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THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameTHE JEWELERS, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 002

THE JEWELERS, INC. 401(K) PROFIT SHARING 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

THE JEWELERS INC has sponsored the creation of one or more 401k plans.

Company Name:THE JEWELERS INC
Employer identification number (EIN):880138626
NAIC Classification:448310
NAIC Description:Jewelry Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-01MORDECHAI YERUSHALMI2018-10-16
0022016-01-01MORDECHAI YERUSHALMI
0022015-01-01MORDECHAI YERUSHALMI
0022014-01-01MORDECHAI YERUSHALMI
0022013-01-01MORDECHAI YERUSHALMI
0022012-01-01MORDECHAI YERUSHALMI
0022011-01-01MORDECHAI YERUSHALMI
0022010-01-01MORDECHAI YERUSHALMI
0022009-01-01MORDECHAI YERUSHALMI

Plan Statistics for THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01118
Total number of active participants reported on line 7a of the Form 55002016-01-0180
Number of retired or separated participants receiving benefits2016-01-0135
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01115
Number of participants with account balances2016-01-0173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01110
Total number of active participants reported on line 7a of the Form 55002015-01-0174
Number of retired or separated participants receiving benefits2015-01-0133
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01107
Number of participants with account balances2015-01-0169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01122
Total number of active participants reported on line 7a of the Form 55002014-01-0174
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0128
Total of all active and inactive participants2014-01-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01102
Number of participants with account balances2014-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01119
Total number of active participants reported on line 7a of the Form 55002013-01-0183
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0129
Total of all active and inactive participants2013-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01112
Number of participants with account balances2013-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01125
Total number of active participants reported on line 7a of the Form 55002012-01-0182
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0129
Total of all active and inactive participants2012-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01111
Number of participants with account balances2012-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01125
Total number of active participants reported on line 7a of the Form 55002011-01-0183
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0127
Total of all active and inactive participants2011-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01110
Number of participants with account balances2011-01-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01133
Total number of active participants reported on line 7a of the Form 55002010-01-0192
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0130
Total of all active and inactive participants2010-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01122
Number of participants with account balances2010-01-0179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01129
Total number of active participants reported on line 7a of the Form 55002009-01-0193
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0125
Total of all active and inactive participants2009-01-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01118
Number of participants with account balances2009-01-0182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2016 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$57,035
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$53,861
Total income from all sources (including contributions)2016-12-31$537,692
Total of all expenses incurred2016-12-31$228,630
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$189,291
Value of total corrective distributions2016-12-31$280
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$183,045
Value of total assets at end of year2016-12-31$4,281,462
Value of total assets at beginning of year2016-12-31$3,969,226
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$39,059
Total income from rents2016-12-31$67,145
Total interest from all sources2016-12-31$91,013
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Assets. Real estate other than employer real property at end of year2016-12-31$915,000
Assets. Real estate other than employer real property at beginning of year2016-12-31$800,000
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
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$181,594
Participant contributions at end of year2016-12-31$257,705
Participant contributions at beginning of year2016-12-31$221,976
Participant contributions at end of year2016-12-31$11,117
Participant contributions at beginning of year2016-12-31$8,320
Assets. Other investments not covered elsewhere at end of year2016-12-31$3,702
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$3,739
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$57,035
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$53,861
Administrative expenses (other) incurred2016-12-31$33,927
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$309,062
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,224,427
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,915,365
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 registered invesment companies (eg mutual funds) at end of year2016-12-31$2,757,800
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,636,546
Interest on participant loans2016-12-31$12,557
Interest earned on other investments2016-12-31$78,456
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$41,679
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$8,424
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$8,424
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$289,694
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$287,314
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$196,489
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 contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,451
Employer contributions (assets) at end of year2016-12-31$4,765
Employer contributions (assets) at beginning of year2016-12-31$2,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$189,291
Contract administrator fees2016-12-31$5,132
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)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2016-12-31481266910
2015 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$53,861
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$26,821
Total income from all sources (including contributions)2015-12-31$293,853
Total of all expenses incurred2015-12-31$287,825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$179,786
Value of total corrective distributions2015-12-31$53,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$199,710
Value of total assets at end of year2015-12-31$3,969,226
Value of total assets at beginning of year2015-12-31$3,936,158
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$54,928
Total income from rents2015-12-31$67,268
Total interest from all sources2015-12-31$196,202
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Assets. Real estate other than employer real property at end of year2015-12-31$800,000
Assets. Real estate other than employer real property at beginning of year2015-12-31$800,000
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$199,205
Participant contributions at end of year2015-12-31$221,976
Participant contributions at beginning of year2015-12-31$239,897
Participant contributions at end of year2015-12-31$8,320
Participant contributions at beginning of year2015-12-31$6,647
Assets. Other investments not covered elsewhere at end of year2015-12-31$3,739
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$3,821
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$1,410
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$53,861
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$26,821
Administrative expenses (other) incurred2015-12-31$43,577
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$6,028
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,915,365
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,909,337
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,636,546
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,652,688
Interest on participant loans2015-12-31$11,967
Interest earned on other investments2015-12-31$184,235
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$8,424
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$24,640
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$24,640
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$287,314
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$207,055
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-169,327
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$505
Employer contributions (assets) at end of year2015-12-31$2,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$179,786
Contract administrator fees2015-12-31$11,351
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2015-12-31481266910
2014 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$26,821
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$57,412
Total income from all sources (including contributions)2014-12-31$569,357
Total of all expenses incurred2014-12-31$916,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$845,133
Value of total corrective distributions2014-12-31$26,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$161,946
Value of total assets at end of year2014-12-31$3,936,158
Value of total assets at beginning of year2014-12-31$4,313,684
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$45,088
Total income from rents2014-12-31$69,445
Total interest from all sources2014-12-31$217,392
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Assets. Real estate other than employer real property at end of year2014-12-31$800,000
Assets. Real estate other than employer real property at beginning of year2014-12-31$670,000
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$161,946
Participant contributions at end of year2014-12-31$239,897
Participant contributions at beginning of year2014-12-31$281,760
Participant contributions at end of year2014-12-31$6,647
Participant contributions at beginning of year2014-12-31$8,382
Assets. Other investments not covered elsewhere at end of year2014-12-31$3,821
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$3,680
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$1,410
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$26,821
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$57,412
Administrative expenses (other) incurred2014-12-31$33,617
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-346,935
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,909,337
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$4,256,272
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,652,688
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,838,743
Interest on participant loans2014-12-31$14,548
Interest earned on other investments2014-12-31$202,844
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$24,640
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$17,837
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$17,837
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$207,055
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$492,974
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$120,574
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$845,133
Contract administrator fees2014-12-31$11,471
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2014-12-31481266910
2013 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$57,412
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$43,997
Total income from all sources (including contributions)2013-12-31$719,691
Total of all expenses incurred2013-12-31$339,707
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$221,289
Value of total corrective distributions2013-12-31$61,451
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$164,050
Value of total assets at end of year2013-12-31$4,313,684
Value of total assets at beginning of year2013-12-31$3,920,285
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$56,967
Total income from rents2013-12-31$58,053
Total interest from all sources2013-12-31$184,060
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Assets. Real estate other than employer real property at end of year2013-12-31$670,000
Assets. Real estate other than employer real property at beginning of year2013-12-31$670,000
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$400,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$164,050
Participant contributions at end of year2013-12-31$281,760
Participant contributions at beginning of year2013-12-31$303,788
Participant contributions at end of year2013-12-31$8,382
Participant contributions at beginning of year2013-12-31$6,838
Assets. Other investments not covered elsewhere at end of year2013-12-31$3,680
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$4,840
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$308
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$4,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$57,412
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$43,997
Administrative expenses (other) incurred2013-12-31$47,291
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$379,984
Value of net assets at end of year (total assets less liabilities)2013-12-31$4,256,272
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$3,876,288
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,838,743
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,582,964
Interest on participant loans2013-12-31$16,302
Interest earned on other investments2013-12-31$167,758
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$17,837
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$6,801
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$6,801
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$492,974
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$340,455
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$313,528
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$221,289
Contract administrator fees2013-12-31$9,676
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2013-12-31481266910
2012 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$-4,500
Total unrealized appreciation/depreciation of assets2012-12-31$-4,500
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$43,997
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$750
Total income from all sources (including contributions)2012-12-31$521,299
Total of all expenses incurred2012-12-31$160,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$73,251
Value of total corrective distributions2012-12-31$38,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$100,876
Value of total assets at end of year2012-12-31$3,920,285
Value of total assets at beginning of year2012-12-31$3,516,697
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$49,415
Total income from rents2012-12-31$67,897
Total interest from all sources2012-12-31$22,888
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Assets. Real estate other than employer real property at end of year2012-12-31$670,000
Assets. Real estate other than employer real property at beginning of year2012-12-31$670,000
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$100,876
Participant contributions at end of year2012-12-31$303,788
Participant contributions at beginning of year2012-12-31$313,821
Participant contributions at end of year2012-12-31$6,838
Participant contributions at beginning of year2012-12-31$11,039
Assets. Other investments not covered elsewhere at end of year2012-12-31$4,840
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$5,146
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$4,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$7,401
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$43,997
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$750
Administrative expenses (other) incurred2012-12-31$43,941
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$360,341
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,876,288
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,515,947
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,582,964
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,318,109
Interest on participant loans2012-12-31$19,474
Interest earned on other investments2012-12-31$3,414
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$6,801
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$7,446
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$7,446
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$340,455
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$183,735
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$334,138
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$73,251
Contract administrator fees2012-12-31$5,474
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2012-12-31481266910
2011 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$-81,450
Total unrealized appreciation/depreciation of assets2011-12-31$-81,450
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$750
Total income from all sources (including contributions)2011-12-31$24,055
Total of all expenses incurred2011-12-31$746,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$646,027
Value of total corrective distributions2011-12-31$41,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$143,338
Value of total assets at end of year2011-12-31$3,516,697
Value of total assets at beginning of year2011-12-31$4,239,416
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$59,052
Total income from rents2011-12-31$63,533
Total interest from all sources2011-12-31$46,216
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Assets. Real estate other than employer real property at end of year2011-12-31$670,000
Assets. Real estate other than employer real property at beginning of year2011-12-31$725,000
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$400,000
If this is an individual account plan, was there a blackout period2011-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$143,338
Participant contributions at end of year2011-12-31$313,821
Participant contributions at beginning of year2011-12-31$332,231
Participant contributions at end of year2011-12-31$11,039
Assets. Other investments not covered elsewhere at end of year2011-12-31$5,146
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$5,146
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$7,401
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$750
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$750
Administrative expenses (other) incurred2011-12-31$26,477
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$6,203
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-722,719
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,515,947
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,238,666
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,318,109
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,091,882
Interest on participant loans2011-12-31$18,721
Interest earned on other investments2011-12-31$27,172
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$7,446
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$36,840
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$36,840
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$323
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$183,735
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$42,114
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-147,582
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$646,027
Contract administrator fees2011-12-31$32,575
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31Yes
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31RICH WIGHTMAN & COMPANY, CPAS, LLC
Accountancy firm EIN2011-12-31481266910
2010 : THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$950
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$647,632
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$425,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$287,785
Expenses. Certain deemed distributions of participant loans2010-12-31$5,453
Value of total corrective distributions2010-12-31$50,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$153,578
Value of total assets at end of year2010-12-31$4,239,416
Value of total assets at beginning of year2010-12-31$4,017,774
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$82,536
Total interest from all sources2010-12-31$91,184
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
Assets. Real estate other than employer real property at end of year2010-12-31$725,000
Assets. Real estate other than employer real property at beginning of year2010-12-31$725,000
Administrative expenses professional fees incurred2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$153,578
Participant contributions at end of year2010-12-31$332,231
Participant contributions at beginning of year2010-12-31$297,218
Assets. Other investments not covered elsewhere at end of year2010-12-31$5,146
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$8,007
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$750
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$950
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$44,513
Total non interest bearing cash at end of year2010-12-31$6,203
Total non interest bearing cash at beginning of year2010-12-31$6,203
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$221,842
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,238,666
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$4,016,824
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,091,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,899,143
Interest on participant loans2010-12-31$17,819
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$71,893
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$36,840
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$26,799
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$26,799
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,472
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$42,114
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$53,735
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$402,870
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31Yes
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$1,669
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$287,785
Contract administrator fees2010-12-31$38,023
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31RICH WIGHTMAN & COMPANY, CPS, LLC
Accountancy firm EIN2010-12-31481266910
2009 : THE JEWELERS, INC. 401(K) PROFIT SHARING 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 THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN

2016: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: THE JEWELERS, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: THE JEWELERS, INC. 401(K) PROFIT SHARING 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333272-01
Policy instance 1
Insurance contract or identification number333272-01
Number of Individuals Covered68
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 number333272-01
Policy instance 1
Insurance contract or identification number333272-01
Number of Individuals Covered63
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 number333272-01
Policy instance 1
Insurance contract or identification number333272-01
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 number333272-01
Policy instance 1
Insurance contract or identification number333272-01
Number of Individuals Covered65
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 number64913
Policy instance 1
Insurance contract or identification number64913
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $8,581
Total amount of fees paid to insurance companyUSD $46
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
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 number333272-01
Policy instance 2
Insurance contract or identification number333272-01
Number of Individuals Covered68
Insurance policy start date2011-12-17
Insurance policy end date2011-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 number64913
Policy instance 1
Insurance contract or identification number64913
Number of Individuals Covered79
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $9,698
Total amount of fees paid to insurance companyUSD $16
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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