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TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 401k Plan overview

Plan NameTEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN
Plan identification number 001

TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

TEXAS ORTHOPAEDIC ASSOCIATES, LLP has sponsored the creation of one or more 401k plans.

Company Name:TEXAS ORTHOPAEDIC ASSOCIATES, LLP
Employer identification number (EIN):752688609
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01
0012020-01-01ROBERT R. SCHEINBERG, MD2021-10-15
0012019-01-01ROBERT R. SCHEINBERG, MD2020-10-14
0012018-01-01ROBERT R SCHEINBERG, MD2019-09-11
0012017-01-01ROBERT R SCHEINBERG, MD2018-10-03
0012016-01-01ROBERT R SCHEINBERG, MD2017-08-16
0012015-01-01ROBERT R SCHEINBERG, MD2016-09-12
0012014-01-01ROBERT R SCHEINBERG, MD2015-09-09
0012013-01-01ROBERT R SCHEINBERG, MD2014-06-30
0012012-01-01ROBERT R SCHEINBERG, MD2013-10-14
0012011-01-01ROBERT R. SCHEINBERG, M.D.2012-07-25
0012010-01-01ROBERT R. SCHEINBERG, M.D.2011-07-28

Plan Statistics for TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN

401k plan membership statisitcs for TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN

Measure Date Value
2021: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01144
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-010
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01131
Total number of active participants reported on line 7a of the Form 55002020-01-0184
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-0157
Total of all active and inactive participants2020-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01144
Number of participants with account balances2020-01-01134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-012
2019: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01130
Total number of active participants reported on line 7a of the Form 55002019-01-0188
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-0136
Total of all active and inactive participants2019-01-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01127
Number of participants with account balances2019-01-01119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-014

Financial Data on TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN

Measure Date Value
2021 : TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-10-31$0
Total transfer of assets from this plan2021-10-31$17,963,130
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-10-31$0
Total income from all sources (including contributions)2021-10-31$1,970,301
Total loss/gain on sale of assets2021-10-31$923,707
Total of all expenses incurred2021-10-31$2,427,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-10-31$2,341,892
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-10-31$469,349
Value of total assets at end of year2021-10-31$0
Value of total assets at beginning of year2021-10-31$18,420,135
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-10-31$85,414
Total interest from all sources2021-10-31$5,385
Total dividends received (eg from common stock, registered investment company shares)2021-10-31$571,860
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-10-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-10-31$571,860
Was this plan covered by a fidelity bond2021-10-31Yes
Value of fidelity bond cover2021-10-31$500,000
If this is an individual account plan, was there a blackout period2021-10-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-10-31$0
Were there any nonexempt tranactions with any party-in-interest2021-10-31No
Contributions received from participants2021-10-31$6,641
Participant contributions at end of year2021-10-31$0
Participant contributions at beginning of year2021-10-31$150,045
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-10-31No
Value of net income/loss2021-10-31$-457,005
Value of net assets at end of year (total assets less liabilities)2021-10-31$0
Value of net assets at beginning of year (total assets less liabilities)2021-10-31$18,420,135
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-10-31No
Were any leases to which the plan was party in default or uncollectible2021-10-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-10-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-10-31$16,400,120
Interest on participant loans2021-10-31$5,385
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-10-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-10-31$15,719
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-10-31$15,719
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-10-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-10-31$1,854,251
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-10-31No
Was there a failure to transmit to the plan any participant contributions2021-10-31No
Has the plan failed to provide any benefit when due under the plan2021-10-31No
Contributions received in cash from employer2021-10-31$462,708
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-10-31$2,341,892
Contract administrator fees2021-10-31$85,414
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-10-31Yes
Did the plan have assets held for investment2021-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-10-31Yes
Aggregate proceeds on sale of assets2021-10-31$923,707
Opinion of an independent qualified public accountant for this plan2021-10-31Unqualified
Accountancy firm name2021-10-31BAKER TILLY US, LLP
Accountancy firm EIN2021-10-31390859910
2020 : TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$996,809
Total unrealized appreciation/depreciation of assets2020-12-31$996,809
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,134,558
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,902,807
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,829,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$936,571
Value of total assets at end of year2020-12-31$18,420,135
Value of total assets at beginning of year2020-12-31$17,188,384
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$73,373
Total interest from all sources2020-12-31$6,658
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$1,194,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$1,194,520
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$495,464
Participant contributions at end of year2020-12-31$150,045
Participant contributions at beginning of year2020-12-31$175,339
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$6,898
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,231,751
Value of net assets at end of year (total assets less liabilities)2020-12-31$18,420,135
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$17,188,384
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$16,400,120
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$15,165,025
Interest on participant loans2020-12-31$6,624
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$15,719
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$2,677
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$2,677
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$34
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,854,251
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,845,343
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$434,209
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,829,434
Contract administrator fees2020-12-31$73,373
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BAKER TILLY US, LLP
Accountancy firm EIN2020-12-31390859910
2019 : TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$1,784,174
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$1,784,174
Total unrealized appreciation/depreciation of assets2019-12-31$1,784,174
Total unrealized appreciation/depreciation of assets2019-12-31$1,784,174
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,631,521
Total income from all sources (including contributions)2019-12-31$3,631,521
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$674,619
Total of all expenses incurred2019-12-31$674,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$647,339
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$647,339
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$945,678
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$945,678
Value of total assets at end of year2019-12-31$17,188,384
Value of total assets at end of year2019-12-31$17,188,384
Value of total assets at beginning of year2019-12-31$14,231,482
Value of total assets at beginning of year2019-12-31$14,231,482
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$27,280
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$27,280
Total interest from all sources2019-12-31$9,899
Total interest from all sources2019-12-31$9,899
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$891,770
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$891,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$891,770
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$891,770
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$565,250
Contributions received from participants2019-12-31$565,250
Participant contributions at end of year2019-12-31$175,339
Participant contributions at end of year2019-12-31$175,339
Participant contributions at beginning of year2019-12-31$190,291
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$171,011
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$171,011
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
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,956,902
Value of net income/loss2019-12-31$2,956,902
Value of net assets at end of year (total assets less liabilities)2019-12-31$17,188,384
Value of net assets at end of year (total assets less liabilities)2019-12-31$17,188,384
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$14,231,482
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$14,231,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$15,165,025
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$15,165,025
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$12,401,353
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$12,401,353
Interest on participant loans2019-12-31$9,589
Interest on participant loans2019-12-31$9,589
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,677
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,677
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$32,552
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$32,552
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$310
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$310
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,845,343
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,845,343
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,607,286
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,607,286
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$209,417
Contributions received in cash from employer2019-12-31$209,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$647,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$647,339
Contract administrator fees2019-12-31$27,280
Contract administrator fees2019-12-31$27,280
Did the plan have assets held for investment2019-12-31Yes
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
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
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BAKER TILLY US, LLP
Accountancy firm name2019-12-31BAKER TILLY US, LLP
Accountancy firm EIN2019-12-31390859910
Accountancy firm EIN2019-12-31390859910

Form 5500 Responses for TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN

2021: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TEXAS ORTHOPAEDIC ASSOCIATES, LLP 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333865-01
Policy instance 1
Insurance contract or identification number333865-01
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-10-11
Total amount of commissions paid to insurance brokerUSD $3,220
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $3,220
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333865-01
Policy instance 1
Insurance contract or identification number333865-01
Number of Individuals Covered110
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,247
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $3,247
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333865-01
Policy instance 1
Insurance contract or identification number333865-01
Number of Individuals Covered101
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,378
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $3,378
Insurance broker organization code?3

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