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JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 401k Plan overview

Plan NameJAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN
Plan identification number 002

JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • 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.
  • Plan covering Self-Employed individuals.
  • 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

JAJ ENTERPRISES, LLC has sponsored the creation of one or more 401k plans.

Company Name:JAJ ENTERPRISES, LLC
Employer identification number (EIN):931210953
NAIC Classification:441300
NAIC Description: Automotive Parts, Accessories, and Tire Stores

Additional information about JAJ ENTERPRISES, LLC

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1995-12-27
Company Identification Number: 49274780
Legal Registered Office Address: 1203 WILLAMETTE STREET STE 200

EUGENE
United States of America (USA)
97401

More information about JAJ ENTERPRISES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01JOHN A. TOKATLY2023-08-29
0022021-01-01JOHN A. TOKATLY2022-07-27
0022020-01-01JOHN A. TOKATLY2021-09-28
0022019-01-01JOHN A. TOKATLY2020-09-01
0022018-01-01
0022017-01-01
0022016-01-01
0022015-01-01
0022014-01-01JOHN A. TOKATLY2015-09-03
0022013-01-01JOHN A. TOKATLY2014-09-08
0022012-01-01JOHN A. TOKATLY2013-09-24
0022011-01-01JOHN A. TOKATLY2012-09-14
0022010-01-01JOHN A. TOKATLY2011-10-11

Plan Statistics for JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN

401k plan membership statisitcs for JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN

Measure Date Value
2022: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01140
Total number of active participants reported on line 7a of the Form 55002022-01-01101
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0140
Total of all active and inactive participants2022-01-01141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01141
Number of participants with account balances2022-01-01136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-017
2021: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01151
Total number of active participants reported on line 7a of the Form 55002021-01-01104
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0132
Total of all active and inactive participants2021-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01136
Number of participants with account balances2021-01-01131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0114
2020: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01147
Total number of active participants reported on line 7a of the Form 55002020-01-01119
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0133
Total of all active and inactive participants2020-01-01152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01152
Number of participants with account balances2020-01-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0110
2019: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01142
Total number of active participants reported on line 7a of the Form 55002019-01-01126
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0121
Total of all active and inactive participants2019-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01147
Number of participants with account balances2019-01-01140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01125
Total number of active participants reported on line 7a of the Form 55002018-01-01120
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0118
Total of all active and inactive participants2018-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01138
Number of participants with account balances2018-01-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-014
2017: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01135
Total number of active participants reported on line 7a of the Form 55002017-01-01105
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0120
Total of all active and inactive participants2017-01-01125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01125
Number of participants with account balances2017-01-01121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-018
2016: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01127
Total number of active participants reported on line 7a of the Form 55002016-01-01103
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-0125
Total of all active and inactive participants2016-01-01132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01132
Number of participants with account balances2016-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-017

Financial Data on JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN

Measure Date Value
2022 : JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-164,590
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$563,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$527,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$512,418
Value of total assets at end of year2022-12-31$5,950,177
Value of total assets at beginning of year2022-12-31$6,678,212
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$36,072
Total interest from all sources2022-12-31$18,184
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$156,295
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$156,295
Administrative expenses professional fees incurred2022-12-31$6,094
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$293,674
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$3,780
Other income not declared elsewhere2022-12-31$15,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-728,035
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,950,177
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,678,212
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
Investment advisory and management fees2022-12-31$15,009
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,050,749
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$3,510,754
Interest earned on other investments2022-12-31$18,184
Value of interest in common/collective trusts at end of year2022-12-31$1,081,530
Value of interest in common/collective trusts at beginning of year2022-12-31$1,437,835
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,609,024
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,530,403
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-629,038
Net investment gain or loss from common/collective trusts2022-12-31$-237,458
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$214,964
Employer contributions (assets) at end of year2022-12-31$208,874
Employer contributions (assets) at beginning of year2022-12-31$199,220
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$527,373
Contract administrator fees2022-12-31$14,969
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 name2022-12-31BVAL CPAS & ADVISORS, LLP
Accountancy firm EIN2022-12-31452635340
2021 : JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$403
Total income from all sources (including contributions)2021-12-31$1,111,274
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$880,117
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$845,082
Value of total corrective distributions2021-12-31$129
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$503,714
Value of total assets at end of year2021-12-31$6,678,212
Value of total assets at beginning of year2021-12-31$6,447,458
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$34,906
Total interest from all sources2021-12-31$17,260
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$218,958
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$218,958
Administrative expenses professional fees incurred2021-12-31$3,739
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$289,211
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$1,424
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$403
Other income not declared elsewhere2021-12-31$15,943
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$231,157
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,678,212
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$6,447,055
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
Investment advisory and management fees2021-12-31$15,926
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,510,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,281,068
Interest earned on other investments2021-12-31$17,260
Value of interest in common/collective trusts at end of year2021-12-31$1,437,835
Value of interest in common/collective trusts at beginning of year2021-12-31$1,513,298
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,530,403
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,445,281
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$176,658
Net investment gain or loss from common/collective trusts2021-12-31$178,741
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$213,079
Employer contributions (assets) at end of year2021-12-31$199,220
Employer contributions (assets) at beginning of year2021-12-31$207,811
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$845,082
Contract administrator fees2021-12-31$15,241
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 name2021-12-31BVAL CPAS & ADVISORS, LLP
Accountancy firm EIN2021-12-31452635340
2020 : JAJ ENTERPRISES, LLC PROFIT SHARING 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$403
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,088,029
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$779,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$742,788
Value of total corrective distributions2020-12-31$6,252
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$508,854
Value of total assets at end of year2020-12-31$6,447,458
Value of total assets at beginning of year2020-12-31$6,138,461
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$30,395
Total interest from all sources2020-12-31$22,536
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$105,538
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$105,538
Administrative expenses professional fees incurred2020-12-31$4,231
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$290,425
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$743
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$403
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$14,549
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$308,594
Value of net assets at end of year (total assets less liabilities)2020-12-31$6,447,055
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,138,461
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
Investment advisory and management fees2020-12-31$14,548
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,281,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,842,709
Interest earned on other investments2020-12-31$22,536
Value of interest in common/collective trusts at end of year2020-12-31$1,513,298
Value of interest in common/collective trusts at beginning of year2020-12-31$1,324,881
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,445,281
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,756,895
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$235,050
Net investment gain or loss from common/collective trusts2020-12-31$201,502
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$217,686
Employer contributions (assets) at end of year2020-12-31$207,811
Employer contributions (assets) at beginning of year2020-12-31$213,976
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$742,788
Contract administrator fees2020-12-31$11,616
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 name2020-12-31BVAL CPAS & ADVISORS, LLP
Accountancy firm EIN2020-12-31452635340
2019 : JAJ ENTERPRISES, LLC PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$929
Total income from all sources (including contributions)2019-12-31$1,593,497
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$187,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$155,712
Value of total corrective distributions2019-12-31$2,885
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$892,853
Value of total assets at end of year2019-12-31$6,138,461
Value of total assets at beginning of year2019-12-31$4,732,911
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$28,421
Total interest from all sources2019-12-31$21,255
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$115,784
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$115,784
Administrative expenses professional fees incurred2019-12-31$1,981
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$274,359
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$395,419
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$929
Other income not declared elsewhere2019-12-31$13,389
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$1,406,479
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,138,461
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,731,982
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
Investment advisory and management fees2019-12-31$13,398
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,842,709
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,202,838
Interest earned on other investments2019-12-31$21,255
Value of interest in common/collective trusts at end of year2019-12-31$1,324,881
Value of interest in common/collective trusts at beginning of year2019-12-31$1,027,194
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,756,895
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,304,822
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$340,776
Net investment gain or loss from common/collective trusts2019-12-31$209,440
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$223,075
Employer contributions (assets) at end of year2019-12-31$213,976
Employer contributions (assets) at beginning of year2019-12-31$198,057
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$155,712
Contract administrator fees2019-12-31$13,042
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 name2019-12-31BVAL CPAS & ADVISORS, LLP
Accountancy firm EIN2019-12-31452635340
2018 : JAJ ENTERPRISES, LLC PROFIT SHARING 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$929
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$27
Total income from all sources (including contributions)2018-12-31$227,371
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$158,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$133,169
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$469,858
Value of total assets at end of year2018-12-31$4,732,911
Value of total assets at beginning of year2018-12-31$4,662,949
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$25,142
Total interest from all sources2018-12-31$13,007
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$178,512
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$178,512
Administrative expenses professional fees incurred2018-12-31$1,350
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$474,000
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$263,293
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$4,204
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$929
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$27
Other income not declared elsewhere2018-12-31$11,682
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$69,060
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,731,982
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$4,662,922
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
Investment advisory and management fees2018-12-31$11,642
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,202,838
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,275,468
Interest earned on other investments2018-12-31$13,007
Value of interest in common/collective trusts at end of year2018-12-31$1,027,194
Value of interest in common/collective trusts at beginning of year2018-12-31$1,064,741
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,304,822
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,156,706
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-370,317
Net investment gain or loss from common/collective trusts2018-12-31$-75,371
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 contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$202,361
Employer contributions (assets) at end of year2018-12-31$198,057
Employer contributions (assets) at beginning of year2018-12-31$166,034
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$133,169
Contract administrator fees2018-12-31$12,150
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 name2018-12-31BESEMANN VALENTINE LLP
Accountancy firm EIN2018-12-31452635340
2017 : JAJ ENTERPRISES, LLC PROFIT SHARING 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$27
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,012,293
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$189,140
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$165,623
Value of total corrective distributions2017-12-31$1,104
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$544,489
Value of total assets at end of year2017-12-31$4,662,949
Value of total assets at beginning of year2017-12-31$3,839,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$22,413
Total interest from all sources2017-12-31$12,190
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$128,621
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$128,621
Administrative expenses professional fees incurred2017-12-31$1,993
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$467,000
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$220,358
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$149,993
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$778
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$27
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$10,146
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$823,153
Value of net assets at end of year (total assets less liabilities)2017-12-31$4,662,922
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,839,769
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
Investment advisory and management fees2017-12-31$10,148
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,275,468
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,885,283
Interest earned on other investments2017-12-31$12,190
Value of interest in common/collective trusts at end of year2017-12-31$1,064,741
Value of interest in common/collective trusts at beginning of year2017-12-31$784,793
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,156,706
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$1,010,512
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$175,347
Net investment gain or loss from common/collective trusts2017-12-31$141,500
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 contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$174,138
Employer contributions (assets) at end of year2017-12-31$166,034
Employer contributions (assets) at beginning of year2017-12-31$158,403
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$165,623
Contract administrator fees2017-12-31$10,272
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 name2017-12-31BESEMANN VALENTINE LLP
Accountancy firm EIN2017-12-31452635340
2016 : JAJ ENTERPRISES, LLC PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,537
Total income from all sources (including contributions)2016-12-31$621,888
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$222,821
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$204,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$361,473
Value of total assets at end of year2016-12-31$3,839,769
Value of total assets at beginning of year2016-12-31$3,442,239
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$18,055
Total interest from all sources2016-12-31$8,772
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$91,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$91,634
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$385,000
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$194,480
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$4,316
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$778
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$1,537
Other income not declared elsewhere2016-12-31$8,453
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$399,067
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,839,769
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,440,702
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
Investment advisory and management fees2016-12-31$8,453
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$1,885,283
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,753,974
Interest earned on other investments2016-12-31$8,772
Value of interest in common/collective trusts at end of year2016-12-31$784,793
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$1,010,512
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$529,842
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$149,259
Net investment gain or loss from common/collective trusts2016-12-31$2,297
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$162,677
Employer contributions (assets) at end of year2016-12-31$158,403
Employer contributions (assets) at beginning of year2016-12-31$158,423
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$204,766
Contract administrator fees2016-12-31$9,602
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 name2016-12-31BESEMANN VALENTINE LLP
Accountancy firm EIN2016-12-31452635340

Form 5500 Responses for JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN

2022: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: JAJ ENTERPRISES, LLC PROFIT SHARING 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: JAJ ENTERPRISES, LLC PROFIT SHARING 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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: JAJ ENTERPRISES, LLC PROFIT SHARING 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 funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: JAJ ENTERPRISES, LLC PROFIT SHARING 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 funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: JAJ ENTERPRISES, LLC PROFIT SHARING 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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan 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 number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered25
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 number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered23
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 number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered23
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered35
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered50
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 number333109-01
Policy instance 1
Insurance contract or identification number333109-01
Number of Individuals Covered37
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

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