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UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 401k Plan overview

Plan NameUBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE
Plan identification number 002

UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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.
  • 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

COUNTRY PARTNERS COOPERATIVE has sponsored the creation of one or more 401k plans.

Company Name:COUNTRY PARTNERS COOPERATIVE
Employer identification number (EIN):470303317
NAIC Classification:493100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01BRENT EVANS DONNA SCHNACKENBERG2018-10-02
0022016-01-01BRENT A EVANS DONNA SCHNACKENBERG2017-10-12

Plan Statistics for UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE

401k plan membership statisitcs for UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE

Measure Date Value
2022: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2022 401k membership
Total participants, beginning-of-year2022-01-01356
Total number of active participants reported on line 7a of the Form 55002022-01-01310
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-0141
Total of all active and inactive participants2022-01-01353
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01353
Number of participants with account balances2022-01-01149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0132
2021: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2021 401k membership
Total participants, beginning-of-year2021-01-01312
Total number of active participants reported on line 7a of the Form 55002021-01-01318
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-0136
Total of all active and inactive participants2021-01-01356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01356
Number of participants with account balances2021-01-01162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0129
2020: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2020 401k membership
Total participants, beginning-of-year2020-01-01324
Total number of active participants reported on line 7a of the Form 55002020-01-01270
Number of retired or separated participants receiving benefits2020-01-017
Number of other retired or separated participants entitled to future benefits2020-01-0127
Total of all active and inactive participants2020-01-01304
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01304
Number of participants with account balances2020-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2019 401k membership
Total participants, beginning-of-year2019-01-01321
Total number of active participants reported on line 7a of the Form 55002019-01-01300
Number of retired or separated participants receiving benefits2019-01-015
Number of other retired or separated participants entitled to future benefits2019-01-0118
Total of all active and inactive participants2019-01-01323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01323
Number of participants with account balances2019-01-01151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2018 401k membership
Total participants, beginning-of-year2018-01-01401
Total number of active participants reported on line 7a of the Form 55002018-01-01369
Number of retired or separated participants receiving benefits2018-01-013
Number of other retired or separated participants entitled to future benefits2018-01-0136
Total of all active and inactive participants2018-01-01408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01408
Number of participants with account balances2018-01-01176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2017 401k membership
Total participants, beginning-of-year2017-01-01362
Total number of active participants reported on line 7a of the Form 55002017-01-01361
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-0132
Total of all active and inactive participants2017-01-01399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01399
Number of participants with account balances2017-01-01170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2016 401k membership
Total participants, beginning-of-year2016-01-01154
Total number of active participants reported on line 7a of the Form 55002016-01-01324
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0132
Total of all active and inactive participants2016-01-01359
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01359
Number of participants with account balances2016-01-01166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE

Measure Date Value
2022 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets2022-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$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
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,089,802
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,602,954
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,581,572
Expenses. Certain deemed distributions of participant loans2022-12-31$4,256
Value of total corrective distributions2022-12-31$7,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$471,970
Value of total assets at end of year2022-12-31$7,061,756
Value of total assets at beginning of year2022-12-31$9,754,512
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$9,512
Total income from rents2022-12-31$0
Total interest from all sources2022-12-31$4,872
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$135,824
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$135,824
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Administrative expenses professional fees incurred2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$3,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$462,223
Participant contributions at end of year2022-12-31$108,185
Participant contributions at beginning of year2022-12-31$65,892
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$9,747
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-2,692,756
Value of net assets at end of year (total assets less liabilities)2022-12-31$7,061,756
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$9,754,512
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Investment advisory and management fees2022-12-31$9,512
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,774,864
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$8,194,633
Interest on participant loans2022-12-31$3,271
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$1,601
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$979,810
Value of interest in common/collective trusts at beginning of year2022-12-31$387,898
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$198,897
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,106,089
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,552,670
Net investment gain/loss from pooled separate accounts2022-12-31$0
Net investment gain or loss from common/collective trusts2022-12-31$-149,798
Net gain/loss from 103.12 investment entities2022-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Assets. Invements in employer securities at end of year2022-12-31$0
Assets. Invements in employer securities at beginning of year2022-12-31$0
Assets. Value of employer real property at end of year2022-12-31$0
Assets. Value of employer real property at beginning of year2022-12-31$0
Contributions received in cash from employer2022-12-31$0
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,581,572
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Contract administrator fees2022-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Liabilities. Value of benefit claims payable at end of year2022-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2022-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31GARDINER + COMPANY
Accountancy firm EIN2022-12-31421186197
2021 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$0
Total unrealized appreciation/depreciation of assets2021-12-31$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
Expenses. Interest paid2021-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,963,943
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$916,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$907,436
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$439,700
Value of total assets at end of year2021-12-31$9,754,512
Value of total assets at beginning of year2021-12-31$8,706,735
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$8,730
Total income from rents2021-12-31$0
Total interest from all sources2021-12-31$4,896
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$285,132
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$285,132
Assets. Real estate other than employer real property at end of year2021-12-31$0
Assets. Real estate other than employer real property at beginning of year2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$3,000,000
If this is an individual account plan, was there a blackout period2021-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$439,700
Participant contributions at end of year2021-12-31$65,892
Participant contributions at beginning of year2021-12-31$72,754
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Assets. Loans (other than to participants) at end of year2021-12-31$0
Assets. Loans (other than to participants) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Other income not declared elsewhere2021-12-31$-4,958
Administrative expenses (other) incurred2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$1,047,777
Value of net assets at end of year (total assets less liabilities)2021-12-31$9,754,512
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,706,735
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Assets. partnership/joint venture interests at end of year2021-12-31$0
Assets. partnership/joint venture interests at beginning of year2021-12-31$0
Investment advisory and management fees2021-12-31$8,590
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$8,194,633
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,940,452
Interest on participant loans2021-12-31$3,506
Income. Interest from loans (other than to participants)2021-12-31$0
Interest earned on other investments2021-12-31$1,390
Income. Interest from US Government securities2021-12-31$0
Income. Interest from corporate debt instruments2021-12-31$0
Value of interest in master investment trust accounts at end of year2021-12-31$0
Value of interest in master investment trust accounts at beginning of year2021-12-31$0
Value of interest in common/collective trusts at end of year2021-12-31$387,898
Value of interest in common/collective trusts at beginning of year2021-12-31$1,693,529
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2021-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,106,089
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Asset value of US Government securities at end of year2021-12-31$0
Asset value of US Government securities at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,242,098
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$-2,925
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Assets. Value of employer real property at end of year2021-12-31$0
Assets. Value of employer real property at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$0
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Income. Dividends from preferred stock2021-12-31$0
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$907,436
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$0
Contract administrator fees2021-12-31$140
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$0
Liabilities. Value of benefit claims payable at end of year2021-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$0
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$0
Aggregate carrying amount (costs) on sale of assets2021-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2021-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31GARDINER + COMPANY
Accountancy firm EIN2021-12-31421186197
2020 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$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$1,887,050
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$438,389
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$430,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$555,198
Value of total assets at end of year2020-12-31$8,706,735
Value of total assets at beginning of year2020-12-31$7,258,074
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$8,012
Total interest from all sources2020-12-31$3,755
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$196,939
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$196,939
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$3,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$429,607
Participant contributions at end of year2020-12-31$72,754
Participant contributions at beginning of year2020-12-31$62,402
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$125,591
Administrative expenses (other) incurred2020-12-31$8,012
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,448,661
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,706,735
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$7,258,074
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$6,940,452
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,664,172
Interest on participant loans2020-12-31$3,755
Value of interest in common/collective trusts at end of year2020-12-31$1,693,529
Value of interest in common/collective trusts at beginning of year2020-12-31$1,531,500
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$907,521
Net investment gain or loss from common/collective trusts2020-12-31$223,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$430,377
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31GARDINER + COMPANY, CPAS
Accountancy firm EIN2020-12-31421186197
2019 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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$1,849,258
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$575,133
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$564,608
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$446,290
Value of total assets at end of year2019-12-31$7,258,074
Value of total assets at beginning of year2019-12-31$5,983,949
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$10,525
Total interest from all sources2019-12-31$3,810
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$165,388
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$165,388
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$3,000,000
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$431,855
Participant contributions at end of year2019-12-31$62,402
Participant contributions at beginning of year2019-12-31$64,204
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$14,435
Administrative expenses (other) incurred2019-12-31$10,525
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$1,274,125
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,258,074
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,983,949
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 registered invesment companies (eg mutual funds) at end of year2019-12-31$5,664,172
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,517,668
Interest on participant loans2019-12-31$3,810
Value of interest in common/collective trusts at end of year2019-12-31$1,531,500
Value of interest in common/collective trusts at beginning of year2019-12-31$1,402,077
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$952,579
Net investment gain or loss from common/collective trusts2019-12-31$281,191
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$564,608
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 name2019-12-31GARDINER + COMPANY, PC
Accountancy firm EIN2019-12-31421186197
2018 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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$113,228
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$361,180
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$352,092
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$377,892
Value of total assets at end of year2018-12-31$5,983,949
Value of total assets at beginning of year2018-12-31$6,231,901
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$9,088
Total interest from all sources2018-12-31$3,205
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$174,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$174,004
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
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$377,892
Participant contributions at end of year2018-12-31$64,204
Participant contributions at beginning of year2018-12-31$71,702
Administrative expenses (other) incurred2018-12-31$9,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-247,952
Value of net assets at end of year (total assets less liabilities)2018-12-31$5,983,949
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$6,231,901
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 registered invesment companies (eg mutual funds) at end of year2018-12-31$5,375,401
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$5,587,699
Interest on participant loans2018-12-31$3,205
Value of interest in common/collective trusts at end of year2018-12-31$544,344
Value of interest in common/collective trusts at beginning of year2018-12-31$572,500
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-460,920
Net investment gain or loss from common/collective trusts2018-12-31$19,047
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$352,092
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 name2018-12-31GARDINER + COMPANY, PC
Accountancy firm EIN2018-12-31421186197
2017 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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$1,509,097
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$426,417
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$416,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$579,822
Value of total assets at end of year2017-12-31$6,231,901
Value of total assets at beginning of year2017-12-31$5,149,221
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$9,955
Total interest from all sources2017-12-31$2,569
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$143,894
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$143,894
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
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$362,705
Participant contributions at end of year2017-12-31$71,702
Participant contributions at beginning of year2017-12-31$64,510
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$217,117
Administrative expenses (other) incurred2017-12-31$9,955
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$8,151
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$1,082,680
Value of net assets at end of year (total assets less liabilities)2017-12-31$6,231,901
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$5,149,221
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 registered invesment companies (eg mutual funds) at end of year2017-12-31$5,587,699
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$4,369,948
Interest on participant loans2017-12-31$2,569
Value of interest in common/collective trusts at end of year2017-12-31$572,500
Value of interest in common/collective trusts at beginning of year2017-12-31$706,612
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$771,266
Net investment gain or loss from common/collective trusts2017-12-31$11,546
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$416,462
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 name2017-12-31GARDNER THOMSEN
Accountancy firm EIN2017-12-31421186197
2016 : UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$2,663,181
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$741,924
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$139,920
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$132,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$350,468
Value of total assets at end of year2016-12-31$5,149,221
Value of total assets at beginning of year2016-12-31$1,884,036
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$7,181
Total interest from all sources2016-12-31$9,589
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$101,885
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$101,885
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
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$349,191
Participant contributions at end of year2016-12-31$64,510
Participant contributions at beginning of year2016-12-31$20,805
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$1,277
Administrative expenses (other) incurred2016-12-31$7,181
Total non interest bearing cash at end of year2016-12-31$8,151
Total non interest bearing cash at beginning of year2016-12-31$1,899
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$602,004
Value of net assets at end of year (total assets less liabilities)2016-12-31$5,149,221
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,884,036
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 registered invesment companies (eg mutual funds) at end of year2016-12-31$4,369,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,700,759
Interest on participant loans2016-12-31$9,589
Value of interest in common/collective trusts at end of year2016-12-31$706,612
Value of interest in common/collective trusts at beginning of year2016-12-31$160,573
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$272,925
Net investment gain or loss from common/collective trusts2016-12-31$7,057
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$132,739
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
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 name2016-12-31GARDINER THOMSEN
Accountancy firm EIN2016-12-31421186197

Form 5500 Responses for UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE

2022: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: UBG 401(K) PLAN - COUNTRY PARTNERS COOPERATIVE 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 – TrustYes
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 number515008-01
Policy instance 1
Insurance contract or identification number515008-01
Number of Individuals Covered32
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number515008-01
Policy instance 1
Insurance contract or identification number515008-01
Number of Individuals Covered60
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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

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