401k Plan data: LASER DYNAMICS 401K PLAN plan

LASER DYNAMICS 401K PLAN 401k Plan overview

Plan Name	LASER DYNAMICS 401K PLAN
Plan identification number	001

LASER DYNAMICS 401K PLAN Benefits

401k Plan Type

Defined 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GREAT LAKES LASER DYNAMICS has sponsored the creation of one or more 401k plans.

Company Name: GREAT LAKES LASER DYNAMICS

Employer identification number (EIN): 383511123

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LASER DYNAMICS 401K 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 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 WILLIAM HERBERG
001 2016-01-01 WILLIAM HERBERG 2017-10-11
001 2015-01-01 WILLIAM HERBERG 2016-10-17
001 2014-01-01 WILLIAM HERBERG 2015-10-05
001 2013-01-01 WILLIAM HERBERG 2014-06-12
001 2012-01-01 WILLIAM HERBERG 2013-05-15
001 2011-01-01 WILLIAM HERBERG 2012-05-16
001 2010-01-01 WILLIAM HERBERG 2011-04-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	WILLIAM HERBERG
001	2016-01-01	WILLIAM HERBERG	2017-10-11
001	2015-01-01	WILLIAM HERBERG	2016-10-17
001	2014-01-01	WILLIAM HERBERG	2015-10-05
001	2013-01-01	WILLIAM HERBERG	2014-06-12
001	2012-01-01	WILLIAM HERBERG	2013-05-15
001	2011-01-01	WILLIAM HERBERG	2012-05-16
001	2010-01-01	WILLIAM HERBERG	2011-04-29

Plan Statistics for LASER DYNAMICS 401K PLAN

401k plan membership statisitcs for LASER DYNAMICS 401K PLAN

Measure Date Value
2022: LASER DYNAMICS 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 99
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 31
Total of all active and inactive participants 2022-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 130
Number of participants with account balances 2022-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: LASER DYNAMICS 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 113
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 29
Total of all active and inactive participants 2021-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 142
Number of participants with account balances 2021-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: LASER DYNAMICS 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 122
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 25
Total of all active and inactive participants 2020-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 147
Number of participants with account balances 2020-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: LASER DYNAMICS 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 133
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 12
Total of all active and inactive participants 2019-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 145
Number of participants with account balances 2019-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: LASER DYNAMICS 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 115
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 12
Total of all active and inactive participants 2018-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 127
Number of participants with account balances 2018-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: LASER DYNAMICS 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 108
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 12
Total of all active and inactive participants 2017-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 120
Number of participants with account balances 2017-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: LASER DYNAMICS 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	99
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	31
Total of all active and inactive participants	2022-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	130
Number of participants with account balances	2022-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: LASER DYNAMICS 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	113
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	29
Total of all active and inactive participants	2021-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	142
Number of participants with account balances	2021-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: LASER DYNAMICS 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	122
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	25
Total of all active and inactive participants	2020-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	147
Number of participants with account balances	2020-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: LASER DYNAMICS 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	133
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	12
Total of all active and inactive participants	2019-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	145
Number of participants with account balances	2019-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: LASER DYNAMICS 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	115
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	12
Total of all active and inactive participants	2018-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	127
Number of participants with account balances	2018-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: LASER DYNAMICS 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	108
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	12
Total of all active and inactive participants	2017-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	120
Number of participants with account balances	2017-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on LASER DYNAMICS 401K PLAN

Measure	Date	Value
2022 : LASER DYNAMICS 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-261,739
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$386,699
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$373,745
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$402,917
Value of total assets at end of year	2022-12-31	$3,397,355
Value of total assets at beginning of year	2022-12-31	$4,045,793
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$12,954
Total interest from all sources	2022-12-31	$887
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$217,617
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	$217,617
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$405,000
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	$266,114
Participant contributions at end of year	2022-12-31	$1,573
Participant contributions 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	$-648,438
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,397,355
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,045,793
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	$3,317,912
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$3,950,717
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$887
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$76,855
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$95,076
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-883,160
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	$136,803
Employer contributions (assets) at end of year	2022-12-31	$1,015
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$373,745
Contract administrator fees	2022-12-31	$12,954
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	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2022-12-31	382621598
2021 : LASER DYNAMICS 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,009,110
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$545,456
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$532,618
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$452,118
Value of total assets at end of year	2021-12-31	$4,045,793
Value of total assets at beginning of year	2021-12-31	$3,582,139
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$12,838
Total interest from all sources	2021-12-31	$594
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$275,855
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	$275,855
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$359,000
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	$288,311
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$2,301
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$13,078
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning 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	$463,654
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,045,793
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,582,139
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	$3,950,717
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,554,805
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$594
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$95,076
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$23,458
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$280,543
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	$150,729
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$1,575
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$532,618
Contract administrator fees	2021-12-31	$12,838
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	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2021-12-31	382621598
2020 : LASER DYNAMICS 401K PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$890,381
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$134,922
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$125,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$429,945
Value of total assets at end of year	2020-12-31	$3,582,139
Value of total assets at beginning of year	2020-12-31	$2,826,680
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$9,302
Total interest from all sources	2020-12-31	$195
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$136,180
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$136,180
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$283,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$262,685
Participant contributions at end of year	2020-12-31	$2,301
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$7,239
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) 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	$755,459
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,582,139
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,826,680
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	$3,554,805
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,809,574
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$195
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$23,458
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$17,106
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$324,061
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	Yes
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	$160,021
Employer contributions (assets) at end of year	2020-12-31	$1,575
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	$125,620
Contract administrator fees	2020-12-31	$9,302
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	Unqualified
Accountancy firm name	2020-12-31	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2020-12-31	382621598
2019 : LASER DYNAMICS 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$8,000
Total income from all sources (including contributions)	2019-12-31	$1,016,160
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$231,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$222,763
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$519,329
Value of total assets at end of year	2019-12-31	$2,826,680
Value of total assets at beginning of year	2019-12-31	$2,049,761
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,478
Total interest from all sources	2019-12-31	$286
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$127,286
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	$127,286
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$205,000
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	$238,994
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$146,703
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$8,000
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	$784,919
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,826,680
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,041,761
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	$2,809,574
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,999,935
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$286
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$17,106
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$49,826
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$369,259
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	$133,632
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	$222,763
Contract administrator fees	2019-12-31	$8,478
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	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2019-12-31	382621598
2018 : LASER DYNAMICS 401K PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$8,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$8,000
Total income from all sources (including contributions)	2018-12-31	$195,197
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$259,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$251,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$327,875
Value of total assets at end of year	2018-12-31	$2,049,761
Value of total assets at beginning of year	2018-12-31	$2,113,785
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$7,867
Total interest from all sources	2018-12-31	$510
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$131,350
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	$131,350
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$214,000
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	$201,285
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$7,644
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$8,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$8,000
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	$-64,024
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,041,761
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,105,785
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	$1,999,935
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,059,788
Interest earned on other investments	2018-12-31	$510
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$49,826
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$41,120
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-264,538
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	$126,590
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$5,233
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$251,354
Contract administrator fees	2018-12-31	$7,867
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	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2018-12-31	382621598
2017 : LASER DYNAMICS 401K PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$8,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$652,257
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$56,796
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$50,963
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$352,693
Value of total assets at end of year	2017-12-31	$2,113,785
Value of total assets at beginning of year	2017-12-31	$1,510,324
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,833
Total interest from all sources	2017-12-31	$397
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$90,815
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	$90,815
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$214,900
Participant contributions at end of year	2017-12-31	$7,644
Participant contributions at beginning of year	2017-12-31	$3,613
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$8,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) 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	$595,461
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,105,785
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,510,324
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,059,788
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,472,427
Interest earned on other investments	2017-12-31	$397
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$41,120
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$32,028
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$208,352
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	Yes
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	$137,793
Employer contributions (assets) at end of year	2017-12-31	$5,233
Employer contributions (assets) at beginning of year	2017-12-31	$2,256
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$50,963
Contract administrator fees	2017-12-31	$5,833
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	MONROE SWEERIS & TROMP PLC
Accountancy firm EIN	2017-12-31	382621598

Form 5500 Responses for LASER DYNAMICS 401K PLAN

2022: LASER DYNAMICS 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
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: LASER DYNAMICS 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
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: LASER DYNAMICS 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Mulitple employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
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: LASER DYNAMICS 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Mulitple employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
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: LASER DYNAMICS 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
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: LASER DYNAMICS 401K PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	16
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $410
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $410
Insurance broker organization code?	3

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	20
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $450
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $450
Insurance broker organization code?	3

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	20
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $94
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $94
Insurance broker organization code?	3

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	17
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $71
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $71
Insurance broker organization code?	3

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	13
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $275
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $275
Insurance broker organization code?	3

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

Policy contract number

374231-01

Policy instance

Insurance contract or identification number	374231-01
Number of Individuals Covered	9
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $173
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $173
Insurance broker organization code?	3
Insurance broker name	NORTHWEST MUTUAL INVESTMENT SVCS

Potentially related plans

LASER DYNAMICS INC 401K PLAN [EIN = 200049535]

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Company Name:	GREAT LAKES LASER DYNAMICS
Employer identification number (EIN):	383511123
NAIC Classification:	332900