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CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 401k Plan overview

Plan NameCORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN
Plan identification number 001

CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

CORTELCO SYSTEMS PUERTO RICO, INC. has sponsored the creation of one or more 401k plans.

Company Name:CORTELCO SYSTEMS PUERTO RICO, INC.
Employer identification number (EIN):660567491
NAIC Classification:541512
NAIC Description:Computer Systems Design Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN

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
0012018-01-01VIVIAN PEREZ VIVIAN PEREZ2019-06-10
0012017-01-01VIVIAN PEREZ VIVIAN PEREZ2018-04-26
0012016-01-01VIVIAN PEREZ VIVIAN PEREZ2017-05-07
0012015-01-01VIVIAN PEREZ VIVIAN PEREZ2016-10-03
0012014-01-01NORMA FRED2015-06-15
0012013-01-01NORMA FRED2014-07-17
0012012-01-01NORMA FRED2013-10-02
0012011-01-01FRANCISCO SANCHEZ2012-10-10
0012010-01-01FRANCISCO SANCHEZ2011-07-26 FRANCISCO SANCHEZ2011-07-26

Plan Statistics for CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN

401k plan membership statisitcs for CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN

Measure Date Value
2022: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0144
Total number of active participants reported on line 7a of the Form 55002022-01-0130
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0116
Total of all active and inactive participants2022-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0146
Number of participants with account balances2022-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0147
Total number of active participants reported on line 7a of the Form 55002021-01-0129
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0115
Total of all active and inactive participants2021-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0144
Number of participants with account balances2021-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0145
Total number of active participants reported on line 7a of the Form 55002020-01-0133
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0114
Total of all active and inactive participants2020-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0147
Number of participants with account balances2020-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0154
Total number of active participants reported on line 7a of the Form 55002019-01-0130
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0115
Total of all active and inactive participants2019-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0145
Number of participants with account balances2019-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0154
Total number of active participants reported on line 7a of the Form 55002018-01-0137
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0116
Total of all active and inactive participants2018-01-0153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-0154
Number of participants with account balances2018-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0149
Total number of active participants reported on line 7a of the Form 55002017-01-0138
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0116
Total of all active and inactive participants2017-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0154
Number of participants with account balances2017-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0152
Total number of active participants reported on line 7a of the Form 55002016-01-0135
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0114
Total of all active and inactive participants2016-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0149
Number of participants with account balances2016-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0162
Total number of active participants reported on line 7a of the Form 55002015-01-0138
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0114
Total of all active and inactive participants2015-01-0152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0152
Number of participants with account balances2015-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN

Measure Date Value
2022 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2022 401k financial data
Total income from all sources2022-12-31$-121,082
Expenses. Total of all expenses incurred2022-12-31$62,619
Benefits paid (including direct rollovers)2022-12-31$51,047
Total plan assets at end of year2022-12-31$1,583,051
Total plan assets at beginning of year2022-12-31$1,766,752
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$64,702
Expenses. Other expenses not covered elsewhere2022-12-31$10,879
Other income received2022-12-31$-199,568
Net income (gross income less expenses)2022-12-31$-183,701
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,583,051
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,766,752
Assets. Value of participant loans2022-12-31$27,244
Total contributions received or receivable from employer(s)2022-12-31$13,784
Value of certain deemed distributions of participant loans2022-12-31$693
2021 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2021 401k financial data
Total income from all sources2021-12-31$261,654
Expenses. Total of all expenses incurred2021-12-31$69,531
Benefits paid (including direct rollovers)2021-12-31$47,463
Total plan assets at end of year2021-12-31$1,766,752
Total plan assets at beginning of year2021-12-31$1,574,629
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$52,200
Expenses. Other expenses not covered elsewhere2021-12-31$12,141
Other income received2021-12-31$204,533
Net income (gross income less expenses)2021-12-31$192,123
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,766,752
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,574,629
Assets. Value of participant loans2021-12-31$27,142
Total contributions received or receivable from employer(s)2021-12-31$4,921
Value of certain deemed distributions of participant loans2021-12-31$9,927
2020 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2020 401k financial data
Total income from all sources2020-12-31$192,940
Expenses. Total of all expenses incurred2020-12-31$123,854
Benefits paid (including direct rollovers)2020-12-31$105,428
Total plan assets at end of year2020-12-31$1,574,629
Total plan assets at beginning of year2020-12-31$1,505,543
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$49,392
Expenses. Other expenses not covered elsewhere2020-12-31$10,663
Other income received2020-12-31$139,039
Net income (gross income less expenses)2020-12-31$69,086
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,574,629
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,505,543
Assets. Value of participant loans2020-12-31$30,413
Total contributions received or receivable from employer(s)2020-12-31$4,509
Value of certain deemed distributions of participant loans2020-12-31$7,763
2019 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2019 401k financial data
Total income from all sources2019-12-31$279,679
Expenses. Total of all expenses incurred2019-12-31$71,919
Benefits paid (including direct rollovers)2019-12-31$60,131
Total plan assets at end of year2019-12-31$1,505,543
Total plan assets at beginning of year2019-12-31$1,297,783
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$48,191
Expenses. Other expenses not covered elsewhere2019-12-31$10,434
Other income received2019-12-31$227,614
Net income (gross income less expenses)2019-12-31$207,760
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,505,543
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,297,783
Assets. Value of participant loans2019-12-31$27,372
Total contributions received or receivable from employer(s)2019-12-31$3,874
Value of corrective distributions2019-12-31$1,354
2018 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2018 401k financial data
Total income from all sources2018-12-31$-34,938
Expenses. Total of all expenses incurred2018-12-31$189,414
Benefits paid (including direct rollovers)2018-12-31$186,471
Total plan assets at end of year2018-12-31$1,297,783
Total plan assets at beginning of year2018-12-31$1,522,135
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$37,027
Expenses. Other expenses not covered elsewhere2018-12-31$2,943
Other income received2018-12-31$-71,965
Net income (gross income less expenses)2018-12-31$-224,352
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,297,783
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,522,135
Assets. Value of participant loans2018-12-31$17,672
2017 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2017 401k financial data
Total income from all sources2017-12-31$226,478
Expenses. Total of all expenses incurred2017-12-31$75,375
Benefits paid (including direct rollovers)2017-12-31$73,901
Total plan assets at end of year2017-12-31$1,522,135
Total plan assets at beginning of year2017-12-31$1,371,032
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$46,379
Expenses. Other expenses not covered elsewhere2017-12-31$225
Other income received2017-12-31$180,099
Net income (gross income less expenses)2017-12-31$151,103
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,522,135
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,371,032
Assets. Value of participant loans2017-12-31$26,071
Value of corrective distributions2017-12-31$1,249
2016 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$113,670
Expenses. Total of all expenses incurred2016-12-31$63,635
Benefits paid (including direct rollovers)2016-12-31$53,975
Total plan assets at end of year2016-12-31$1,371,032
Total plan assets at beginning of year2016-12-31$1,320,997
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$41,835
Expenses. Other expenses not covered elsewhere2016-12-31$144
Other income received2016-12-31$71,835
Net income (gross income less expenses)2016-12-31$50,035
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,371,032
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,320,997
Assets. Value of participant loans2016-12-31$45,905
Value of certain deemed distributions of participant loans2016-12-31$4,315
Value of corrective distributions2016-12-31$5,201
2015 : CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$31,909
Expenses. Total of all expenses incurred2015-12-31$77,791
Benefits paid (including direct rollovers)2015-12-31$77,791
Total plan assets at end of year2015-12-31$1,320,997
Total plan assets at beginning of year2015-12-31$1,366,879
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$39,136
Other income received2015-12-31$-7,227
Net income (gross income less expenses)2015-12-31$-45,882
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,320,997
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,366,879
Assets. Value of participant loans2015-12-31$65,865

Form 5500 Responses for CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN

2022: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 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: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
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: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 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 – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CORTELCO SYSTEMS PUERTO RICO, INC. PROFIT SHARING RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered24
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered24
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered17
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered19
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 $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered22
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $327
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $327
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered23
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,582
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,582
Insurance broker organization code?3
Insurance broker nameFERNANDO AGUDO NIDO
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number373994-P1
Policy instance 1
Insurance contract or identification number373994-P1
Number of Individuals Covered25
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $292
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
Commission paid to Insurance BrokerUSD $292
Insurance broker organization code?3
Insurance broker nameROBERTO SANTA MARIA MENDEZ

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