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GRANCARE, INC. 401(K) PLAN 401k Plan overview

Plan NameGRANCARE, INC. 401(K) PLAN
Plan identification number 001

GRANCARE, INC. 401(K) 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.
  • Plan covering Self-Employed individuals.
  • 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

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

Company Name:GRANCARE, INC.
Employer identification number (EIN):391998671
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRANCARE, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01SARA KAHL
0012016-01-01WILLIAM MACKENZIE
0012015-01-01WILLIAM MACKENZIE
0012014-01-01WILLIAM MACKENZIE
0012013-01-01WILLIAM MACKENZIE
0012012-01-01WILLIAM MACKENZIE
0012011-01-01MARY TANK
0012010-01-01MARY TANK
0012009-01-01MARY TANK

Plan Statistics for GRANCARE, INC. 401(K) PLAN

401k plan membership statisitcs for GRANCARE, INC. 401(K) PLAN

Measure Date Value
2017: GRANCARE, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0131
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: GRANCARE, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0149
Total number of active participants reported on line 7a of the Form 55002016-01-0123
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0113
Total of all active and inactive participants2016-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0136
Number of participants with account balances2016-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-013
2015: GRANCARE, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0128
Total number of active participants reported on line 7a of the Form 55002015-01-0125
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0124
Total of all active and inactive participants2015-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0149
Number of participants with account balances2015-01-0144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: GRANCARE, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0137
Total number of active participants reported on line 7a of the Form 55002014-01-0124
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0121
Total of all active and inactive participants2014-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0145
Number of participants with account balances2014-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: GRANCARE, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0137
Total number of active participants reported on line 7a of the Form 55002013-01-0130
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0137
Number of participants with account balances2013-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: GRANCARE, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0135
Total number of active participants reported on line 7a of the Form 55002012-01-0131
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-016
Total of all active and inactive participants2012-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0137
Number of participants with account balances2012-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: GRANCARE, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0142
Total number of active participants reported on line 7a of the Form 55002011-01-0129
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-016
Total of all active and inactive participants2011-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0135
Number of participants with account balances2011-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: GRANCARE, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0140
Total number of active participants reported on line 7a of the Form 55002010-01-0138
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-014
Total of all active and inactive participants2010-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0142
Number of participants with account balances2010-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: GRANCARE, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0134
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 benefits2009-01-016
Total of all active and inactive participants2009-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0140
Number of participants with account balances2009-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GRANCARE, INC. 401(K) PLAN

Measure Date Value
2017 : GRANCARE, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-11-30$80,049
Expenses. Total of all expenses incurred2017-11-30$1,650,158
Benefits paid (including direct rollovers)2017-11-30$1,647,658
Total plan assets at end of year2017-11-30$0
Total plan assets at beginning of year2017-11-30$1,570,109
Value of fidelity bond covering the plan2017-11-30$158,000
Total contributions received or receivable from participants2017-11-30$977
Contributions received from other sources (not participants or employers)2017-11-30$0
Other income received2017-11-30$78,421
Net income (gross income less expenses)2017-11-30$-1,570,109
Net plan assets at end of year (total assets less liabilities)2017-11-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-11-30$1,570,109
Total contributions received or receivable from employer(s)2017-11-30$651
Expenses. Administrative service providers (salaries,fees and commissions)2017-11-30$2,500
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-11-30$0
2016 : GRANCARE, INC. 401(K) PLAN 2016 401k financial data
Total income from all sources2016-12-31$167,501
Expenses. Total of all expenses incurred2016-12-31$133,852
Benefits paid (including direct rollovers)2016-12-31$133,252
Total plan assets at end of year2016-12-31$1,570,109
Total plan assets at beginning of year2016-12-31$1,536,460
Value of fidelity bond covering the plan2016-12-31$158,000
Total contributions received or receivable from participants2016-12-31$14,776
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$145,771
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$33,649
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,570,109
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,536,460
Total contributions received or receivable from employer(s)2016-12-31$6,954
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$600
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : GRANCARE, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources2015-12-31$-581
Expenses. Total of all expenses incurred2015-12-31$106,345
Benefits paid (including direct rollovers)2015-12-31$106,145
Total plan assets at end of year2015-12-31$1,536,460
Total plan assets at beginning of year2015-12-31$1,643,386
Value of fidelity bond covering the plan2015-12-31$250,000
Total contributions received or receivable from participants2015-12-31$30,381
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-41,742
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-106,926
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,536,460
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,643,386
Total contributions received or receivable from employer(s)2015-12-31$10,780
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$200
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : GRANCARE, INC. 401(K) PLAN 2014 401k financial data
Total income from all sources2014-12-31$97,685
Expenses. Total of all expenses incurred2014-12-31$304,930
Benefits paid (including direct rollovers)2014-12-31$304,730
Total plan assets at end of year2014-12-31$1,643,386
Total plan assets at beginning of year2014-12-31$1,850,631
Value of fidelity bond covering the plan2014-12-31$250,000
Total contributions received or receivable from participants2014-12-31$23,359
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$71,425
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$-207,245
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,643,386
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,850,631
Total contributions received or receivable from employer(s)2014-12-31$2,901
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$200
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : GRANCARE, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources2013-12-31$405,199
Expenses. Total of all expenses incurred2013-12-31$173,300
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,850,631
Total plan assets at beginning of year2013-12-31$1,618,732
Total contributions received or receivable from participants2013-12-31$77,966
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$257,190
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$231,899
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,850,631
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,618,732
Total contributions received or receivable from employer(s)2013-12-31$70,043
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$173,300
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : GRANCARE, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources2012-12-31$364,663
Expenses. Total of all expenses incurred2012-12-31$64,617
Benefits paid (including direct rollovers)2012-12-31$59,533
Total plan assets at end of year2012-12-31$1,618,732
Total plan assets at beginning of year2012-12-31$1,318,686
Total contributions received or receivable from participants2012-12-31$91,904
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$193
Other income received2012-12-31$186,167
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$300,046
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,618,732
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,318,686
Total contributions received or receivable from employer(s)2012-12-31$86,399
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$5,084
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : GRANCARE, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources2011-12-31$122,065
Expenses. Total of all expenses incurred2011-12-31$495
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$1,318,686
Total plan assets at beginning of year2011-12-31$1,197,116
Total contributions received or receivable from participants2011-12-31$89,559
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-54,183
Net income (gross income less expenses)2011-12-31$121,570
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,318,686
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,197,116
Total contributions received or receivable from employer(s)2011-12-31$86,689
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$495
2010 : GRANCARE, INC. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$313,785
Expenses. Total of all expenses incurred2010-12-31$16,248
Benefits paid (including direct rollovers)2010-12-31$14,923
Total plan assets at end of year2010-12-31$1,197,116
Total plan assets at beginning of year2010-12-31$899,579
Total contributions received or receivable from participants2010-12-31$92,329
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$137,718
Net income (gross income less expenses)2010-12-31$297,537
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,197,116
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$899,579
Total contributions received or receivable from employer(s)2010-12-31$83,738
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,325

Form 5500 Responses for GRANCARE, INC. 401(K) PLAN

2017: GRANCARE, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: GRANCARE, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: GRANCARE, INC. 401(K) 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: GRANCARE, INC. 401(K) 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: GRANCARE, INC. 401(K) 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: GRANCARE, INC. 401(K) 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: GRANCARE, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2010: GRANCARE, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2009: GRANCARE, INC. 401(K) 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number874371
Policy instance 1
Insurance contract or identification number874371
Number of Individuals Covered44
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,696
Total amount of fees paid to insurance companyUSD $821
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 $5,696
Insurance broker organization code?7
Amount paid for insurance broker fees821
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES LTD
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number874371
Policy instance 1
Insurance contract or identification number874371
Number of Individuals Covered41
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,842
Total amount of fees paid to insurance companyUSD $863
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 $5,842
Insurance broker organization code?7
Amount paid for insurance broker fees863
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES LTD
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number927159
Policy instance 1
Insurance contract or identification number927159
Number of Individuals Covered15
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,913
Total amount of fees paid to insurance companyUSD $2,121
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 $5,913
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES LTD
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number927159
Policy instance 1
Insurance contract or identification number927159
Number of Individuals Covered16
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,097
Total amount of fees paid to insurance companyUSD $4,870
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 $16,097
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
Insurance broker namePENSION CONSULTANTS CO
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number927159
Policy instance 1
Insurance contract or identification number927159
Number of Individuals Covered16
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,179
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?Yes
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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number927159
Policy instance 1
Insurance contract or identification number927159
Number of Individuals Covered16
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,916
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?Yes
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
Commission paid to Insurance BrokerUSD $2,916
Insurance broker organization code?4
Insurance broker nameMORGAN STANLEY SMITH BARNEY LLC

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