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WORKFORCE RESOURCES, INC. 401(K) PLAN 401k Plan overview

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

WORKFORCE RESOURCES, INC. 401(K) 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.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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

Company Name:WORKFORCE RESOURCES, INC.
Employer identification number (EIN):450589246
NAIC Classification:561110
NAIC Description:Office Administrative Services

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01CHARLENE WADE2023-04-06
0012021-01-01CHARLENE WADE2022-03-18
0012020-01-01CHARLENE WADE2021-04-29
0012019-01-01
0012018-01-01
0012017-01-01CHARLENE WADE
0012016-01-01CHARLENE WADE
0012015-01-01ROSALIND A. WHITE2016-06-01
0012014-01-01ROSALIND A. WHITE2015-05-08
0012013-01-01ROSALIND A. WHITE2014-05-28

Plan Statistics for WORKFORCE RESOURCES, INC. 401(K) PLAN

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

Measure Date Value
2019: WORKFORCE RESOURCES, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01122
Total number of active participants reported on line 7a of the Form 55002019-01-0181
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0121
Total of all active and inactive participants2019-01-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01102
Number of participants with account balances2019-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: WORKFORCE RESOURCES, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01152
Total number of active participants reported on line 7a of the Form 55002018-01-0187
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0135
Total of all active and inactive participants2018-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01122
Number of participants with account balances2018-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: WORKFORCE RESOURCES, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01128
Total number of active participants reported on line 7a of the Form 55002017-01-01128
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0124
Total of all active and inactive participants2017-01-01152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01152
Number of participants with account balances2017-01-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: WORKFORCE RESOURCES, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01125
Total number of active participants reported on line 7a of the Form 55002016-01-01100
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0124
Total of all active and inactive participants2016-01-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01124
Number of participants with account balances2016-01-0161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on WORKFORCE RESOURCES, INC. 401(K) PLAN

Measure Date Value
2019 : WORKFORCE RESOURCES, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$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$0
Total income from all sources (including contributions)2019-12-31$164,753
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$428,481
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$426,544
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$65,567
Value of total assets at end of year2019-12-31$454,300
Value of total assets at beginning of year2019-12-31$718,028
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,937
Total interest from all sources2019-12-31$1,168
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$150,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$37,593
Participant contributions at end of year2019-12-31$10,786
Participant contributions at beginning of year2019-12-31$24,002
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-263,728
Value of net assets at end of year (total assets less liabilities)2019-12-31$454,300
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$718,028
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$401,479
Value of interest in pooled separate accounts at beginning of year2019-12-31$647,692
Interest on participant loans2019-12-31$673
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$495
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$42,035
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$46,334
Net investment gain/loss from pooled separate accounts2019-12-31$98,018
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$27,974
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$426,544
Contract administrator fees2019-12-31$1,937
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31GELMAN, ROSENBERG & FREEDMAN
Accountancy firm EIN2019-12-31521392008
2018 : WORKFORCE RESOURCES, INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$78,657
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$139,508
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$138,558
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$134,075
Value of total assets at end of year2018-12-31$718,028
Value of total assets at beginning of year2018-12-31$778,879
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$950
Total interest from all sources2018-12-31$1,651
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$150,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$85,526
Participant contributions at end of year2018-12-31$24,002
Participant contributions at beginning of year2018-12-31$23,979
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-60,851
Value of net assets at end of year (total assets less liabilities)2018-12-31$718,028
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$778,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$647,692
Value of interest in pooled separate accounts at beginning of year2018-12-31$716,525
Interest on participant loans2018-12-31$1,190
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$461
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$46,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$38,375
Net investment gain/loss from pooled separate accounts2018-12-31$-57,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$48,549
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$138,558
Contract administrator fees2018-12-31$950
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31GELMAN, ROSENBERG & FREEDMAN
Accountancy firm EIN2018-12-31521392008
2017 : WORKFORCE RESOURCES, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
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$296,440
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$287,012
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$286,112
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$196,148
Value of total assets at end of year2017-12-31$778,879
Value of total assets at beginning of year2017-12-31$769,451
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$900
Total interest from all sources2017-12-31$1,679
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$150,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$100,721
Participant contributions at end of year2017-12-31$23,979
Participant contributions at beginning of year2017-12-31$36,939
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$37,693
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$9,428
Value of net assets at end of year (total assets less liabilities)2017-12-31$778,879
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$769,451
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$716,525
Value of interest in pooled separate accounts at beginning of year2017-12-31$698,847
Interest on participant loans2017-12-31$1,289
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$390
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$38,375
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$33,665
Net investment gain/loss from pooled separate accounts2017-12-31$98,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$57,734
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$286,112
Contract administrator fees2017-12-31$900
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31GELMAN, ROSENBERG & FREEDMAN
Accountancy firm EIN2017-12-31521392008
2016 : WORKFORCE RESOURCES, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$223,537
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$54,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$53,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$170,822
Value of total assets at end of year2016-12-31$769,451
Value of total assets at beginning of year2016-12-31$600,328
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$763
Total interest from all sources2016-12-31$1,198
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$103,373
Participant contributions at end of year2016-12-31$36,939
Participant contributions at beginning of year2016-12-31$2,438
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$7,545
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$169,123
Value of net assets at end of year (total assets less liabilities)2016-12-31$769,451
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$600,328
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$698,847
Value of interest in pooled separate accounts at beginning of year2016-12-31$570,356
Interest on participant loans2016-12-31$844
Interest earned on other investments2016-12-31$25
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$329
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$33,665
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$27,534
Net investment gain/loss from pooled separate accounts2016-12-31$51,517
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$59,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$53,651
Contract administrator fees2016-12-31$763
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31GELMAN, ROSENBERG & FREEDMAN
Accountancy firm EIN2016-12-31521392008

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

2019: WORKFORCE RESOURCES, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: WORKFORCE RESOURCES, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: WORKFORCE RESOURCES, 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 filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
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: WORKFORCE RESOURCES, 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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number915090-01
Policy instance 1
Insurance contract or identification number915090-01
Number of Individuals Covered40
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number915090-01
Policy instance 1
Insurance contract or identification number915090-01
Number of Individuals Covered60
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,274
Total amount of fees paid to insurance companyUSD $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 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 $1,274
Insurance broker organization code?3
Insurance broker nameBRETT HOFFMAN

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