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VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameVELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN
Plan identification number 002

VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PARKER HANNIFIN CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:PARKER HANNIFIN CORPORATION
Employer identification number (EIN):340451060
NAIC Classification:333200

Additional information about PARKER HANNIFIN CORPORATION

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 572429

More information about PARKER HANNIFIN CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022016-01-01TERESA KAMSTRA
0022016-01-01
0022015-01-01TERESA KAMSTRA
0022014-01-01TERESA KAMSTRA
0022013-01-01JIM MEDLEY

Plan Statistics for VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01119
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01154
Total number of active participants reported on line 7a of the Form 55002015-01-0191
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0128
Total of all active and inactive participants2015-01-01119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01119
Number of participants with account balances2015-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01160
Total number of active participants reported on line 7a of the Form 55002014-01-01126
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0128
Total of all active and inactive participants2014-01-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01154
Number of participants with account balances2014-01-01121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01166
Total number of active participants reported on line 7a of the Form 55002013-01-01117
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0131
Total of all active and inactive participants2013-01-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01148
Number of participants with account balances2013-01-01132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014

Financial Data on VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN

Measure Date Value
2016 : VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-09-30$-595
Total unrealized appreciation/depreciation of assets2016-09-30$-595
Total transfer of assets from this plan2016-09-30$4,716,218
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$0
Total income from all sources (including contributions)2016-09-30$240,382
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$317,027
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$300,192
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$0
Value of total assets at end of year2016-09-30$0
Value of total assets at beginning of year2016-09-30$4,792,863
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$16,835
Total interest from all sources2016-09-30$2,195
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$15,000,000
If this is an individual account plan, was there a blackout period2016-09-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-09-30$0
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Participant contributions at end of year2016-09-30$0
Participant contributions at beginning of year2016-09-30$48,181
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$-76,645
Value of net assets at end of year (total assets less liabilities)2016-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$4,792,863
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-09-30$4,744,682
Interest on participant loans2016-09-30$2,104
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$91
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-09-30$238,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$300,192
Contract administrator fees2016-09-30$16,835
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-09-30Yes
Did the plan have assets held for investment2016-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30Yes
Opinion of an independent qualified public accountant for this plan2016-09-30Disclaimer
Accountancy firm name2016-09-30EKS&H LLLP
Accountancy firm EIN2016-09-30461497033
2015 : VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$-661
Total unrealized appreciation/depreciation of assets2015-12-31$-661
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$-37,897
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,008,319
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,006,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$0
Value of total assets at end of year2015-12-31$4,792,863
Value of total assets at beginning of year2015-12-31$6,839,079
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,096
Total interest from all sources2015-12-31$16,515
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$78
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$78
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$15,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Participant contributions at end of year2015-12-31$48,181
Participant contributions at beginning of year2015-12-31$87,447
Assets. Loans (other than to participants) at end of year2015-12-31$0
Assets. Loans (other than to participants) at beginning of year2015-12-31$304,000
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$180
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,046,216
Value of net assets at end of year (total assets less liabilities)2015-12-31$4,792,863
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$6,839,079
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$4,744,682
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$6,447,452
Interest on participant loans2015-12-31$4,318
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$12,197
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-53,829
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,006,223
Contract administrator fees2015-12-31$2,096
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31EKS&H LLLP
Accountancy firm EIN2015-12-31461497033
2014 : VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-12-31$-404
Total unrealized appreciation/depreciation of assets2014-12-31$-404
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$372,102
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$537,633
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$533,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$0
Value of total assets at end of year2014-12-31$6,839,079
Value of total assets at beginning of year2014-12-31$7,004,610
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$4,520
Total interest from all sources2014-12-31$49,994
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$47
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$47
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$15,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Participant contributions at end of year2014-12-31$87,447
Participant contributions at beginning of year2014-12-31$150,237
Assets. Loans (other than to participants) at end of year2014-12-31$304,000
Assets. Loans (other than to participants) at beginning of year2014-12-31$655,000
Total non interest bearing cash at end of year2014-12-31$180
Total non interest bearing cash at beginning of year2014-12-31$180
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-165,531
Value of net assets at end of year (total assets less liabilities)2014-12-31$6,839,079
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$7,004,610
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$6,447,452
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$6,199,193
Interest on participant loans2014-12-31$6,575
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$43,419
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$322,465
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$533,113
Contract administrator fees2014-12-31$4,520
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31EKS&H LLLP
Accountancy firm EIN2014-12-31461497033
2013 : VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$-785
Total unrealized appreciation/depreciation of assets2013-12-31$-785
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,060
Total income from all sources (including contributions)2013-12-31$814,326
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$2,109,965
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,105,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$0
Value of total assets at end of year2013-12-31$7,004,610
Value of total assets at beginning of year2013-12-31$8,301,309
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$4,850
Total interest from all sources2013-12-31$72,876
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$44
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$44
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$40,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Participant contributions at end of year2013-12-31$150,237
Participant contributions at beginning of year2013-12-31$223,673
Assets. Loans (other than to participants) at end of year2013-12-31$655,000
Assets. Loans (other than to participants) at beginning of year2013-12-31$1,006,000
Liabilities. Value of operating payables at end of year2013-12-31$0
Liabilities. Value of operating payables at beginning of year2013-12-31$1,060
Total non interest bearing cash at end of year2013-12-31$180
Total non interest bearing cash at beginning of year2013-12-31$1,060
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-1,295,639
Value of net assets at end of year (total assets less liabilities)2013-12-31$7,004,610
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$8,300,249
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$180,760
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$6,199,193
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$6,889,816
Interest on participant loans2013-12-31$9,666
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$63,210
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$742,191
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,105,115
Contract administrator fees2013-12-31$4,850
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31EKS&H LLLP
Accountancy firm EIN2013-12-31461497033

Form 5500 Responses for VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN

2016: VELCON FILTERS, LLC 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: VELCON FILTERS, LLC 401(K) 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: VELCON FILTERS, LLC 401(K) 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: VELCON FILTERS, LLC 401(K) 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 – TrustYes
2013-01-01Plan 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 number331262-01
Policy instance 1
Insurance contract or identification number331262-01
Number of Individuals Covered33
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 number331262-01
Policy instance 1
Insurance contract or identification number331262-01
Number of Individuals Covered41
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 number331262-01
Policy instance 1
Insurance contract or identification number331262-01
Number of Individuals Covered43
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,770
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $1,770
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameCORBIN MARTINEZ

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