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THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameTHREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

THREE DREAMS, LLC has sponsored the creation of one or more 401k plans.

Company Name:THREE DREAMS, LLC
Employer identification number (EIN):593792606
NAIC Classification:561790
NAIC Description:Other Services to Buildings and Dwellings

Additional information about THREE DREAMS, LLC

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2011-01-01
Company Identification Number: 20101677461
Legal Registered Office Address: 3288 Shadow Ridge Ct

Clifton
United States of America (USA)
81520

More information about THREE DREAMS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01KATHLEEN LINDERMAN
0012016-01-01KATHLEEN LINDERMAN
0012016-01-01KATHLEEN S LINDERMAN2017-07-31
0012015-01-01KATHLEEN LINDERMAN
0012014-01-01KATHLEEN LINDERMAN
0012013-01-01KATHLEEN LINDERMAN
0012012-01-01KATHLEEN LINDERMAN
0012011-01-01KATHLEEN LINDERMAN
0012010-01-01KATHLEEN LINDERMAN
0012009-01-01KATHLEEN LINDERMAN

Plan Statistics for THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2022: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-0111
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-019
Total of all active and inactive participants2022-01-019
Total participants2022-01-019
Number of participants with account balances2022-01-019
2021: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-0111
Number of other retired or separated participants entitled to future benefits2021-01-0111
Total of all active and inactive participants2021-01-0111
Total participants2021-01-0111
Number of participants with account balances2021-01-0111
2020: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-0111
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-0111
Total of all active and inactive participants2020-01-0111
Total participants2020-01-0111
Number of participants with account balances2020-01-0111
2019: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-0117
Total number of active participants reported on line 7a of the Form 55002019-01-0111
Total of all active and inactive participants2019-01-0111
Total participants2019-01-0111
Number of participants with account balances2019-01-0111
2018: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-0117
Total number of active participants reported on line 7a of the Form 55002018-01-0114
Number of retired or separated participants receiving benefits2018-01-013
Total of all active and inactive participants2018-01-0117
Total participants2018-01-0117
Number of participants with account balances2018-01-0117
2017: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-0118
Total number of active participants reported on line 7a of the Form 55002017-01-0110
Number of other retired or separated participants entitled to future benefits2017-01-017
Total of all active and inactive participants2017-01-0117
Total participants2017-01-0117
Number of participants with account balances2017-01-0117
2016: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-0134
Total number of active participants reported on line 7a of the Form 55002016-01-0113
Number of retired or separated participants receiving benefits2016-01-0110
Total of all active and inactive participants2016-01-0123
Total participants2016-01-0123
Number of participants with account balances2016-01-0123
2015: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0135
Total number of active participants reported on line 7a of the Form 55002015-01-0134
Total of all active and inactive participants2015-01-0134
Total participants2015-01-0134
Number of participants with account balances2015-01-0134
2014: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0136
Total number of active participants reported on line 7a of the Form 55002014-01-0135
Total of all active and inactive participants2014-01-0135
Total participants2014-01-0135
Number of participants with account balances2014-01-0135
2013: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0140
Total number of active participants reported on line 7a of the Form 55002013-01-0136
Total of all active and inactive participants2013-01-0136
Total participants2013-01-0136
Number of participants with account balances2013-01-0136
2012: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0139
Total number of active participants reported on line 7a of the Form 55002012-01-0121
Number of other retired or separated participants entitled to future benefits2012-01-0119
Total of all active and inactive participants2012-01-0140
Total participants2012-01-0140
Number of participants with account balances2012-01-0140
2011: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0136
Total number of active participants reported on line 7a of the Form 55002011-01-0128
Number of other retired or separated participants entitled to future benefits2011-01-019
Total of all active and inactive participants2011-01-0137
Total participants2011-01-0137
Number of participants with account balances2011-01-0137
2010: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-0135
Total number of active participants reported on line 7a of the Form 55002010-01-0128
Number of other retired or separated participants entitled to future benefits2010-01-018
Total of all active and inactive participants2010-01-0136
Total participants2010-01-0136
Number of participants with account balances2010-01-0136
2009: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-016
Total number of active participants reported on line 7a of the Form 55002009-01-0135
Total of all active and inactive participants2009-01-0135
Total participants2009-01-0135
Number of participants with account balances2009-01-0135

Financial Data on THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2022 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 401k financial data
Total income from all sources2022-12-31$1,001,336
Expenses. Total of all expenses incurred2022-12-31$1,023,849
Benefits paid (including direct rollovers)2022-12-31$1,023,849
Total plan assets at end of year2022-12-31$30,093
Total plan assets at beginning of year2022-12-31$52,606
Value of fidelity bond covering the plan2022-12-31$10,000
Contributions received from other sources (not participants or employers)2022-12-31$1,119,457
Other income received2022-12-31$-118,121
Net income (gross income less expenses)2022-12-31$-22,513
Net plan assets at end of year (total assets less liabilities)2022-12-31$30,093
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$52,606
2021 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 401k financial data
Total income from all sources2021-12-31$5,377
Total plan assets at end of year2021-12-31$52,606
Total plan assets at beginning of year2021-12-31$47,229
Value of fidelity bond covering the plan2021-12-31$10,000
Other income received2021-12-31$5,377
Net income (gross income less expenses)2021-12-31$5,377
Net plan assets at end of year (total assets less liabilities)2021-12-31$52,606
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$47,229
2020 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 401k financial data
Total income from all sources2020-12-31$4,838
Total plan assets at end of year2020-12-31$47,229
Total plan assets at beginning of year2020-12-31$42,391
Value of fidelity bond covering the plan2020-12-31$10,000
Other income received2020-12-31$4,838
Net income (gross income less expenses)2020-12-31$4,838
Net plan assets at end of year (total assets less liabilities)2020-12-31$47,229
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$42,391
2019 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 401k financial data
Total income from all sources2019-12-31$-9,749
Expenses. Total of all expenses incurred2019-12-31$96,753
Benefits paid (including direct rollovers)2019-12-31$96,705
Total plan assets at end of year2019-12-31$42,391
Total plan assets at beginning of year2019-12-31$148,893
Value of fidelity bond covering the plan2019-12-31$10,000
Total contributions received or receivable from participants2019-12-31$1,664
Other income received2019-12-31$-11,413
Net income (gross income less expenses)2019-12-31$-106,502
Net plan assets at end of year (total assets less liabilities)2019-12-31$42,391
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$148,893
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$48
2018 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 401k financial data
Total income from all sources2018-12-31$-721
Expenses. Total of all expenses incurred2018-12-31$66
Total plan assets at end of year2018-12-31$148,893
Total plan assets at beginning of year2018-12-31$149,680
Value of fidelity bond covering the plan2018-12-31$25,000
Total contributions received or receivable from participants2018-12-31$16,135
Other income received2018-12-31$-16,856
Net income (gross income less expenses)2018-12-31$-787
Net plan assets at end of year (total assets less liabilities)2018-12-31$148,893
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$149,680
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$66
2017 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 401k financial data
Total income from all sources2017-12-31$27,029
Expenses. Total of all expenses incurred2017-12-31$898
Benefits paid (including direct rollovers)2017-12-31$844
Total plan assets at end of year2017-12-31$149,680
Total plan assets at beginning of year2017-12-31$123,549
Value of fidelity bond covering the plan2017-12-31$25,000
Total contributions received or receivable from participants2017-12-31$13,915
Other income received2017-12-31$13,114
Net income (gross income less expenses)2017-12-31$26,131
Net plan assets at end of year (total assets less liabilities)2017-12-31$149,680
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$123,549
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$54
2016 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2016 401k financial data
Total income from all sources2016-12-31$33,700
Expenses. Total of all expenses incurred2016-12-31$14,821
Benefits paid (including direct rollovers)2016-12-31$14,790
Total plan assets at end of year2016-12-31$123,549
Total plan assets at beginning of year2016-12-31$104,670
Value of fidelity bond covering the plan2016-12-31$25,000
Total contributions received or receivable from participants2016-12-31$14,227
Other income received2016-12-31$19,473
Net income (gross income less expenses)2016-12-31$18,879
Net plan assets at end of year (total assets less liabilities)2016-12-31$123,549
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$104,670
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$31
2015 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2015 401k financial data
Total income from all sources2015-12-31$16,710
Expenses. Total of all expenses incurred2015-12-31$8,156
Benefits paid (including direct rollovers)2015-12-31$8,124
Total plan assets at end of year2015-12-31$104,670
Total plan assets at beginning of year2015-12-31$96,116
Value of fidelity bond covering the plan2015-12-31$25,000
Total contributions received or receivable from participants2015-12-31$14,449
Expenses. Other expenses not covered elsewhere2015-12-31$32
Other income received2015-12-31$2,261
Net income (gross income less expenses)2015-12-31$8,554
Net plan assets at end of year (total assets less liabilities)2015-12-31$104,670
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$96,116
2014 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$23,598
Expenses. Total of all expenses incurred2014-12-31$2,988
Benefits paid (including direct rollovers)2014-12-31$2,964
Total plan assets at end of year2014-12-31$96,116
Total plan assets at beginning of year2014-12-31$75,506
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$11,119
Expenses. Other expenses not covered elsewhere2014-12-31$24
Other income received2014-12-31$12,479
Net income (gross income less expenses)2014-12-31$20,610
Net plan assets at end of year (total assets less liabilities)2014-12-31$96,116
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$75,506
2013 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2013 401k financial data
Total income from all sources2013-12-31$30,936
Expenses. Total of all expenses incurred2013-12-31$30,734
Benefits paid (including direct rollovers)2013-12-31$30,723
Total plan assets at end of year2013-12-31$75,506
Total plan assets at beginning of year2013-12-31$75,304
Value of fidelity bond covering the plan2013-12-31$25,000
Total contributions received or receivable from participants2013-12-31$9,352
Expenses. Other expenses not covered elsewhere2013-12-31$11
Other income received2013-12-31$21,584
Net income (gross income less expenses)2013-12-31$202
Net plan assets at end of year (total assets less liabilities)2013-12-31$75,506
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$75,304
2012 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k financial data
Total income from all sources2012-12-31$-7,240
Expenses. Total of all expenses incurred2012-12-31$3
Total plan assets at end of year2012-12-31$75,304
Total plan assets at beginning of year2012-12-31$82,547
Value of fidelity bond covering the plan2012-12-31$25,000
Total contributions received or receivable from participants2012-12-31$10,120
Expenses. Other expenses not covered elsewhere2012-12-31$3
Other income received2012-12-31$-17,360
Net income (gross income less expenses)2012-12-31$-7,243
Net plan assets at end of year (total assets less liabilities)2012-12-31$75,304
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$82,547
2011 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total income from all sources2011-12-31$-15,657
Expenses. Total of all expenses incurred2011-12-31$19,157
Benefits paid (including direct rollovers)2011-12-31$19,157
Total plan assets at end of year2011-12-31$82,547
Total plan assets at beginning of year2011-12-31$117,361
Value of fidelity bond covering the plan2011-12-31$25,000
Total contributions received or receivable from participants2011-12-31$11,016
Other income received2011-12-31$-26,673
Net income (gross income less expenses)2011-12-31$-34,814
Net plan assets at end of year (total assets less liabilities)2011-12-31$82,547
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$117,361
2010 : THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$-14,650
Expenses. Total of all expenses incurred2010-12-31$44,000
Benefits paid (including direct rollovers)2010-12-31$44,000
Total plan assets at end of year2010-12-31$117,361
Total plan assets at beginning of year2010-12-31$176,011
Value of fidelity bond covering the plan2010-12-31$25,000
Total contributions received or receivable from participants2010-12-31$4,348
Other income received2010-12-31$-18,998
Net income (gross income less expenses)2010-12-31$-58,650
Net plan assets at end of year (total assets less liabilities)2010-12-31$117,361
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$176,011

Form 5500 Responses for THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST

2022: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: THREE DREAMS, LLC 401(K) PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan 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 number944968-01
Policy instance 1
Insurance contract or identification number944968-01
Number of Individuals Covered9
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $968
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $968
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 1
Insurance contract or identification number944968-01
Number of Individuals Covered11
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $268
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $268
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 1
Insurance contract or identification number944968-01
Number of Individuals Covered11
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $218
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $218
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 1
Insurance contract or identification number944968-01
Number of Individuals Covered11
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees450
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 2
Insurance contract or identification number944968-01
Number of Individuals Covered17
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $555
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $555
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 3
Insurance contract or identification number944968-01
Number of Individuals Covered18
Total amount of fees paid to insurance companyUSD $392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees392
Insurance broker organization code?3
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number944968-01
Policy instance 3
Insurance contract or identification number944968-01
Number of Individuals Covered21
Total amount of commissions paid to insurance brokerUSD $346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $346
Insurance broker organization code?3
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?4
Insurance broker nameARLO J STOLL
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Total amount of commissions paid to insurance brokerUSD $18,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 2
Insurance contract or identification numberVP65904000
Number of Individuals Covered1
Total amount of commissions paid to insurance brokerUSD $41,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVP65904000
Policy instance 1
Insurance contract or identification numberVP65904000
Number of Individuals Covered1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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