$523,445
Contract administrator fees	2018-12-31	$41,872
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BAUER & COMPANY LLC
Accountancy firm EIN	2018-12-31	471743368
2017 : APOLLO ENDOSURGERY 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$3,138,056
Total of all expenses incurred	2017-12-31	$710,189
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$677,611
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,087,003
Value of total assets at end of year	2017-12-31	$6,596,387
Value of total assets at beginning of year	2017-12-31	$4,168,520
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$32,578
Total interest from all sources	2017-12-31	$5,121
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,002,487
Participant contributions at end of year	2017-12-31	$124,054
Participant contributions at beginning of year	2017-12-31	$88,620
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$642,157
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$2,427,867
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$6,596,387
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,168,520
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$32,578
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$6,450,596
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,891,509
Interest on participant loans	2017-12-31	$3,943
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$21,736
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$186,604
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$186,604
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$1,178
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,787
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,045,932
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$442,359
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$677,611
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BAUER & COMPANY, LLC
Accountancy firm EIN	2017-12-31	471743368
2016 : APOLLO ENDOSURGERY 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,801,331
Total of all expenses incurred	2016-12-31	$1,223,237
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,201,345
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,483,147
Value of total assets at end of year	2016-12-31	$4,168,520
Value of total assets at beginning of year	2016-12-31	$3,590,426
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$21,892
Total interest from all sources	2016-12-31	$5,199
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$400,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$885,944
Participant contributions at end of year	2016-12-31	$88,620
Participant contributions at beginning of year	2016-12-31	$64,407
Participant contributions at end of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$208,085
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$578,094
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,168,520
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,590,426
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$21,892
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,891,509
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,392,737
Interest on participant loans	2016-12-31	$3,370
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$186,604
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$132,832
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$132,832
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$1,829
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,787
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$450
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$312,985
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$389,118
Employer contributions (assets) at end of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,201,345
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BAUER & COMPANY, LLC
Accountancy firm EIN	2016-12-31	471743368

Form 5500 Responses for APOLLO ENDOSURGERY 401(K) PLAN

2022: APOLLO ENDOSURGERY 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: APOLLO ENDOSURGERY 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: APOLLO ENDOSURGERY 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: APOLLO ENDOSURGERY 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: APOLLO ENDOSURGERY 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: APOLLO ENDOSURGERY 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: APOLLO ENDOSURGERY 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	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

942777-01

Policy instance

Insurance contract or identification number	942777-01
Number of Individuals Covered	5
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

942777-01

Policy instance

Insurance contract or identification number	942777-01
Number of Individuals Covered	3
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

942777-01

Policy instance

Insurance contract or identification number	942777-01
Number of Individuals Covered	5
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

942777-01

Policy instance

Insurance contract or identification number	942777-01
Number of Individuals Covered	5
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $77
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $77
Insurance broker organization code?	3

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

Policy contract number

942777-01

Policy instance

Insurance contract or identification number	942777-01
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $47
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $47
Insurance broker organization code?	3
Insurance broker name	THOMAS OLEY

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Company Name:	APOLLO ENDOSURGERY, INC.
Employer identification number (EIN):	203412701
NAIC Classification:	339110

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4009847