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OPEN MORTGAGE 401(K) PLAN 401k Plan overview

Plan NameOPEN MORTGAGE 401(K) PLAN
Plan identification number 001

OPEN MORTGAGE 401(K) PLAN 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.
  • 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

OPEN MORTGAGE, LLC has sponsored the creation of one or more 401k plans.

Company Name:OPEN MORTGAGE, LLC
Employer identification number (EIN):830345906
NAIC Classification:522292
NAIC Description:Real Estate Credit

Additional information about OPEN MORTGAGE, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2003-01-05
Company Identification Number: 0800159637
Legal Registered Office Address: 5316 W HIGHWAY 290 STE 220

AUSTIN
United States of America (USA)
78735

More information about OPEN MORTGAGE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPEN MORTGAGE 401(K) 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
0012019-11-01

Plan Statistics for OPEN MORTGAGE 401(K) PLAN

401k plan membership statisitcs for OPEN MORTGAGE 401(K) PLAN

Measure Date Value
2022: OPEN MORTGAGE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01504
Total number of active participants reported on line 7a of the Form 55002022-01-01311
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-01173
Total of all active and inactive participants2022-01-01492
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01492
Number of participants with account balances2022-01-01478
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0149
2021: OPEN MORTGAGE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01422
Total number of active participants reported on line 7a of the Form 55002021-01-01407
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-0179
Total of all active and inactive participants2021-01-01489
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-01490
Number of participants with account balances2021-01-01482
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0125
2020: OPEN MORTGAGE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01361
Total number of active participants reported on line 7a of the Form 55002020-01-01329
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-0122
Total of all active and inactive participants2020-01-01354
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01354
Number of participants with account balances2020-01-01338
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: OPEN MORTGAGE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-01334
Total number of active participants reported on line 7a of the Form 55002019-11-01329
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-01329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-11-010
Total participants2019-11-01329
Number of participants with account balances2019-11-01120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-11-010

Financial Data on OPEN MORTGAGE 401(K) PLAN

Measure Date Value
2022 : OPEN MORTGAGE 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$1,409,397
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,000,847
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$934,359
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,260,587
Value of total assets at end of year2022-12-31$5,568,217
Value of total assets at beginning of year2022-12-31$5,159,667
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$66,488
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$80,454
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$80,454
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$250,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,071,800
Participant contributions at end of year2022-12-31$2,427
Participant contributions at beginning of year2022-12-31$2,549
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$188,787
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$408,550
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,568,217
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,159,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$2,156,888
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$2,094,895
Value of interest in common/collective trusts at end of year2022-12-31$3,333,435
Value of interest in common/collective trusts at beginning of year2022-12-31$2,932,137
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$75,467
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$17,971
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-463,620
Net investment gain or loss from common/collective trusts2022-12-31$-468,024
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$112,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$934,359
Contract administrator fees2022-12-31$66,488
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WEAVER AND TIDWELL, LLP
Accountancy firm EIN2022-12-31750786316
2021 : OPEN MORTGAGE 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$336
Total income from all sources (including contributions)2021-12-31$3,344,446
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$842,730
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$808,653
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,834,247
Value of total assets at end of year2021-12-31$5,159,667
Value of total assets at beginning of year2021-12-31$2,658,287
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$34,077
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$65,558
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$65,558
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,361,871
Participant contributions at end of year2021-12-31$2,549
Participant contributions at beginning of year2021-12-31$85,910
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$360,261
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$336
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,501,716
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,159,667
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,657,951
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$2,094,895
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,136,080
Value of interest in common/collective trusts at end of year2021-12-31$2,932,137
Value of interest in common/collective trusts at beginning of year2021-12-31$1,298,795
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$17,971
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$11,324
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$195,084
Net investment gain or loss from common/collective trusts2021-12-31$249,557
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$112,115
Employer contributions (assets) at end of year2021-12-31$112,115
Employer contributions (assets) at beginning of year2021-12-31$126,178
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$808,653
Contract administrator fees2021-12-31$34,077
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WEAVER AND TIDWELL, LLP
Accountancy firm EIN2021-12-31750786316
2020 : OPEN MORTGAGE 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$336
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$549
Total income from all sources (including contributions)2020-12-31$2,623,614
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$219,115
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$212,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,292,545
Value of total assets at end of year2020-12-31$2,658,287
Value of total assets at beginning of year2020-12-31$254,001
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,969
Total interest from all sources2020-12-31$84
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$21,607
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$21,607
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,872,699
Participant contributions at end of year2020-12-31$85,910
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$293,668
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$336
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$549
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,404,499
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,657,951
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$253,452
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$1,136,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$253,491
Interest earned on other investments2020-12-31$84
Value of interest in common/collective trusts at end of year2020-12-31$1,298,795
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$11,324
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$510
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$130,789
Net investment gain or loss from common/collective trusts2020-12-31$178,589
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$126,178
Employer contributions (assets) at end of year2020-12-31$126,178
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$212,146
Contract administrator fees2020-12-31$6,969
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31WEAVER AND TIDWELL, LLP
Accountancy firm EIN2020-12-31750786316
2019 : OPEN MORTGAGE 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$549
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$253,452
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$249,248
Value of total assets at end of year2019-12-31$254,001
Value of total assets at beginning of year2019-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$249,248
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$549
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$253,452
Value of net assets at end of year (total assets less liabilities)2019-12-31$253,452
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$253,491
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$510
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$4,204
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No

Form 5500 Responses for OPEN MORTGAGE 401(K) PLAN

2022: OPEN MORTGAGE 401(K) 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: OPEN MORTGAGE 401(K) 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: OPEN MORTGAGE 401(K) 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: OPEN MORTGAGE 401(K) PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01First time form 5500 has been submittedYes
2019-11-01Submission has been amendedNo
2019-11-01This submission is the final filingNo
2019-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-11-01Plan is a collectively bargained planNo
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – TrustYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan 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 number507807-01
Policy instance 1
Insurance contract or identification number507807-01
Number of Individuals Covered39
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number507807-01
Policy instance 1
Insurance contract or identification number507807-01
Number of Individuals Covered13
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number507807-01
Policy instance 1
Insurance contract or identification number507807-01
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number507807-01
Policy instance 1
Insurance contract or identification number507807-01
Number of Individuals Covered6
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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