401k Plan data: KING CYCLE GROUP 401(K) PLAN plan

KING CYCLE GROUP 401(K) PLAN 401k Plan overview

Plan Name	KING CYCLE GROUP 401(K) PLAN
Plan identification number	001

KING CYCLE GROUP 401(K) PLAN Benefits

401k Plan Type

Defined 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).
Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

KING CYCLE GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: KING CYCLE GROUP, INC.

Employer identification number (EIN): 770361801

NAIC Classification: 336990

Additional information about KING CYCLE GROUP, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2003-12-23

Company Identification Number: 19144294

Legal Registered Office Address: 12276 NW BARNES ROAD

PORTLAND
United States of America (USA)
97229

More information about KING CYCLE GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KING CYCLE GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 CARYN MILLAR 2023-07-18
001 2021-01-01 KIRBY BEDSAUL 2022-10-10
001 2020-01-01 KIRBY BEDSAUL 2021-10-08
001 2019-01-01 KIRBY BEDSAUL 2020-10-13
001 2018-01-01 KIRBY BEDSAUL 2019-10-01
001 2017-01-01
001 2016-01-01 KIRBY BEDSAUL
001 2015-01-01
001 2014-01-01 KRIS BEDSAUL
001 2013-01-01 CHRIS KING 2014-10-02
001 2012-01-01 CHRIS KING 2013-10-09
001 2011-01-01 DIANE CHALMERS 2012-07-10
001 2010-01-01 PENSION PLANNERS NORTHWEST 2011-07-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	CARYN MILLAR	2023-07-18
001	2021-01-01	KIRBY BEDSAUL	2022-10-10
001	2020-01-01	KIRBY BEDSAUL	2021-10-08
001	2019-01-01	KIRBY BEDSAUL	2020-10-13
001	2018-01-01	KIRBY BEDSAUL	2019-10-01
001	2017-01-01
001	2016-01-01	KIRBY BEDSAUL
001	2015-01-01
001	2014-01-01	KRIS BEDSAUL
001	2013-01-01	CHRIS KING	2014-10-02
001	2012-01-01	CHRIS KING	2013-10-09
001	2011-01-01	DIANE CHALMERS	2012-07-10
001	2010-01-01	PENSION PLANNERS NORTHWEST	2011-07-20

Plan Statistics for KING CYCLE GROUP 401(K) PLAN

401k plan membership statisitcs for KING CYCLE GROUP 401(K) PLAN

Measure Date Value
2016: KING CYCLE GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 83
Total of all active and inactive participants 2016-01-01 83
Total participants 2016-01-01 83
Number of participants with account balances 2016-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 12
2015: KING CYCLE GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 112
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 17
Total of all active and inactive participants 2015-01-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 129
Number of participants with account balances 2015-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 7
2014: KING CYCLE GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 124
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 16
Total of all active and inactive participants 2014-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 140
Number of participants with account balances 2014-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 4

Measure	Date	Value
2016: KING CYCLE GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	83
Total of all active and inactive participants	2016-01-01	83
Total participants	2016-01-01	83
Number of participants with account balances	2016-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	12
2015: KING CYCLE GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	112
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	17
Total of all active and inactive participants	2015-01-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	129
Number of participants with account balances	2015-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	7
2014: KING CYCLE GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	124
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	16
Total of all active and inactive participants	2014-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	140
Number of participants with account balances	2014-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	4

Financial Data on KING CYCLE GROUP 401(K) PLAN

Measure	Date	Value
2016 : KING CYCLE GROUP 401(K) PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$53
Total income from all sources (including contributions)	2016-12-31	$286,609
Total of all expenses incurred	2016-12-31	$74,954
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$64,342
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$169,372
Value of total assets at end of year	2016-12-31	$1,408,315
Value of total assets at beginning of year	2016-12-31	$1,196,607
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$10,612
Total interest from all sources	2016-12-31	$2,742
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$45,410
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$45,410
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$150,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$97,101
Participant contributions at end of year	2016-12-31	$69,757
Participant contributions at beginning of year	2016-12-31	$56,298
Participant contributions at end of year	2016-12-31	$22
Participant contributions at beginning of year	2016-12-31	$378
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$513
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$53
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$211,655
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,408,262
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,196,607
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,295,790
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,098,173
Interest on participant loans	2016-12-31	$2,742
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$41,182
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$38,784
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$69,085
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$71,758
Employer contributions (assets) at end of year	2016-12-31	$1,564
Employer contributions (assets) at beginning of year	2016-12-31	$2,974
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$64,342
Contract administrator fees	2016-12-31	$10,612
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MAGINNIS & CAREY LLP
Accountancy firm EIN	2016-12-31	930567723
2015 : KING CYCLE GROUP 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$186,825
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$413,088
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$401,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$193,862
Value of total assets at end of year	2015-12-31	$1,196,607
Value of total assets at beginning of year	2015-12-31	$1,422,870
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$11,352
Total interest from all sources	2015-12-31	$997
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$52,361
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$52,361
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$150,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$92,437
Participant contributions at end of year	2015-12-31	$378
Participant contributions at beginning of year	2015-12-31	$4,069
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$31,359
Assets. Loans (other than to participants) at end of year	2015-12-31	$56,298
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$17,103
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-226,263
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,196,607
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,422,870
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,098,173
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,340,884
Interest on participant loans	2015-12-31	$997
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$38,784
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$56,830
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-60,395
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$70,066
Employer contributions (assets) at end of year	2015-12-31	$2,974
Employer contributions (assets) at beginning of year	2015-12-31	$3,984
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$401,736
Contract administrator fees	2015-12-31	$11,352
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MAGINNIS & CAREY LLP
Accountancy firm EIN	2015-12-31	930567723
2014 : KING CYCLE GROUP 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$3,040
Total income from all sources (including contributions)	2014-12-31	$206,040
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$84,382
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$84,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$132,506
Value of total assets at end of year	2014-12-31	$1,422,870
Value of total assets at beginning of year	2014-12-31	$1,304,252
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$308
Total interest from all sources	2014-12-31	$970
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$63,931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$63,931
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$79,133
Participant contributions at end of year	2014-12-31	$4,069
Participant contributions at beginning of year	2014-12-31	$-75
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$8,451
Assets. Loans (other than to participants) at end of year	2014-12-31	$17,103
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$20,581
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$3,040
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$57,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$121,658
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,422,870
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,301,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,340,884
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,225,788
Interest on participant loans	2014-12-31	$970
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$56,830
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$8,633
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$44,922
Employer contributions (assets) at end of year	2014-12-31	$3,984
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$84,074
Contract administrator fees	2014-12-31	$308
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	Yes
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MAGINNIS & CAREY LLP
Accountancy firm EIN	2014-12-31	930567723

Form 5500 Responses for KING CYCLE GROUP 401(K) PLAN

2016: KING CYCLE GROUP 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: KING CYCLE GROUP 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: KING CYCLE GROUP 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371179-01

Policy instance

Insurance contract or identification number	371179-01
Number of Individuals Covered	13
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $172
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $172
Insurance broker organization code?	3
Insurance broker name	RBC CAPITAL MARKETS LLC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371179-01

Policy instance

Insurance contract or identification number	371179-01
Number of Individuals Covered	13
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $58
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $58
Insurance broker organization code?	3
Insurance broker name	RBC CAPITAL MARKETS LLC

Potentially related plans

KING CYCLES INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 113157416]

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Company Name:	KING CYCLE GROUP, INC.
Employer identification number (EIN):	770361801
NAIC Classification:	336990

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2003-12-23
Company Identification Number:	19144294
Legal Registered Office Address:	12276 NW BARNES ROAD PORTLAND United States of America (USA) 97229