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PRO-LINE 401K PROFIT SHARING PLAN 401k Plan overview

Plan NamePRO-LINE 401K PROFIT SHARING PLAN
Plan identification number 001

PRO-LINE 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined 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

PRO-LINE has sponsored the creation of one or more 401k plans.

Company Name:PRO-LINE
Employer identification number (EIN):330109473
NAIC Classification:326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRO-LINE 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01DAVID MATTSON2023-10-31
0012021-01-01DAVID MATTSON2022-10-07
0012020-01-01DAVID MATTSON2021-10-14
0012019-01-01DAVID MATTSON2020-07-07
0012018-01-01DAVID MATTSON2019-07-17
0012017-01-01DAVID MATTSON2018-06-13
0012016-01-01DAVID MATTSON2017-10-12
0012015-01-01DAVID MATTSON
0012014-01-01DAVID MATTSON
0012013-01-01DAVID MATTSON
0012012-01-01DAVID MATTSON
0012011-01-01DAVID MATTSON
0012010-01-01DAVID MATTSON
0012009-01-01DAVID MATTSON

Plan Statistics for PRO-LINE 401K PROFIT SHARING PLAN

401k plan membership statisitcs for PRO-LINE 401K PROFIT SHARING PLAN

Measure Date Value
2015: PRO-LINE 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0158
Total number of active participants reported on line 7a of the Form 55002015-01-0146
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0111
Total of all active and inactive participants2015-01-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0157
Number of participants with account balances2015-01-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: PRO-LINE 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0165
Total number of active participants reported on line 7a of the Form 55002014-01-0146
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0112
Total of all active and inactive participants2014-01-0158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0158
Number of participants with account balances2014-01-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PRO-LINE 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0160
Total number of active participants reported on line 7a of the Form 55002013-01-0143
Number of retired or separated participants receiving benefits2013-01-0122
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0165
Number of participants with account balances2013-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PRO-LINE 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0156
Total number of active participants reported on line 7a of the Form 55002012-01-0142
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0118
Total of all active and inactive participants2012-01-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0160
Number of participants with account balances2012-01-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PRO-LINE 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0164
Total number of active participants reported on line 7a of the Form 55002011-01-0138
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0118
Total of all active and inactive participants2011-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0156
Number of participants with account balances2011-01-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PRO-LINE 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0159
Total number of active participants reported on line 7a of the Form 55002010-01-0132
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0132
Total of all active and inactive participants2010-01-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0164
Number of participants with account balances2010-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-013
2009: PRO-LINE 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0155
Total number of active participants reported on line 7a of the Form 55002009-01-0134
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0125
Total of all active and inactive participants2009-01-0159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0159
Number of participants with account balances2009-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-014

Financial Data on PRO-LINE 401K PROFIT SHARING PLAN

Measure Date Value
2015 : PRO-LINE 401K PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$277,646
Expenses. Total of all expenses incurred2015-12-31$22,097
Benefits paid (including direct rollovers)2015-12-31$4,189
Total plan assets at end of year2015-12-31$2,845,003
Total plan assets at beginning of year2015-12-31$2,589,454
Value of fidelity bond covering the plan2015-12-31$260,000
Total contributions received or receivable from participants2015-12-31$128,661
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$1,465
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$255,549
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,845,003
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,589,454
Assets. Value of participant loans2015-12-31$82,782
Total contributions received or receivable from employer(s)2015-12-31$147,520
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$17,908
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : PRO-LINE 401K PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$337,798
Expenses. Total of all expenses incurred2014-12-31$27,189
Benefits paid (including direct rollovers)2014-12-31$11,336
Total plan assets at end of year2014-12-31$2,589,454
Total plan assets at beginning of year2014-12-31$2,278,845
Value of fidelity bond covering the plan2014-12-31$260,000
Total contributions received or receivable from participants2014-12-31$122,881
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$89,406
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$310,609
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,589,454
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,278,845
Assets. Value of participant loans2014-12-31$56,095
Total contributions received or receivable from employer(s)2014-12-31$125,511
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$15,853
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PRO-LINE 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$366,722
Expenses. Total of all expenses incurred2013-12-31$95,689
Benefits paid (including direct rollovers)2013-12-31$82,459
Total plan assets at end of year2013-12-31$2,278,845
Total plan assets at beginning of year2013-12-31$2,007,812
Value of fidelity bond covering the plan2013-12-31$150,000
Total contributions received or receivable from participants2013-12-31$86,391
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$194,073
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$271,033
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,278,845
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,007,812
Assets. Value of participant loans2013-12-31$41,832
Total contributions received or receivable from employer(s)2013-12-31$86,258
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$13,230
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : PRO-LINE 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$192,855
Expenses. Total of all expenses incurred2012-12-31$19,555
Benefits paid (including direct rollovers)2012-12-31$4,146
Total plan assets at end of year2012-12-31$2,007,812
Total plan assets at beginning of year2012-12-31$1,834,512
Value of fidelity bond covering the plan2012-12-31$150,000
Total contributions received or receivable from participants2012-12-31$94,155
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$98,700
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$173,300
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,007,812
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,834,512
Assets. Value of participant loans2012-12-31$30,128
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$168
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$15,241
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : PRO-LINE 401K PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$209,473
Expenses. Total of all expenses incurred2011-12-31$68,026
Benefits paid (including direct rollovers)2011-12-31$52,238
Total plan assets at end of year2011-12-31$1,834,512
Total plan assets at beginning of year2011-12-31$1,693,065
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$75,622
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$16,129
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$141,447
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,834,512
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,693,065
Assets. Value of participant loans2011-12-31$36,548
Total contributions received or receivable from employer(s)2011-12-31$117,722
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$15,788
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : PRO-LINE 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$412
Total income from all sources2010-12-31$277,560
Expenses. Total of all expenses incurred2010-12-31$136,914
Benefits paid (including direct rollovers)2010-12-31$111,802
Total plan assets at end of year2010-12-31$1,693,065
Total plan assets at beginning of year2010-12-31$1,552,831
Value of fidelity bond covering the plan2010-12-31$120,000
Total contributions received or receivable from participants2010-12-31$70,106
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$114,013
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$140,646
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,693,065
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,552,419
Assets. Value of participant loans2010-12-31$39,838
Total contributions received or receivable from employer(s)2010-12-31$93,441
Value of certain deemed distributions of participant loans2010-12-31$9,731
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$15,381
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : PRO-LINE 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PRO-LINE 401K PROFIT SHARING PLAN

2015: PRO-LINE 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PRO-LINE 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PRO-LINE 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PRO-LINE 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PRO-LINE 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PRO-LINE 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PRO-LINE 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number384409-01
Policy instance 1
Insurance contract or identification number384409-01
Number of Individuals Covered51
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number384409-01
Policy instance 1
Insurance contract or identification number384409-01
Number of Individuals Covered47
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number384409-01
Policy instance 1
Insurance contract or identification number384409-01
Number of Individuals Covered55
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number384409-01
Policy instance 1
Insurance contract or identification number384409-01
Number of Individuals Covered52
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF THE SOUTHWEST (National Association of Insurance Commissioners NAIC id number: 65528 )
Policy contract numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered30
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF THE SOUTHWEST (National Association of Insurance Commissioners NAIC id number: 65528 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF THE SOUTHWEST (National Association of Insurance Commissioners NAIC id number: 65528 )
Policy contract numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered5
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number384409-01
Policy instance 2
Insurance contract or identification number384409-01
Number of Individuals Covered48
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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