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FIBERS, INC. 401(K) PLAN 401k Plan overview

Plan NameFIBERS, INC. 401(K) PLAN
Plan identification number 001

FIBERS, INC. 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.
  • 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

FIBERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:FIBERS, INC.
Employer identification number (EIN):870640816
NAIC Classification:442210
NAIC Description:Floor Covering Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIBERS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01ROBERT CRAWFORD2023-06-22
0012021-01-01ROBERT CRAWFORD2022-06-28
0012020-01-01ROBERT CRAWFORD2021-04-28
0012019-01-01
0012018-01-01PAUL RICHARDSON
0012017-01-01PAUL RICHARDSON
0012016-01-01PAUL RICHARDSON
0012015-01-01PAUL RICHARDSON PAUL RICHARDSON2016-05-25
0012014-01-01PAUL RICHARDSON PAUL RICHARDSON2015-06-05
0012013-01-01PAUL RICAHRDSON PAUL RICAHRDSON2014-07-01
0012012-01-01PAUL RICHARDSON PAUL RICHARDSON2013-04-23
0012011-01-01PAUL RICHARDSON PAUL RICHARDSON2012-06-12
0012010-01-01PAUL RICHARDSON PAUL RICHARDSON2011-07-01
0012009-01-01PAUL RICHARDSON PAUL RICHARDSON2010-07-28

Plan Statistics for FIBERS, INC. 401(K) PLAN

401k plan membership statisitcs for FIBERS, INC. 401(K) PLAN

Measure Date Value
2019: FIBERS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0110
Total number of active participants reported on line 7a of the Form 55002019-01-019
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0110
Number of participants with account balances2019-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: FIBERS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0111
Total number of active participants reported on line 7a of the Form 55002018-01-018
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0110
Number of participants with account balances2018-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: FIBERS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0113
Total number of active participants reported on line 7a of the Form 55002017-01-0112
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0113
Number of participants with account balances2017-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: FIBERS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0111
Total number of active participants reported on line 7a of the Form 55002016-01-0111
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0112
Number of participants with account balances2016-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: FIBERS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-018
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-019
Number of participants with account balances2015-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: FIBERS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-017
Total number of active participants reported on line 7a of the Form 55002014-01-016
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-017
Number of participants with account balances2014-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: FIBERS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017
Total number of active participants reported on line 7a of the Form 55002013-01-016
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-017
Number of participants with account balances2013-01-016
2012: FIBERS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-017
Total number of active participants reported on line 7a of the Form 55002012-01-016
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-017
Number of participants with account balances2012-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: FIBERS, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-019
Total number of active participants reported on line 7a of the Form 55002011-01-017
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-017
Number of participants with account balances2011-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: FIBERS, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-019
Total number of active participants reported on line 7a of the Form 55002010-01-018
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-011
Total of all active and inactive participants2010-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-019
Number of participants with account balances2010-01-016
2009: FIBERS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-019
Total number of active participants reported on line 7a of the Form 55002009-01-018
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-018
Number of participants with account balances2009-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on FIBERS, INC. 401(K) PLAN

Measure Date Value
2019 : FIBERS, INC. 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$175,854
Expenses. Total of all expenses incurred2019-12-31$10,333
Benefits paid (including direct rollovers)2019-12-31$4,444
Total plan assets at end of year2019-12-31$638,211
Total plan assets at beginning of year2019-12-31$472,690
Value of fidelity bond covering the plan2019-12-31$70,000
Total contributions received or receivable from participants2019-12-31$41,209
Other income received2019-12-31$120,427
Net income (gross income less expenses)2019-12-31$165,521
Net plan assets at end of year (total assets less liabilities)2019-12-31$638,211
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$472,690
Assets. Value of participant loans2019-12-31$2,331
Total contributions received or receivable from employer(s)2019-12-31$14,218
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,889
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : FIBERS, INC. 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$31,547
Expenses. Total of all expenses incurred2018-12-31$20,852
Benefits paid (including direct rollovers)2018-12-31$15,457
Total plan assets at end of year2018-12-31$472,690
Total plan assets at beginning of year2018-12-31$461,995
Value of fidelity bond covering the plan2018-12-31$50,000
Total contributions received or receivable from participants2018-12-31$41,922
Expenses. Other expenses not covered elsewhere2018-12-31$5,395
Other income received2018-12-31$-24,411
Net income (gross income less expenses)2018-12-31$10,695
Net plan assets at end of year (total assets less liabilities)2018-12-31$472,690
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$461,995
Assets. Value of participant loans2018-12-31$23,549
Total contributions received or receivable from employer(s)2018-12-31$14,036
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : FIBERS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$138,292
Expenses. Total of all expenses incurred2017-12-31$7,854
Benefits paid (including direct rollovers)2017-12-31$3,828
Total plan assets at end of year2017-12-31$461,995
Total plan assets at beginning of year2017-12-31$331,557
Value of fidelity bond covering the plan2017-12-31$50,000
Total contributions received or receivable from participants2017-12-31$35,567
Other income received2017-12-31$87,819
Net income (gross income less expenses)2017-12-31$130,438
Net plan assets at end of year (total assets less liabilities)2017-12-31$461,995
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$331,557
Assets. Value of participant loans2017-12-31$5,358
Total contributions received or receivable from employer(s)2017-12-31$14,906
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$4,026
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : FIBERS, INC. 401(K) PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-12-31$1,422
Total income from all sources2016-12-31$56,880
Expenses. Total of all expenses incurred2016-12-31$257
Benefits paid (including direct rollovers)2016-12-31$257
Total plan assets at end of year2016-12-31$331,557
Total plan assets at beginning of year2016-12-31$276,356
Value of fidelity bond covering the plan2016-12-31$40,000
Total contributions received or receivable from participants2016-12-31$32,521
Other income received2016-12-31$8,458
Net income (gross income less expenses)2016-12-31$56,623
Net plan assets at end of year (total assets less liabilities)2016-12-31$331,557
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$274,934
Assets. Value of participant loans2016-12-31$4,773
Total contributions received or receivable from employer(s)2016-12-31$15,901
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : FIBERS, INC. 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$1,422
Total plan liabilities at beginning of year2015-12-31$1,250
Total income from all sources2015-12-31$30,405
Expenses. Total of all expenses incurred2015-12-31$1,422
Total plan assets at end of year2015-12-31$276,356
Total plan assets at beginning of year2015-12-31$247,201
Value of fidelity bond covering the plan2015-12-31$30,000
Total contributions received or receivable from participants2015-12-31$25,789
Other income received2015-12-31$-8,017
Net income (gross income less expenses)2015-12-31$28,983
Net plan assets at end of year (total assets less liabilities)2015-12-31$274,934
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$245,951
Assets. Value of participant loans2015-12-31$4,507
Total contributions received or receivable from employer(s)2015-12-31$12,633
Value of corrective distributions2015-12-31$1,422
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : FIBERS, INC. 401(K) PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$1,250
Total plan liabilities at beginning of year2014-12-31$1,539
Total income from all sources2014-12-31$47,209
Expenses. Total of all expenses incurred2014-12-31$1,250
Total plan assets at end of year2014-12-31$247,201
Total plan assets at beginning of year2014-12-31$201,531
Value of fidelity bond covering the plan2014-12-31$30,000
Total contributions received or receivable from participants2014-12-31$25,053
Other income received2014-12-31$10,327
Net income (gross income less expenses)2014-12-31$45,959
Net plan assets at end of year (total assets less liabilities)2014-12-31$245,951
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$199,992
Assets. Value of participant loans2014-12-31$3,933
Total contributions received or receivable from employer(s)2014-12-31$11,829
Value of corrective distributions2014-12-31$1,250
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : FIBERS, INC. 401(K) PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$1,539
Total income from all sources2013-12-31$62,356
Expenses. Total of all expenses incurred2013-12-31$1,564
Total plan assets at end of year2013-12-31$201,531
Total plan assets at beginning of year2013-12-31$139,200
Value of fidelity bond covering the plan2013-12-31$30,000
Total contributions received or receivable from participants2013-12-31$24,140
Other income received2013-12-31$27,382
Net income (gross income less expenses)2013-12-31$60,792
Net plan assets at end of year (total assets less liabilities)2013-12-31$199,992
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$139,200
Assets. Value of participant loans2013-12-31$3,078
Total contributions received or receivable from employer(s)2013-12-31$10,834
Value of corrective distributions2013-12-31$1,539
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$25
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : FIBERS, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources2012-12-31$45,546
Expenses. Total of all expenses incurred2012-12-31$3,795
Total plan assets at end of year2012-12-31$139,200
Total plan assets at beginning of year2012-12-31$97,449
Value of fidelity bond covering the plan2012-12-31$20,000
Total contributions received or receivable from participants2012-12-31$23,082
Other income received2012-12-31$10,583
Net income (gross income less expenses)2012-12-31$41,751
Net plan assets at end of year (total assets less liabilities)2012-12-31$139,200
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$97,449
Assets. Value of participant loans2012-12-31$2,522
Total contributions received or receivable from employer(s)2012-12-31$11,881
Value of certain deemed distributions of participant loans2012-12-31$3,720
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$75
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : FIBERS, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources2011-12-31$29,687
Expenses. Total of all expenses incurred2011-12-31$15,114
Benefits paid (including direct rollovers)2011-12-31$14,964
Total plan assets at end of year2011-12-31$97,449
Total plan assets at beginning of year2011-12-31$82,876
Value of fidelity bond covering the plan2011-12-31$10,000
Total contributions received or receivable from participants2011-12-31$20,415
Other income received2011-12-31$-2,136
Net income (gross income less expenses)2011-12-31$14,573
Net plan assets at end of year (total assets less liabilities)2011-12-31$97,449
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$82,876
Assets. Value of participant loans2011-12-31$5,991
Total contributions received or receivable from employer(s)2011-12-31$11,408
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : FIBERS, INC. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$38,346
Expenses. Total of all expenses incurred2010-12-31$0
Total plan assets at end of year2010-12-31$82,876
Total plan assets at beginning of year2010-12-31$44,530
Value of fidelity bond covering the plan2010-12-31$10,000
Total contributions received or receivable from participants2010-12-31$19,019
Other income received2010-12-31$9,827
Net income (gross income less expenses)2010-12-31$38,346
Net plan assets at end of year (total assets less liabilities)2010-12-31$82,876
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$44,530
Total contributions received or receivable from employer(s)2010-12-31$9,500
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : FIBERS, INC. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for FIBERS, INC. 401(K) PLAN

2019: FIBERS, INC. 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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: FIBERS, INC. 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: FIBERS, INC. 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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: FIBERS, INC. 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FIBERS, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FIBERS, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: FIBERS, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FIBERS, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FIBERS, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: FIBERS, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: FIBERS, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan 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 number374327-01
Policy instance 1
Insurance contract or identification number374327-01
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number374327-01
Policy instance 1
Insurance contract or identification number374327-01
Number of Individuals Covered0
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
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
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number374327-01
Policy instance 1
Insurance contract or identification number374327-01
Number of Individuals Covered9
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?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
Insurance broker organization code?3
Insurance broker nameDAVID BOYD WAGTAFF

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