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ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 401k Plan overview

Plan NameANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN
Plan identification number 001

ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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.

401k Sponsoring company profile

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

Company Name:SERVICE SUCCESS, INC.
Employer identification number (EIN):208484920
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012020-01-01
0012019-01-01
0012016-01-01MARK MITCHELL2018-06-27
0012015-01-01MARK MITCHELL2016-07-01
0012014-01-01MARK MITCHELL2015-07-13
0012013-01-01MARK MITCHELL2014-06-06
0012012-01-01MARK MITCHELL2013-08-08
0012011-01-01MARK MITCHELL2012-07-20
0012010-01-01STEVE BURBRIDGE2011-07-25 STEVE BURBRIDGE2011-07-25

Plan Statistics for ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN

401k plan membership statisitcs for ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN

Measure Date Value
2020: ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01186
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-010
Number of participants with account balances2020-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01146
Total number of active participants reported on line 7a of the Form 55002019-01-01158
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0128
Total of all active and inactive participants2019-01-01186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01186
Number of participants with account balances2019-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0149

Financial Data on ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN

Measure Date Value
2020 : ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-07-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-07-31$0
Total unrealized appreciation/depreciation of assets2020-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-31$0
Expenses. Interest paid2020-07-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-07-31$0
Total income from all sources (including contributions)2020-07-31$478,210
Total loss/gain on sale of assets2020-07-31$0
Total of all expenses incurred2020-07-31$4,753,232
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-07-31$4,661,160
Expenses. Certain deemed distributions of participant loans2020-07-31$0
Value of total corrective distributions2020-07-31$65,526
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-07-31$472,250
Value of total assets at end of year2020-07-31$0
Value of total assets at beginning of year2020-07-31$4,275,022
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-07-31$26,546
Total income from rents2020-07-31$0
Total interest from all sources2020-07-31$2,899
Total dividends received (eg from common stock, registered investment company shares)2020-07-31$14,575
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-07-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2020-07-31$0
Total dividends received from registered investment company shares (eg mutual funds)2020-07-31$14,575
Assets. Real estate other than employer real property at end of year2020-07-31$0
Assets. Real estate other than employer real property at beginning of year2020-07-31$0
Administrative expenses professional fees incurred2020-07-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2020-07-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-07-31$0
Was this plan covered by a fidelity bond2020-07-31Yes
Value of fidelity bond cover2020-07-31$500,000
If this is an individual account plan, was there a blackout period2020-07-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-07-31$0
Were there any nonexempt tranactions with any party-in-interest2020-07-31No
Contributions received from participants2020-07-31$213,334
Participant contributions at end of year2020-07-31$0
Participant contributions at beginning of year2020-07-31$19,345
Participant contributions at end of year2020-07-31$0
Participant contributions at beginning of year2020-07-31$0
Assets. Other investments not covered elsewhere at end of year2020-07-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-07-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-07-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-07-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-07-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-07-31$0
Assets. Loans (other than to participants) at end of year2020-07-31$0
Assets. Loans (other than to participants) at beginning of year2020-07-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-07-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-07-31$0
Other income not declared elsewhere2020-07-31$400
Administrative expenses (other) incurred2020-07-31$0
Total non interest bearing cash at end of year2020-07-31$0
Total non interest bearing cash at beginning of year2020-07-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-31No
Income. Non cash contributions2020-07-31$0
Value of net income/loss2020-07-31$-4,275,022
Value of net assets at end of year (total assets less liabilities)2020-07-31$0
Value of net assets at beginning of year (total assets less liabilities)2020-07-31$4,275,022
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-07-31No
Were any leases to which the plan was party in default or uncollectible2020-07-31No
Assets. partnership/joint venture interests at end of year2020-07-31$0
Assets. partnership/joint venture interests at beginning of year2020-07-31$0
Investment advisory and management fees2020-07-31$10,621
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-07-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-07-31$3,932,036
Interest on participant loans2020-07-31$617
Income. Interest from loans (other than to participants)2020-07-31$0
Interest earned on other investments2020-07-31$2,282
Income. Interest from US Government securities2020-07-31$0
Income. Interest from corporate debt instruments2020-07-31$0
Value of interest in master investment trust accounts at end of year2020-07-31$0
Value of interest in master investment trust accounts at beginning of year2020-07-31$0
Value of interest in common/collective trusts at end of year2020-07-31$0
Value of interest in common/collective trusts at beginning of year2020-07-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-07-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-07-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-07-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-07-31$0
Assets. Value of investments in 103.12 investment entities at end of year2020-07-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2020-07-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-07-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-07-31$323,641
Expenses. Payments to insurance carriers foe the provision of benefits2020-07-31$0
Asset value of US Government securities at end of year2020-07-31$0
Asset value of US Government securities at beginning of year2020-07-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-07-31$-11,914
Net investment gain/loss from pooled separate accounts2020-07-31$0
Net investment gain or loss from common/collective trusts2020-07-31$0
Net gain/loss from 103.12 investment entities2020-07-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-07-31No
Was there a failure to transmit to the plan any participant contributions2020-07-31No
Has the plan failed to provide any benefit when due under the plan2020-07-31No
Assets. Invements in employer securities at end of year2020-07-31$0
Assets. Invements in employer securities at beginning of year2020-07-31$0
Assets. Value of employer real property at end of year2020-07-31$0
Assets. Value of employer real property at beginning of year2020-07-31$0
Contributions received in cash from employer2020-07-31$258,916
Employer contributions (assets) at end of year2020-07-31$0
Employer contributions (assets) at beginning of year2020-07-31$0
Income. Dividends from preferred stock2020-07-31$0
Income. Dividends from common stock2020-07-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-07-31$4,661,160
Asset. Corporate debt instrument preferred debt at end of year2020-07-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2020-07-31$0
Asset. Corporate debt instrument debt (other) at end of year2020-07-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-07-31$0
Contract administrator fees2020-07-31$15,925
Assets. Corporate common stocks other than exployer securities at end of year2020-07-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2020-07-31$0
Liabilities. Value of benefit claims payable at end of year2020-07-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-07-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2020-07-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-07-31$0
Did the plan have assets held for investment2020-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-07-31Yes
Aggregate proceeds on sale of assets2020-07-31$0
Aggregate carrying amount (costs) on sale of assets2020-07-31$0
Liabilities. Value of acquisition indebtedness at end of year2020-07-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-07-31$0
Opinion of an independent qualified public accountant for this plan2020-07-31Disclaimer
Accountancy firm name2020-07-31MIZE CPAS INC.
Accountancy firm EIN2020-07-31480882363
2019 : ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$3,708,077
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$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Total income from all sources (including contributions)2019-12-31$607,226
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$40,281
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$35,950
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$323,715
Value of total assets at end of year2019-12-31$4,275,022
Value of total assets at beginning of year2019-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$4,331
Total income from rents2019-12-31$0
Total interest from all sources2019-12-31$3,470
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$115,741
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$115,741
Assets. Real estate other than employer real property at end of year2019-12-31$0
Assets. Real estate other than employer real property at beginning of year2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
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 period2019-12-31Yes
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$323,715
Participant contributions at end of year2019-12-31$19,345
Participant contributions at beginning of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Assets. Loans (other than to participants) at end of year2019-12-31$0
Assets. Loans (other than to participants) at beginning of year2019-12-31$0
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$0
Other income not declared elsewhere2019-12-31$667
Administrative expenses (other) incurred2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$566,945
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,275,022
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
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
Assets. partnership/joint venture interests at end of year2019-12-31$0
Assets. partnership/joint venture interests at beginning of year2019-12-31$0
Investment advisory and management fees2019-12-31$4,331
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,932,036
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$667
Income. Interest from loans (other than to participants)2019-12-31$0
Interest earned on other investments2019-12-31$2,803
Income. Interest from US Government securities2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Value of interest in master investment trust accounts at end of year2019-12-31$0
Value of interest in master investment trust accounts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$323,641
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$163,633
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
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
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Value of employer real property at end of year2019-12-31$0
Assets. Value of employer real property at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$35,950
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$0
Contract administrator fees2019-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$0
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$0
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
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0

Form 5500 Responses for ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN

2020: ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S 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 filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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: ANTHONY PLUMBING, HEATING AND COOLING, INC. 401(K) P/S PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number506947-01
Policy instance 1
Insurance contract or identification number506947-01
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-07-31
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 number506947-01
Policy instance 1
Insurance contract or identification number506947-01
Number of Individuals Covered45
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

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