401k Plan data: DIAGNOSTIC LABORATORIES 401(K) PLAN plan

DIAGNOSTIC LABORATORIES 401(K) PLAN 401k Plan overview

Plan Name	DIAGNOSTIC LABORATORIES 401(K) PLAN
Plan identification number	001

DIAGNOSTIC LABORATORIES 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KAN-DI-KI, LLC has sponsored the creation of one or more 401k plans.

Company Name: KAN-DI-KI, LLC

Employer identification number (EIN): 952706100

NAIC Classification: 621510
NAIC Description: Medical and Diagnostic Laboratories

Additional information about KAN-DI-KI, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4687041

More information about KAN-DI-KI, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIAGNOSTIC LABORATORIES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 JULIE RAVIN
001 2014-01-01 FERNANDO RIVAS
001 2013-01-01 WAYNE ALBERTS
001 2012-01-01 WAYNE ALBERTS
001 2011-01-01 WAYNE ALBERTS
001 2010-01-01 COLLEEN GRABLE
001 2009-01-01 COLLEEN GRABLE COLLEEN GRABLE 2010-10-12
001 2009-01-01 COLLEEN GRABLE COLLEEN GRABLE 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	JULIE RAVIN
001	2014-01-01	FERNANDO RIVAS
001	2013-01-01	WAYNE ALBERTS
001	2012-01-01	WAYNE ALBERTS
001	2011-01-01	WAYNE ALBERTS
001	2010-01-01	COLLEEN GRABLE
001	2009-01-01	COLLEEN GRABLE	COLLEEN GRABLE	2010-10-12
001	2009-01-01	COLLEEN GRABLE	COLLEEN GRABLE	2010-10-11

Plan Statistics for DIAGNOSTIC LABORATORIES 401(K) PLAN

401k plan membership statisitcs for DIAGNOSTIC LABORATORIES 401(K) PLAN

Measure Date Value
2015: DIAGNOSTIC LABORATORIES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,395
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: DIAGNOSTIC LABORATORIES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,204
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,256
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 139
Total of all active and inactive participants 2014-01-01 1,395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 1,395
Number of participants with account balances 2014-01-01 754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 119
2013: DIAGNOSTIC LABORATORIES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,381
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,170
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 34
Total of all active and inactive participants 2013-01-01 1,204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 1,204
Number of participants with account balances 2013-01-01 410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DIAGNOSTIC LABORATORIES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,201
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,338
Number of retired or separated participants receiving benefits 2012-01-01 11
Number of other retired or separated participants entitled to future benefits 2012-01-01 32
Total of all active and inactive participants 2012-01-01 1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1,381
Number of participants with account balances 2012-01-01 282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: DIAGNOSTIC LABORATORIES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,097
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,071
Number of retired or separated participants receiving benefits 2011-01-01 13
Number of other retired or separated participants entitled to future benefits 2011-01-01 34
Total of all active and inactive participants 2011-01-01 1,118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,118
Number of participants with account balances 2011-01-01 256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 7
2010: DIAGNOSTIC LABORATORIES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 485
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 816
Number of retired or separated participants receiving benefits 2010-01-01 17
Number of other retired or separated participants entitled to future benefits 2010-01-01 35
Total of all active and inactive participants 2010-01-01 868
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 868
Number of participants with account balances 2010-01-01 232
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 16
2009: DIAGNOSTIC LABORATORIES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 536
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 440
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 45
Total of all active and inactive participants 2009-01-01 485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 485
Number of participants with account balances 2009-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 60

Measure	Date	Value
2015: DIAGNOSTIC LABORATORIES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,395
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: DIAGNOSTIC LABORATORIES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,204
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,256
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	139
Total of all active and inactive participants	2014-01-01	1,395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	1,395
Number of participants with account balances	2014-01-01	754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	119
2013: DIAGNOSTIC LABORATORIES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,381
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,170
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	34
Total of all active and inactive participants	2013-01-01	1,204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	1,204
Number of participants with account balances	2013-01-01	410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DIAGNOSTIC LABORATORIES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,201
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,338
Number of retired or separated participants receiving benefits	2012-01-01	11
Number of other retired or separated participants entitled to future benefits	2012-01-01	32
Total of all active and inactive participants	2012-01-01	1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1,381
Number of participants with account balances	2012-01-01	282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: DIAGNOSTIC LABORATORIES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,097
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,071
Number of retired or separated participants receiving benefits	2011-01-01	13
Number of other retired or separated participants entitled to future benefits	2011-01-01	34
Total of all active and inactive participants	2011-01-01	1,118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,118
Number of participants with account balances	2011-01-01	256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	7
2010: DIAGNOSTIC LABORATORIES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	485
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	816
Number of retired or separated participants receiving benefits	2010-01-01	17
Number of other retired or separated participants entitled to future benefits	2010-01-01	35
Total of all active and inactive participants	2010-01-01	868
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	868
Number of participants with account balances	2010-01-01	232
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	16
2009: DIAGNOSTIC LABORATORIES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	536
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	440
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	45
Total of all active and inactive participants	2009-01-01	485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	485
Number of participants with account balances	2009-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	60

Financial Data on DIAGNOSTIC LABORATORIES 401(K) PLAN

Measure	Date	Value
2015 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$10,220,511
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$2,196,904
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,294,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,217,675
Expenses. Certain deemed distributions of participant loans	2015-12-31	$35,334
Value of total corrective distributions	2015-12-31	$7,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,140,105
Value of total assets at end of year	2015-12-31	$0
Value of total assets at beginning of year	2015-12-31	$9,318,168
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$34,006
Total interest from all sources	2015-12-31	$31,286
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$411,214
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$411,214
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,715,082
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$499,062
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$139,085
Other income not declared elsewhere	2015-12-31	$23,193
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$902,343
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,318,168
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$34,006
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$7,724,000
Interest on participant loans	2015-12-31	$18,175
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$13,111
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,095,106
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-408,894
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$285,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,217,675
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2015-12-31	954345526
2014 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$2,132,030
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$467,105
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$430,073
Value of total corrective distributions	2014-12-31	$34,482
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,701,973
Value of total assets at end of year	2014-12-31	$9,318,168
Value of total assets at beginning of year	2014-12-31	$7,653,243
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,550
Total interest from all sources	2014-12-31	$28,170
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,472,832
Participant contributions at end of year	2014-12-31	$499,062
Participant contributions at beginning of year	2014-12-31	$331,119
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,664,925
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,318,168
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,653,243
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$2,550
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$7,724,000
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$6,207,038
Interest on participant loans	2014-12-31	$13,217
Interest earned on other investments	2014-12-31	$14,953
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,095,106
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,115,086
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$401,887
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$229,141
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$430,073
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2014-12-31	954345526
2013 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$2,254,584
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$656,965
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$636,819
Value of total corrective distributions	2013-12-31	$17,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,145,088
Value of total assets at end of year	2013-12-31	$7,653,243
Value of total assets at beginning of year	2013-12-31	$6,055,624
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$2,425
Total interest from all sources	2013-12-31	$30,663
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,012,074
Participant contributions at end of year	2013-12-31	$331,119
Participant contributions at beginning of year	2013-12-31	$416,853
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,597,619
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,653,243
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,055,624
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$2,425
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$6,207,038
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,523,646
Interest on participant loans	2013-12-31	$13,942
Interest earned on other investments	2013-12-31	$16,721
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,115,086
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,115,125
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,078,833
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$133,014
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$636,819
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2013-12-31	954345526
2012 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,464,101
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$800,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$791,469
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$927,661
Value of total assets at end of year	2012-12-31	$6,055,624
Value of total assets at beginning of year	2012-12-31	$5,392,340
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$9,348
Total interest from all sources	2012-12-31	$34,040
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$139,345
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$139,345
Administrative expenses professional fees incurred	2012-12-31	$9,348
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$822,355
Participant contributions at end of year	2012-12-31	$416,853
Participant contributions at beginning of year	2012-12-31	$384,250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$663,284
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,055,624
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,392,340
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,523,646
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,794,871
Interest on participant loans	2012-12-31	$14,992
Interest earned on other investments	2012-12-31	$19,048
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,115,125
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,213,219
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$363,055
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$105,306
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$791,469
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2012-12-31	954345526
2011 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$863,336
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$208,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$193,361
Value of total corrective distributions	2011-12-31	$10,470
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$923,812
Value of total assets at end of year	2011-12-31	$5,392,340
Value of total assets at beginning of year	2011-12-31	$4,737,310
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$4,475
Total interest from all sources	2011-12-31	$38,782
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$124,760
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$124,760
Administrative expenses professional fees incurred	2011-12-31	$4,475
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$325,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$699,539
Participant contributions at end of year	2011-12-31	$384,250
Participant contributions at beginning of year	2011-12-31	$331,292
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$133,201
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$655,030
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,392,340
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,737,310
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$3,794,871
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$3,433,381
Interest on participant loans	2011-12-31	$15,609
Interest earned on other investments	2011-12-31	$23,173
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,213,219
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$972,637
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-224,018
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$91,072
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$193,361
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	RICHARD WEGLARZ, CPA
Accountancy firm EIN	2011-12-31	954635567
2010 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$1,350,487
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,010,113
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$286,557
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$256,190
Value of total corrective distributions	2010-12-31	$23,980
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$657,905
Value of total assets at end of year	2010-12-31	$4,737,310
Value of total assets at beginning of year	2010-12-31	$2,663,267
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$6,387
Total interest from all sources	2010-12-31	$31,524
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$51,976
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$51,976
Administrative expenses professional fees incurred	2010-12-31	$6,387
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$325,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$540,622
Participant contributions at end of year	2010-12-31	$331,292
Participant contributions at beginning of year	2010-12-31	$203,068
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$5,500
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$34,817
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$723,556
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,737,310
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,663,267
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,433,381
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,836,892
Interest on participant loans	2010-12-31	$12,556
Interest earned on other investments	2010-12-31	$18,968
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$617,807
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$972,637
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$268,708
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$82,466
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$256,190
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	RICHARD WEGLARZ, CPA
Accountancy firm EIN	2010-12-31	954635567
2009 : DIAGNOSTIC LABORATORIES 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for DIAGNOSTIC LABORATORIES 401(K) PLAN

2015: DIAGNOSTIC LABORATORIES 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: DIAGNOSTIC LABORATORIES 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: DIAGNOSTIC LABORATORIES 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DIAGNOSTIC LABORATORIES 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DIAGNOSTIC LABORATORIES 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DIAGNOSTIC LABORATORIES 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DIAGNOSTIC LABORATORIES 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	CARLTON THOMASY

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	81
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	CARLTON THOMASY

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	87
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	CARLTON THOMASY

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	109
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,073
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1073
Additional information about fees paid to insurance broker	NA
Insurance broker organization code?	3
Insurance broker name	CARLTON THOMASY

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	116
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,854
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 number

331158-01

Policy instance

Insurance contract or identification number	331158-01
Number of Individuals Covered	105
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,828
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

Potentially related plans

DIAGNOSTIC LABORATORIES, LLC 401(K) PLAN [EIN = 208535470]

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The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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Company Name:	KAN-DI-KI, LLC
Employer identification number (EIN):	952706100
NAIC Classification:	621510
NAIC Description:	Medical and Diagnostic Laboratories

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4687041