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UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 401k Plan overview

Plan NameUNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN
Plan identification number 004

UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

UNIFIED INSURANCE GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:UNIFIED INSURANCE GROUP, LLC
Employer identification number (EIN):931232652
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about UNIFIED INSURANCE GROUP, LLC

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1997-10-09
Company Identification Number: 59868688
Legal Registered Office Address: 745 NW VAN BUREN AVE

CORVALLIS
United States of America (USA)
97330

More information about UNIFIED INSURANCE GROUP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042019-01-01
0042018-01-01
0042017-01-01PAUL MILLER PAUL MILLER2018-09-05
0042016-01-01PAUL MILLER PAUL MILLER2017-08-01
0042015-01-01PAUL MILLER PAUL MILLER2016-07-06
0042014-01-01PAUL MILLER PAUL MILLER2015-09-18
0042013-01-01PAUL MILLER PAUL MILLER2014-09-11
0042012-01-01PAUL MILLER PAUL MILLER2013-05-31
0042011-01-01PAUL MILLER PAUL MILLER2012-02-08
0042010-01-01PAUL MILLER PAUL MILLER2011-03-08
0042009-01-01PAUL MILLER PAUL MILLER2010-06-02

Plan Statistics for UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN

401k plan membership statisitcs for UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN

Measure Date Value
2019: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0114
Total number of active participants reported on line 7a of the Form 55002019-01-0112
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-013
Total of all active and inactive participants2019-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0115
Number of participants with account balances2019-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0113
Total number of active participants reported on line 7a of the Form 55002018-01-0112
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0114
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0114
Total number of active participants reported on line 7a of the Form 55002017-01-0110
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0113
Number of participants with account balances2017-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0113
Total number of active participants reported on line 7a of the Form 55002016-01-0110
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-014
Total of all active and inactive participants2016-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0114
Number of participants with account balances2016-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0113
Total number of active participants reported on line 7a of the Form 55002015-01-0111
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0113
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0114
Total number of active participants reported on line 7a of the Form 55002014-01-0110
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0113
Number of participants with account balances2014-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0116
Total number of active participants reported on line 7a of the Form 55002013-01-0110
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0114
Number of participants with account balances2013-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0116
Total number of active participants reported on line 7a of the Form 55002012-01-0111
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-015
Total of all active and inactive participants2012-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0116
Number of participants with account balances2012-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0116
Total number of active participants reported on line 7a of the Form 55002011-01-0112
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0116
Number of participants with account balances2011-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0118
Total number of active participants reported on line 7a of the Form 55002010-01-0114
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-012
Total of all active and inactive participants2010-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0116
Number of participants with account balances2010-01-0116
2009: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0118
Total number of active participants reported on line 7a of the Form 55002009-01-0113
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0117
Number of participants with account balances2009-01-0117

Financial Data on UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN

Measure Date Value
2019 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$1,282,034
Total plan assets at end of year2019-12-31$5,578,401
Total plan assets at beginning of year2019-12-31$4,296,367
Value of fidelity bond covering the plan2019-12-31$400,000
Total contributions received or receivable from participants2019-12-31$50,630
Other income received2019-12-31$1,031,404
Net income (gross income less expenses)2019-12-31$1,282,034
Net plan assets at end of year (total assets less liabilities)2019-12-31$5,578,401
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$4,296,367
Total contributions received or receivable from employer(s)2019-12-31$200,000
2018 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$29,146
Expenses. Total of all expenses incurred2018-12-31$286,201
Benefits paid (including direct rollovers)2018-12-31$284,734
Total plan assets at end of year2018-12-31$4,296,367
Total plan assets at beginning of year2018-12-31$4,553,422
Value of fidelity bond covering the plan2018-12-31$400,000
Total contributions received or receivable from participants2018-12-31$94,830
Other income received2018-12-31$-265,684
Net income (gross income less expenses)2018-12-31$-257,055
Net plan assets at end of year (total assets less liabilities)2018-12-31$4,296,367
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,553,422
Total contributions received or receivable from employer(s)2018-12-31$200,000
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$1,467
2017 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$929,381
Expenses. Total of all expenses incurred2017-12-31$615,660
Benefits paid (including direct rollovers)2017-12-31$613,552
Total plan assets at end of year2017-12-31$4,553,422
Total plan assets at beginning of year2017-12-31$4,239,701
Value of fidelity bond covering the plan2017-12-31$400,000
Total contributions received or receivable from participants2017-12-31$56,200
Other income received2017-12-31$623,181
Net income (gross income less expenses)2017-12-31$313,721
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,553,422
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$4,239,701
Total contributions received or receivable from employer(s)2017-12-31$250,000
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$2,108
2016 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$517,990
Total plan assets at end of year2016-12-31$4,239,701
Total plan assets at beginning of year2016-12-31$3,721,711
Value of fidelity bond covering the plan2016-12-31$400,000
Total contributions received or receivable from participants2016-12-31$51,124
Other income received2016-12-31$291,866
Net income (gross income less expenses)2016-12-31$517,990
Net plan assets at end of year (total assets less liabilities)2016-12-31$4,239,701
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,721,711
Total contributions received or receivable from employer(s)2016-12-31$175,000
2015 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$250,298
Expenses. Total of all expenses incurred2015-12-31$12,826
Benefits paid (including direct rollovers)2015-12-31$12,826
Total plan assets at end of year2015-12-31$3,721,711
Total plan assets at beginning of year2015-12-31$3,484,239
Value of fidelity bond covering the plan2015-12-31$400,000
Total contributions received or receivable from participants2015-12-31$34,050
Other income received2015-12-31$-40,128
Net income (gross income less expenses)2015-12-31$237,472
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,721,711
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,484,239
Total contributions received or receivable from employer(s)2015-12-31$256,376
2014 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$385,457
Expenses. Total of all expenses incurred2014-12-31$93,108
Benefits paid (including direct rollovers)2014-12-31$93,108
Total plan assets at end of year2014-12-31$3,484,239
Total plan assets at beginning of year2014-12-31$3,191,890
Value of fidelity bond covering the plan2014-12-31$300,000
Total contributions received or receivable from participants2014-12-31$55,661
Other income received2014-12-31$204,796
Net income (gross income less expenses)2014-12-31$292,349
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,484,239
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$3,191,890
Total contributions received or receivable from employer(s)2014-12-31$125,000
2013 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$607,758
Expenses. Total of all expenses incurred2013-12-31$21,150
Benefits paid (including direct rollovers)2013-12-31$21,150
Total plan assets at end of year2013-12-31$3,191,890
Total plan assets at beginning of year2013-12-31$2,605,282
Value of fidelity bond covering the plan2013-12-31$300,000
Total contributions received or receivable from participants2013-12-31$45,500
Other income received2013-12-31$476,518
Net income (gross income less expenses)2013-12-31$586,608
Net plan assets at end of year (total assets less liabilities)2013-12-31$3,191,890
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,605,282
Total contributions received or receivable from employer(s)2013-12-31$85,740
2012 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$414,661
Expenses. Total of all expenses incurred2012-12-31$77,266
Benefits paid (including direct rollovers)2012-12-31$68,064
Total plan assets at end of year2012-12-31$2,605,282
Total plan assets at beginning of year2012-12-31$2,267,887
Value of fidelity bond covering the plan2012-12-31$300,000
Total contributions received or receivable from participants2012-12-31$43,075
Other income received2012-12-31$289,821
Net income (gross income less expenses)2012-12-31$337,395
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,605,282
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,267,887
Total contributions received or receivable from employer(s)2012-12-31$81,765
Value of certain deemed distributions of participant loans2012-12-31$9,202
2011 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$71,793
Total plan assets at end of year2011-12-31$2,267,887
Total plan assets at beginning of year2011-12-31$2,196,094
Value of fidelity bond covering the plan2011-12-31$300,000
Total contributions received or receivable from participants2011-12-31$32,800
Other income received2011-12-31$-37,877
Net income (gross income less expenses)2011-12-31$71,793
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,267,887
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,196,094
Assets. Value of participant loans2011-12-31$9,214
Total contributions received or receivable from employer(s)2011-12-31$76,870
2010 : UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$289,202
Expenses. Total of all expenses incurred2010-12-31$12,029
Benefits paid (including direct rollovers)2010-12-31$12,029
Total plan assets at end of year2010-12-31$2,196,094
Total plan assets at beginning of year2010-12-31$1,918,921
Value of fidelity bond covering the plan2010-12-31$300,000
Total contributions received or receivable from participants2010-12-31$9,900
Other income received2010-12-31$233,113
Net income (gross income less expenses)2010-12-31$277,173
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,196,094
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,918,921
Assets. Value of participant loans2010-12-31$9,771
Total contributions received or receivable from employer(s)2010-12-31$46,189

Form 5500 Responses for UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN

2019: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
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: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: UNIFIED INSURANCE GROUP, LLC 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 – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: UNIFIED INSURANCE GROUP, LLC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
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 number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered8
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered8
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered13
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 number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered13
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
Insurance broker nameAMERICAN INDEPENDENT SECURITIES GRP
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered14
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,814
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
Commission paid to Insurance BrokerUSD $5,814
Insurance broker nameAMERICAN INDEPENDENT SECURITIES GRP
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered16
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,968
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
Commission paid to Insurance BrokerUSD $5,968
Insurance broker nameAMERICAN INDEPENDENT SECURITIES GRP
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered16
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,592
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 number938103-01
Policy instance 1
Insurance contract or identification number938103-01
Number of Individuals Covered15
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,869
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
Commission paid to Insurance BrokerUSD $4,869
Insurance broker organization code?3
Insurance broker nameAMERICAN INDEPENDENT SECURITIES GRP

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