401k Plan data: MIKE CARLSON MOTOR CO. 401(K) PLAN plan

MIKE CARLSON MOTOR CO. 401(K) PLAN 401k Plan overview

Plan Name	MIKE CARLSON MOTOR CO. 401(K) PLAN
Plan identification number	001

MIKE CARLSON MOTOR CO. 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.
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

MCMC AUTO LTD DBA MIKE CARLSON MOTOR COMPANY has sponsored the creation of one or more 401k plans.

Company Name: MCMC AUTO LTD DBA MIKE CARLSON MOTOR COMPANY

Employer identification number (EIN): 752834494

NAIC Classification: 441120
NAIC Description: Used Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIKE CARLSON MOTOR CO. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01 NATALIE LEGER
001 2015-01-01
001 2014-01-01 NATALIE LEGER
001 2013-01-01 SANDRA PFEIFFER
001 2012-01-01 SANDRA PFEIFFER
001 2011-01-01 SANDRA PFEIFFER
001 2010-01-01 SANDRA PFEIFFER
001 2009-01-01 SANDRA PFEIFFER
001 2008-01-01

Plan Statistics for MIKE CARLSON MOTOR CO. 401(K) PLAN

401k plan membership statisitcs for MIKE CARLSON MOTOR CO. 401(K) PLAN

Measure Date Value
2023: MIKE CARLSON MOTOR CO. 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 79
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 12
Total of all active and inactive participants 2023-01-01 91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 91
Number of participants with account balances 2023-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 16
2022: MIKE CARLSON MOTOR CO. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 85
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 22
Total of all active and inactive participants 2022-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 107
Number of participants with account balances 2022-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: MIKE CARLSON MOTOR CO. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 77
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 18
Total of all active and inactive participants 2021-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 95
Number of participants with account balances 2021-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: MIKE CARLSON MOTOR CO. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 79
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 20
Total of all active and inactive participants 2020-01-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 100
Number of participants with account balances 2020-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MIKE CARLSON MOTOR CO. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 97
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 16
Total of all active and inactive participants 2019-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 113
Number of participants with account balances 2019-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 3
2018: MIKE CARLSON MOTOR CO. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 97
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 10
Total of all active and inactive participants 2018-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 107
Number of participants with account balances 2018-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 4
2017: MIKE CARLSON MOTOR CO. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 97
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 8
Total of all active and inactive participants 2017-01-01 105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 105
Number of participants with account balances 2017-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: MIKE CARLSON MOTOR CO. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 103
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 107
Number of participants with account balances 2016-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: MIKE CARLSON MOTOR CO. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 108
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 7
Total of all active and inactive participants 2015-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 115
Number of participants with account balances 2015-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: MIKE CARLSON MOTOR CO. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 93
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 7
Total of all active and inactive participants 2014-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 101
Number of participants with account balances 2014-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: MIKE CARLSON MOTOR CO. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 85
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 8
Total of all active and inactive participants 2013-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 93
Number of participants with account balances 2013-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: MIKE CARLSON MOTOR CO. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 94
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 11
Total of all active and inactive participants 2012-01-01 105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 105
Number of participants with account balances 2012-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: MIKE CARLSON MOTOR CO. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 97
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 117
Number of participants with account balances 2011-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: MIKE CARLSON MOTOR CO. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 94
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 13
Total of all active and inactive participants 2010-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 107
Number of participants with account balances 2010-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: MIKE CARLSON MOTOR CO. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 89
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 16
Total of all active and inactive participants 2009-01-01 105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 105
Number of participants with account balances 2009-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2023: MIKE CARLSON MOTOR CO. 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	79
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	12
Total of all active and inactive participants	2023-01-01	91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	91
Number of participants with account balances	2023-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	16
2022: MIKE CARLSON MOTOR CO. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	85
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	22
Total of all active and inactive participants	2022-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	107
Number of participants with account balances	2022-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: MIKE CARLSON MOTOR CO. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	77
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	18
Total of all active and inactive participants	2021-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	95
Number of participants with account balances	2021-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: MIKE CARLSON MOTOR CO. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	79
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	20
Total of all active and inactive participants	2020-01-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	100
Number of participants with account balances	2020-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MIKE CARLSON MOTOR CO. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	97
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	16
Total of all active and inactive participants	2019-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	113
Number of participants with account balances	2019-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	3
2018: MIKE CARLSON MOTOR CO. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	97
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	10
Total of all active and inactive participants	2018-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	107
Number of participants with account balances	2018-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	4
2017: MIKE CARLSON MOTOR CO. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	97
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	8
Total of all active and inactive participants	2017-01-01	105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	105
Number of participants with account balances	2017-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: MIKE CARLSON MOTOR CO. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	103
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	107
Number of participants with account balances	2016-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: MIKE CARLSON MOTOR CO. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	108
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	7
Total of all active and inactive participants	2015-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	115
Number of participants with account balances	2015-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: MIKE CARLSON MOTOR CO. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	93
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	7
Total of all active and inactive participants	2014-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	101
Number of participants with account balances	2014-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: MIKE CARLSON MOTOR CO. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	85
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	8
Total of all active and inactive participants	2013-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	93
Number of participants with account balances	2013-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: MIKE CARLSON MOTOR CO. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	94
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	11
Total of all active and inactive participants	2012-01-01	105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	105
Number of participants with account balances	2012-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: MIKE CARLSON MOTOR CO. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	97
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	117
Number of participants with account balances	2011-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: MIKE CARLSON MOTOR CO. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	94
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	13
Total of all active and inactive participants	2010-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	107
Number of participants with account balances	2010-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: MIKE CARLSON MOTOR CO. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	89
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	16
Total of all active and inactive participants	2009-01-01	105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	105
Number of participants with account balances	2009-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on MIKE CARLSON MOTOR CO. 401(K) PLAN

Measure	Date	Value
2023 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2023 401k financial data
Total income from all sources	2023-12-31	$515,548
Expenses. Total of all expenses incurred	2023-12-31	$175,314
Benefits paid (including direct rollovers)	2023-12-31	$157,704
Total plan assets at end of year	2023-12-31	$2,453,097
Total plan assets at beginning of year	2023-12-31	$2,112,863
Value of fidelity bond covering the plan	2023-12-31	$350,000
Total contributions received or receivable from participants	2023-12-31	$108,905
Other income received	2023-12-31	$371,835
Net income (gross income less expenses)	2023-12-31	$340,234
Net plan assets at end of year (total assets less liabilities)	2023-12-31	$2,453,097
Net plan assets at beginning of year (total assets less liabilities)	2023-12-31	$2,112,863
Total contributions received or receivable from employer(s)	2023-12-31	$34,808
Expenses. Administrative service providers (salaries,fees and commissions)	2023-12-31	$17,610
2022 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2022 401k financial data
Total income from all sources	2022-12-31	$-335,025
Expenses. Total of all expenses incurred	2022-12-31	$279,153
Benefits paid (including direct rollovers)	2022-12-31	$260,339
Total plan assets at end of year	2022-12-31	$2,112,863
Total plan assets at beginning of year	2022-12-31	$2,727,041
Value of fidelity bond covering the plan	2022-12-31	$350,000
Total contributions received or receivable from participants	2022-12-31	$113,465
Other income received	2022-12-31	$-448,490
Net income (gross income less expenses)	2022-12-31	$-614,178
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$2,112,863
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$2,727,041
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2022-12-31	$74,052
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$18,814
2021 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$494,673
Expenses. Total of all expenses incurred	2021-12-31	$66,795
Benefits paid (including direct rollovers)	2021-12-31	$48,142
Total plan assets at end of year	2021-12-31	$2,727,041
Total plan assets at beginning of year	2021-12-31	$2,299,163
Value of fidelity bond covering the plan	2021-12-31	$350,000
Total contributions received or receivable from participants	2021-12-31	$103,564
Other income received	2021-12-31	$362,889
Net income (gross income less expenses)	2021-12-31	$427,878
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$2,727,041
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$2,299,163
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2021-12-31	$67,923
Total contributions received or receivable from employer(s)	2021-12-31	$28,220
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$18,653
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$540,190
Expenses. Total of all expenses incurred	2020-12-31	$1,145,245
Benefits paid (including direct rollovers)	2020-12-31	$1,125,555
Total plan assets at end of year	2020-12-31	$2,299,163
Total plan assets at beginning of year	2020-12-31	$2,904,218
Value of fidelity bond covering the plan	2020-12-31	$1,000,000
Total contributions received or receivable from participants	2020-12-31	$118,849
Other income received	2020-12-31	$384,936
Net income (gross income less expenses)	2020-12-31	$-605,055
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$2,299,163
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$2,904,218
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2020-12-31	$57,070
Total contributions received or receivable from employer(s)	2020-12-31	$36,405
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$19,690
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$717,318
Expenses. Total of all expenses incurred	2019-12-31	$137,735
Benefits paid (including direct rollovers)	2019-12-31	$116,788
Total plan assets at end of year	2019-12-31	$2,904,218
Total plan assets at beginning of year	2019-12-31	$2,324,635
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$162,384
Other income received	2019-12-31	$506,926
Net income (gross income less expenses)	2019-12-31	$579,583
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$2,904,218
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$2,324,635
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2019-12-31	$96,350
Total contributions received or receivable from employer(s)	2019-12-31	$48,008
Value of corrective distributions	2019-12-31	$1,910
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$19,037
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$119,142
Expenses. Total of all expenses incurred	2018-12-31	$76,315
Benefits paid (including direct rollovers)	2018-12-31	$58,977
Total plan assets at end of year	2018-12-31	$2,324,635
Total plan assets at beginning of year	2018-12-31	$2,281,808
Value of fidelity bond covering the plan	2018-12-31	$350,000
Total contributions received or receivable from participants	2018-12-31	$151,151
Contributions received from other sources (not participants or employers)	2018-12-31	$31,382
Other income received	2018-12-31	$-113,902
Net income (gross income less expenses)	2018-12-31	$42,827
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$2,324,635
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$2,281,808
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2018-12-31	$103,229
Total contributions received or receivable from employer(s)	2018-12-31	$50,511
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$17,338
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$589,340
Expenses. Total of all expenses incurred	2017-12-31	$540,697
Benefits paid (including direct rollovers)	2017-12-31	$516,507
Total plan assets at end of year	2017-12-31	$2,281,808
Total plan assets at beginning of year	2017-12-31	$2,233,165
Value of fidelity bond covering the plan	2017-12-31	$350,000
Total contributions received or receivable from participants	2017-12-31	$165,781
Other income received	2017-12-31	$365,296
Net income (gross income less expenses)	2017-12-31	$48,643
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$2,281,808
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$2,233,165
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2017-12-31	$160,957
Total contributions received or receivable from employer(s)	2017-12-31	$58,263
Value of corrective distributions	2017-12-31	$8,498
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$15,692
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$379,199
Expenses. Total of all expenses incurred	2016-12-31	$174,180
Benefits paid (including direct rollovers)	2016-12-31	$152,029
Total plan assets at end of year	2016-12-31	$2,233,165
Total plan assets at beginning of year	2016-12-31	$2,028,146
Value of fidelity bond covering the plan	2016-12-31	$350,000
Total contributions received or receivable from participants	2016-12-31	$166,720
Other income received	2016-12-31	$161,924
Net income (gross income less expenses)	2016-12-31	$205,019
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$2,233,165
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$2,028,146
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2016-12-31	$109,706
Total contributions received or receivable from employer(s)	2016-12-31	$50,555
Value of corrective distributions	2016-12-31	$6,916
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$15,235
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$320,228
Expenses. Total of all expenses incurred	2015-12-31	$1,113,734
Benefits paid (including direct rollovers)	2015-12-31	$1,102,061
Total plan assets at end of year	2015-12-31	$2,028,146
Total plan assets at beginning of year	2015-12-31	$2,821,652
Value of fidelity bond covering the plan	2015-12-31	$350,000
Total contributions received or receivable from participants	2015-12-31	$200,381
Contributions received from other sources (not participants or employers)	2015-12-31	$1,950
Other income received	2015-12-31	$4,381
Net income (gross income less expenses)	2015-12-31	$-793,506
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,028,146
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,821,652
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2015-12-31	$73,239
Total contributions received or receivable from employer(s)	2015-12-31	$113,516
Value of corrective distributions	2015-12-31	$8,915
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$2,758
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$428,961
Expenses. Total of all expenses incurred	2014-12-31	$976,604
Benefits paid (including direct rollovers)	2014-12-31	$942,945
Total plan assets at end of year	2014-12-31	$2,821,652
Total plan assets at beginning of year	2014-12-31	$3,369,295
Value of fidelity bond covering the plan	2014-12-31	$350,000
Total contributions received or receivable from participants	2014-12-31	$221,514
Expenses. Other expenses not covered elsewhere	2014-12-31	$19,338
Other income received	2014-12-31	$116,606
Net income (gross income less expenses)	2014-12-31	$-547,643
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,821,652
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,369,295
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2014-12-31	$54,096
Total contributions received or receivable from employer(s)	2014-12-31	$90,841
Value of corrective distributions	2014-12-31	$14,321
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$977,963
Expenses. Total of all expenses incurred	2013-12-31	$699,123
Benefits paid (including direct rollovers)	2013-12-31	$633,082
Total plan assets at end of year	2013-12-31	$3,369,295
Total plan assets at beginning of year	2013-12-31	$3,090,455
Value of fidelity bond covering the plan	2013-12-31	$350,000
Total contributions received or receivable from participants	2013-12-31	$238,046
Expenses. Other expenses not covered elsewhere	2013-12-31	$28,499
Other income received	2013-12-31	$658,940
Net income (gross income less expenses)	2013-12-31	$278,840
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,369,295
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,090,455
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2013-12-31	$70,465
Total contributions received or receivable from employer(s)	2013-12-31	$80,977
Value of corrective distributions	2013-12-31	$37,542
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$634,939
Expenses. Total of all expenses incurred	2012-12-31	$307,456
Benefits paid (including direct rollovers)	2012-12-31	$307,456
Total plan assets at end of year	2012-12-31	$3,090,455
Total plan assets at beginning of year	2012-12-31	$2,762,972
Total contributions received or receivable from participants	2012-12-31	$205,544
Other income received	2012-12-31	$332,942
Net income (gross income less expenses)	2012-12-31	$327,483
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,090,455
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,762,972
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$110,905
Total contributions received or receivable from employer(s)	2012-12-31	$96,453
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$95,043
Expenses. Total of all expenses incurred	2011-12-31	$106,407
Benefits paid (including direct rollovers)	2011-12-31	$70,770
Total plan assets at end of year	2011-12-31	$2,762,972
Total plan assets at beginning of year	2011-12-31	$2,774,336
Total contributions received or receivable from participants	2011-12-31	$208,948
Other income received	2011-12-31	$-176,873
Net income (gross income less expenses)	2011-12-31	$-11,364
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,762,972
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,774,336
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$145,847
Total contributions received or receivable from employer(s)	2011-12-31	$62,968
Value of corrective distributions	2011-12-31	$35,637
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : MIKE CARLSON MOTOR CO. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$614,094
Expenses. Total of all expenses incurred	2010-12-31	$75,387
Benefits paid (including direct rollovers)	2010-12-31	$73,062
Total plan assets at end of year	2010-12-31	$2,774,336
Total plan assets at beginning of year	2010-12-31	$2,235,629
Total contributions received or receivable from participants	2010-12-31	$202,890
Other income received	2010-12-31	$344,173
Net income (gross income less expenses)	2010-12-31	$538,707
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,774,336
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,235,629
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$191,411
Total contributions received or receivable from employer(s)	2010-12-31	$67,031
Value of corrective distributions	2010-12-31	$2,325
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : MIKE CARLSON MOTOR CO. 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 MIKE CARLSON MOTOR CO. 401(K) PLAN

2023: MIKE CARLSON MOTOR CO. 401(K) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: MIKE CARLSON MOTOR CO. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MIKE CARLSON MOTOR CO. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MIKE CARLSON MOTOR CO. 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MIKE CARLSON MOTOR CO. 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MIKE CARLSON MOTOR CO. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MIKE CARLSON MOTOR CO. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MIKE CARLSON MOTOR CO. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MIKE CARLSON MOTOR CO. 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	No
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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: MIKE CARLSON MOTOR CO. 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: MIKE CARLSON MOTOR CO. 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: MIKE CARLSON MOTOR CO. 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: MIKE CARLSON MOTOR CO. 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MIKE CARLSON MOTOR CO. 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MIKE CARLSON MOTOR CO. 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
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
2008: MIKE CARLSON MOTOR CO. 401(K) PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

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

Policy contract number

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	3
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
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 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

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	2
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14
Total amount of fees paid to insurance company	USD $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 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 $14
Insurance broker organization code?	3

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

Policy contract number

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $8
Total amount of fees paid to insurance company	USD $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 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 $6
Insurance broker organization code?	3

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

Policy contract number

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $28
Total amount of fees paid to insurance company	USD $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 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 $28
Insurance broker organization code?	3

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

Policy contract number

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $11
Total amount of fees paid to insurance company	USD $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 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 $11
Insurance broker organization code?	3
Insurance broker name	KESTRA INVESTMENT SERVICES LLC

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

Policy contract number

372961-01

Policy instance

Insurance contract or identification number	372961-01
Number of Individuals Covered	61
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7
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 $7
Insurance broker organization code?	3
Insurance broker name	NFP ADVISOR SERVICES LLC

Potentially related plans

MIKE CARLSON ENTERPRISES, INC. PROFIT SHARING RETIREMENT PLAN [EIN = 911524542]

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Company Name:	MCMC AUTO LTD DBA MIKE CARLSON MOTOR COMPANY
Employer identification number (EIN):	752834494
NAIC Classification:	441120
NAIC Description:	Used Car Dealers