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403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 401k Plan overview

Plan Name403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.
Plan identification number 001

403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

SENIOR SERVICES OF NORTHERN KENTUCK Y, INC. has sponsored the creation of one or more 401k plans.

Company Name:SENIOR SERVICES OF NORTHERN KENTUCK Y, INC.
Employer identification number (EIN):610725458
NAIC Classification:624200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012013-07-01MARIANN DUNN2014-04-25
0012012-07-01MARIANN DUNN MARIANN DUNN2014-04-15
0012011-07-01SHEILA M. GREATOREX SHEILA M. GREATOREX2013-04-15
0012009-07-01BARBARA J. GUNN
0012009-07-01BARBARA J. GUNN
0012009-07-01BARBARA J. GUNN
0012008-07-01

Plan Statistics for 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.

401k plan membership statisitcs for 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.

Measure Date Value
2012: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2012 401k membership
Total participants, beginning-of-year2012-07-01164
Total number of active participants reported on line 7a of the Form 55002012-07-0126
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-013
Total of all active and inactive participants2012-07-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0129
Number of participants with account balances2012-07-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2011 401k membership
Total participants, beginning-of-year2011-07-01198
Total number of active participants reported on line 7a of the Form 55002011-07-0173
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0191
Total of all active and inactive participants2011-07-01164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-01164
Number of participants with account balances2011-07-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-010
2009: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2009 401k membership
Total participants, beginning-of-year2009-07-01191
Total number of active participants reported on line 7a of the Form 55002009-07-0168
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-01124
Total of all active and inactive participants2009-07-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01192
Number of participants with account balances2009-07-01170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-013

Financial Data on 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.

Measure Date Value
2013 : 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total income from all sources (including contributions)2013-06-30$106,495
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$598,099
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$594,522
Expenses. Certain deemed distributions of participant loans2013-06-30$668
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$38,828
Value of total assets at end of year2013-06-30$136,395
Value of total assets at beginning of year2013-06-30$627,999
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$2,909
Total interest from all sources2013-06-30$4,385
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30Yes
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$85,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$19,964
Participant contributions at beginning of year2013-06-30$45,560
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$0
Other income not declared elsewhere2013-06-30$9,911
Administrative expenses (other) incurred2013-06-30$2,909
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$-491,604
Value of net assets at end of year (total assets less liabilities)2013-06-30$136,395
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$627,999
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$89,103
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$157,762
Interest on participant loans2013-06-30$240
Interest earned on other investments2013-06-30$4,145
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$47,292
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$424,677
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$0
Net investment gain/loss from pooled separate accounts2013-06-30$53,371
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30Yes
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$18,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$594,522
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30VONLEHMAN & CO., INC.
Accountancy firm EIN2013-06-30310905417
2012 : 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total income from all sources (including contributions)2012-06-30$32,817
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$293,895
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$289,878
Expenses. Certain deemed distributions of participant loans2012-06-30$3,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$32,206
Value of total assets at end of year2012-06-30$627,999
Value of total assets at beginning of year2012-06-30$889,077
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$984
Total interest from all sources2012-06-30$5,448
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$85,000
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$20,660
Participant contributions at end of year2012-06-30$45,559
Participant contributions at beginning of year2012-06-30$46,044
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$0
Other income not declared elsewhere2012-06-30$2,020
Administrative expenses (other) incurred2012-06-30$984
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-261,078
Value of net assets at end of year (total assets less liabilities)2012-06-30$627,999
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$889,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$424,677
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$668,673
Interest on participant loans2012-06-30$719
Interest earned on other investments2012-06-30$4,729
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$157,763
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$174,360
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$0
Net investment gain/loss from pooled separate accounts2012-06-30$-6,857
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30Yes
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$11,546
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$289,878
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30VONLEHMAN & CO. INC.
Accountancy firm EIN2012-06-30310905417
2011 : 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2011 401k financial data
Total transfer of assets to this plan2011-06-30$5,548
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total income from all sources (including contributions)2011-06-30$215,541
Total of all expenses incurred2011-06-30$156,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$148,332
Expenses. Certain deemed distributions of participant loans2011-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$49,112
Value of total assets at end of year2011-06-30$889,076
Value of total assets at beginning of year2011-06-30$829,543
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$7,676
Total interest from all sources2011-06-30$7,983
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$350,000
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$31,163
Participant contributions at end of year2011-06-30$46,044
Participant contributions at beginning of year2011-06-30$46,583
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$0
Other income not declared elsewhere2011-06-30$12,232
Administrative expenses (other) incurred2011-06-30$7,676
Liabilities. Value of operating payables at end of year2011-06-30$0
Liabilities. Value of operating payables at beginning of year2011-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$59,533
Value of net assets at end of year (total assets less liabilities)2011-06-30$889,076
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$829,543
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$668,673
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$615,415
Interest on participant loans2011-06-30$1,727
Interest earned on other investments2011-06-30$6,256
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$174,359
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$167,545
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$0
Net investment gain/loss from pooled separate accounts2011-06-30$146,214
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30Yes
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$17,949
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$148,332
Liabilities. Value of benefit claims payable at end of year2011-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$0
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Liabilities. Value of acquisition indebtedness at end of year2011-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30VONLEHMAN & CO., INC.
Accountancy firm EIN2011-06-30310905417

Form 5500 Responses for 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC.

2012: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedYes
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes
2008: 403(B) THRIF PLAN OF SENIOR SERVICES OF NORTHERN KENTUCKY, INC. 2008 form 5500 responses
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number014696A
Policy instance 1
Insurance contract or identification number014696A
Number of Individuals Covered29
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees16
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameJASON PINSON
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number9551301
Policy instance 2
Insurance contract or identification number9551301
Number of Individuals Covered0
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number014696A
Policy instance 1
Insurance contract or identification number014696A
Number of Individuals Covered43
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $81
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number9551301
Policy instance 2
Insurance contract or identification number9551301
Number of Individuals Covered103
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number014696A
Policy instance 1
Insurance contract or identification number014696A
Number of Individuals Covered44
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
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 number9551301
Policy instance 2
Insurance contract or identification number9551301
Number of Individuals Covered139
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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