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MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 401k Plan overview

Plan NameMEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN
Plan identification number 001

MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) 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.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

MEDICAL REVIEW INSTITUTE OF AMERICA has sponsored the creation of one or more 401k plans.

Company Name:MEDICAL REVIEW INSTITUTE OF AMERICA
Employer identification number (EIN):870515201
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL REVIEW INSTITUTE OF AMERICA 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
0012019-01-01
0012018-01-01DAVID BAUGH
0012017-01-01DAVID BAUGH
0012016-01-01WILLIAM LOW

Plan Statistics for MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN

401k plan membership statisitcs for MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN

Measure Date Value
2022: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01322
Total number of active participants reported on line 7a of the Form 55002022-01-01328
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-0140
Total of all active and inactive participants2022-01-01376
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01376
Number of participants with account balances2022-01-01370
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0122
2021: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01286
Total number of active participants reported on line 7a of the Form 55002021-01-01263
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-0137
Total of all active and inactive participants2021-01-01302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01302
Number of participants with account balances2021-01-01298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0126
2020: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01257
Total number of active participants reported on line 7a of the Form 55002020-01-01266
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0117
Total of all active and inactive participants2020-01-01284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01284
Number of participants with account balances2020-01-01281
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0110
2019: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01206
Total number of active participants reported on line 7a of the Form 55002019-01-01221
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0136
Total of all active and inactive participants2019-01-01257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01257
Number of participants with account balances2019-01-01250
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01171
Total number of active participants reported on line 7a of the Form 55002018-01-01191
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0114
Total of all active and inactive participants2018-01-01205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01205
Number of participants with account balances2018-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0110
2017: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01154
Total number of active participants reported on line 7a of the Form 55002017-01-01154
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-0111
Total of all active and inactive participants2017-01-01166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01166
Number of participants with account balances2017-01-01122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-013
2016: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01124
Total number of active participants reported on line 7a of the Form 55002016-01-01124
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 participants2016-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01138
Number of participants with account balances2016-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0113

Financial Data on MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN

Measure Date Value
2022 : MEDICAL REVIEW INSTITUTE OF AMERICA 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$57,254
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$125,049
Total income from all sources (including contributions)2022-12-31$-21,907
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,362,386
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,208,836
Expenses. Certain deemed distributions of participant loans2022-12-31$3,760
Value of total corrective distributions2022-12-31$57,254
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,828,161
Value of total assets at end of year2022-12-31$15,068,555
Value of total assets at beginning of year2022-12-31$17,520,643
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$92,536
Total interest from all sources2022-12-31$9,406
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$10,050
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
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$2,059,941
Participant contributions at end of year2022-12-31$222,510
Participant contributions at beginning of year2022-12-31$168,992
Assets. Other investments not covered elsewhere at end of year2022-12-31$890,357
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$596,371
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$340,663
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$57,254
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$125,049
Other income not declared elsewhere2022-12-31$6,705
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,384,293
Value of net assets at end of year (total assets less liabilities)2022-12-31$15,011,301
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$17,395,594
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$12,235,227
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$14,999,409
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$9,204
Value of interest in common/collective trusts at end of year2022-12-31$1,272,768
Value of interest in common/collective trusts at beginning of year2022-12-31$1,348,571
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$20,136
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$11,874
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$11,874
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$202
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,646,992
Net investment gain or loss from common/collective trusts2022-12-31$-219,187
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
Contributions received in cash from employer2022-12-31$427,557
Employer contributions (assets) at end of year2022-12-31$427,557
Employer contributions (assets) at beginning of year2022-12-31$395,426
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,208,836
Contract administrator fees2022-12-31$82,486
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 name2022-12-31TRAVELLER & COMPANY, LLC
Accountancy firm EIN2022-12-31870668060
2021 : MEDICAL REVIEW INSTITUTE OF AMERICA 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$125,049
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$58,820
Total income from all sources (including contributions)2021-12-31$5,351,210
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,004,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,792,974
Value of total corrective distributions2021-12-31$125,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,280,416
Value of total assets at end of year2021-12-31$17,520,643
Value of total assets at beginning of year2021-12-31$14,108,069
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$86,842
Total interest from all sources2021-12-31$7,685
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$7,188
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,005,316
Participant contributions at end of year2021-12-31$168,992
Participant contributions at beginning of year2021-12-31$144,298
Assets. Other investments not covered elsewhere at end of year2021-12-31$596,371
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$1,145,454
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$879,674
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$125,049
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$58,820
Other income not declared elsewhere2021-12-31$7,419
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,346,345
Value of net assets at end of year (total assets less liabilities)2021-12-31$17,395,594
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$14,049,249
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$14,999,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$11,386,255
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$7,591
Value of interest in common/collective trusts at end of year2021-12-31$1,348,571
Value of interest in common/collective trusts at beginning of year2021-12-31$1,004,480
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$11,874
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$2,853
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$2,853
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$94
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,856,079
Net investment gain or loss from common/collective trusts2021-12-31$199,611
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$395,426
Employer contributions (assets) at end of year2021-12-31$395,426
Employer contributions (assets) at beginning of year2021-12-31$424,729
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,792,974
Contract administrator fees2021-12-31$79,654
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 name2021-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2021-12-31202097679
2020 : MEDICAL REVIEW INSTITUTE OF AMERICA 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$58,820
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$895
Total income from all sources (including contributions)2020-12-31$4,105,383
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,285,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,156,686
Value of total corrective distributions2020-12-31$58,820
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,224,395
Value of total assets at end of year2020-12-31$14,108,069
Value of total assets at beginning of year2020-12-31$11,230,169
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$69,902
Total interest from all sources2020-12-31$8,239
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$8,658
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
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$1,761,230
Participant contributions at end of year2020-12-31$144,298
Participant contributions at beginning of year2020-12-31$154,519
Assets. Other investments not covered elsewhere at end of year2020-12-31$1,145,454
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$333,930
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$38,436
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$58,820
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$895
Other income not declared elsewhere2020-12-31$5,350
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,819,975
Value of net assets at end of year (total assets less liabilities)2020-12-31$14,049,249
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$11,229,274
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$11,386,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$9,481,357
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$8,172
Value of interest in common/collective trusts at end of year2020-12-31$1,004,480
Value of interest in common/collective trusts at beginning of year2020-12-31$652,879
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$2,853
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$31,538
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$31,538
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$67
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,768,212
Net investment gain or loss from common/collective trusts2020-12-31$99,187
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$424,729
Employer contributions (assets) at end of year2020-12-31$424,729
Employer contributions (assets) at beginning of year2020-12-31$575,946
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,156,686
Contract administrator fees2020-12-31$61,244
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 name2020-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2020-12-31202097679
2019 : MEDICAL REVIEW INSTITUTE OF AMERICA 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$895
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$59,705
Total income from all sources (including contributions)2019-12-31$3,900,731
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$712,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$692,761
Value of total corrective distributions2019-12-31$895
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,947,344
Value of total assets at end of year2019-12-31$11,230,169
Value of total assets at beginning of year2019-12-31$8,100,528
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$18,624
Total interest from all sources2019-12-31$9,253
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
Administrative expenses professional fees incurred2019-12-31$12,220
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
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$1,308,874
Participant contributions at end of year2019-12-31$154,519
Participant contributions at beginning of year2019-12-31$189,595
Assets. Other investments not covered elsewhere at end of year2019-12-31$333,930
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$62,524
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$895
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$59,705
Other income not declared elsewhere2019-12-31$2,381
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash 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$3,188,451
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,229,274
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$8,040,823
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$9,481,357
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$7,544,585
Interest on participant loans2019-12-31$8,932
Value of interest in common/collective trusts at end of year2019-12-31$652,879
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$31,538
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$16,935
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$16,935
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$321
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$101
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,079,708
Net investment gain/loss from pooled separate accounts2019-12-31$85,217
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
Contributions received in cash from employer2019-12-31$575,946
Employer contributions (assets) at end of year2019-12-31$575,946
Employer contributions (assets) at beginning of year2019-12-31$349,312
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$692,761
Contract administrator fees2019-12-31$6,404
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2019-12-31202097679
2018 : MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$59,705
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$87,155
Total income from all sources (including contributions)2018-12-31$798,952
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$476,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$392,109
Value of total corrective distributions2018-12-31$50,467
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,385,937
Value of total assets at end of year2018-12-31$8,100,528
Value of total assets at beginning of year2018-12-31$7,805,745
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$34,143
Total interest from all sources2018-12-31$8,643
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$34,879
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$822,619
Participant contributions at end of year2018-12-31$189,595
Participant contributions at beginning of year2018-12-31$186,376
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$214,006
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$59,705
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$87,155
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$322,233
Value of net assets at end of year (total assets less liabilities)2018-12-31$8,040,823
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$7,718,590
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$7,544,585
Value of interest in pooled separate accounts at beginning of year2018-12-31$7,618,673
Interest on participant loans2018-12-31$8,643
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$16,935
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$696
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$696
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$101
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-595,628
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$349,312
Employer contributions (assets) at end of year2018-12-31$349,312
Employer contributions (assets) at beginning of year2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$392,109
Contract administrator fees2018-12-31$-736
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2018-12-31202097679
2017 : MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$87,155
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$86,124
Total income from all sources (including contributions)2017-12-31$2,091,613
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$250,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$133,105
Value of total corrective distributions2017-12-31$77,916
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,027,778
Value of total assets at end of year2017-12-31$7,805,745
Value of total assets at beginning of year2017-12-31$5,963,444
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$39,322
Total interest from all sources2017-12-31$7,972
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$37,952
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$702,178
Participant contributions at end of year2017-12-31$186,376
Participant contributions at beginning of year2017-12-31$159,706
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$40,600
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$87,155
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$86,124
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,841,270
Value of net assets at end of year (total assets less liabilities)2017-12-31$7,718,590
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$5,877,320
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$7,618,673
Value of interest in pooled separate accounts at beginning of year2017-12-31$5,467,069
Interest on participant loans2017-12-31$7,972
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$696
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$9,059
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$9,059
Net investment gain/loss from pooled separate accounts2017-12-31$1,055,863
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$285,000
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$327,610
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$133,105
Contract administrator fees2017-12-31$1,370
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2017-12-31202097679
2016 : MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$86,124
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$102,148
Total income from all sources (including contributions)2016-12-31$1,275,125
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$504,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$382,723
Value of total corrective distributions2016-12-31$86,124
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$933,875
Value of total assets at end of year2016-12-31$5,963,444
Value of total assets at beginning of year2016-12-31$5,209,081
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$35,891
Total interest from all sources2016-12-31$6,605
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$32,955
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$599,785
Participant contributions at end of year2016-12-31$159,706
Participant contributions at beginning of year2016-12-31$145,397
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$6,480
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$86,124
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$102,148
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$770,387
Value of net assets at end of year (total assets less liabilities)2016-12-31$5,877,320
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$5,106,933
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$5,467,069
Value of interest in pooled separate accounts at beginning of year2016-12-31$4,728,652
Interest on participant loans2016-12-31$6,605
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$9,059
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$5,732
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$5,732
Net investment gain/loss from pooled separate accounts2016-12-31$334,645
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$327,610
Employer contributions (assets) at end of year2016-12-31$327,610
Employer contributions (assets) at beginning of year2016-12-31$329,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$382,723
Contract administrator fees2016-12-31$2,936
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31TERRY, PRICE & WUNDERLI, LLC
Accountancy firm EIN2016-12-31202097679

Form 5500 Responses for MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) PLAN

2022: MEDICAL REVIEW INSTITUTE OF AMERICA 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 benefit arrangement – InsuranceYes
2021: MEDICAL REVIEW INSTITUTE OF AMERICA 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 benefit arrangement – InsuranceYes
2020: MEDICAL REVIEW INSTITUTE OF AMERICA 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 benefit arrangement – InsuranceYes
2019: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) 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 benefit arrangement – InsuranceYes
2018: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) 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 benefit arrangement – InsuranceYes
2017: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) 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 benefit arrangement – InsuranceYes
2016: MEDICAL REVIEW INSTITUTE OF AMERICA 401(K) 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number506014-01
Policy instance 1
Insurance contract or identification number506014-01
Number of Individuals Covered106
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 number506014-01
Policy instance 1
Insurance contract or identification number506014-01
Number of Individuals Covered101
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 number506014-01
Policy instance 1
Insurance contract or identification number506014-01
Number of Individuals Covered88
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number93925
Policy instance 1
Insurance contract or identification number93925
Number of Individuals Covered0
Insurance policy start date2019-10-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,848
Total amount of fees paid to insurance companyUSD $6,787
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,848
Amount paid for insurance broker fees6787
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number506014-01
Policy instance 2
Insurance contract or identification number506014-01
Number of Individuals Covered105
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number93925
Policy instance 1
Insurance contract or identification number93925
Number of Individuals Covered138
Insurance policy start date2018-10-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $36,137
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees36137
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number93925
Policy instance 1
Insurance contract or identification number93925
Number of Individuals Covered126
Insurance policy start date2017-10-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $37,952
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees37952
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
Insurance broker nameWC ADMINISTRATORS, LLC

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