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ICRM, PC 401(K) PLAN 401k Plan overview

Plan NameICRM, PC 401(K) PLAN
Plan identification number 001

ICRM, PC 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
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

IDAHO CENTER FOR REPRODUCTIVE MEDICINE, PC has sponsored the creation of one or more 401k plans.

Company Name:IDAHO CENTER FOR REPRODUCTIVE MEDICINE, PC
Employer identification number (EIN):300047069
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ICRM, PC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01PAUL D. SLATER
0012016-01-01PAUL D. SLATER
0012015-01-01PAUL D. SLATER
0012014-01-01PAUL D. SLATER

Plan Statistics for ICRM, PC 401(K) PLAN

401k plan membership statisitcs for ICRM, PC 401(K) PLAN

Measure Date Value
2023: ICRM, PC 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0138
Total number of active participants reported on line 7a of the Form 55002023-01-0135
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-016
Total of all active and inactive participants2023-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-0141
Number of participants with account balances2023-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-012
2022: ICRM, PC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0136
Total number of active participants reported on line 7a of the Form 55002022-01-0128
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0110
Total of all active and inactive participants2022-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0138
Number of participants with account balances2022-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: ICRM, PC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0131
Total number of active participants reported on line 7a of the Form 55002021-01-0125
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0111
Total of all active and inactive participants2021-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0136
Number of participants with account balances2021-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: ICRM, PC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0129
Total number of active participants reported on line 7a of the Form 55002020-01-0121
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0110
Total of all active and inactive participants2020-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0131
Number of participants with account balances2020-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-015
2019: ICRM, PC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0127
Total number of active participants reported on line 7a of the Form 55002019-01-0122
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-017
Total of all active and inactive participants2019-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0129
Number of participants with account balances2019-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: ICRM, PC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0124
Total number of active participants reported on line 7a of the Form 55002018-01-0122
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0127
Number of participants with account balances2018-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: ICRM, PC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0125
Total number of active participants reported on line 7a of the Form 55002017-01-0121
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0124
Number of participants with account balances2017-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ICRM, PC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0120
Total number of active participants reported on line 7a of the Form 55002016-01-0120
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0125
Number of participants with account balances2016-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: ICRM, PC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0118
Total number of active participants reported on line 7a of the Form 55002015-01-0116
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0119
Number of participants with account balances2015-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ICRM, PC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0117
Total number of active participants reported on line 7a of the Form 55002014-01-0115
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0118
Number of participants with account balances2014-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012

Financial Data on ICRM, PC 401(K) PLAN

Measure Date Value
2023 : ICRM, PC 401(K) PLAN 2023 401k financial data
Total income from all sources2023-12-31$1,150,691
Expenses. Total of all expenses incurred2023-12-31$94,231
Benefits paid (including direct rollovers)2023-12-31$79,613
Total plan assets at end of year2023-12-31$5,455,182
Total plan assets at beginning of year2023-12-31$4,398,722
Value of fidelity bond covering the plan2023-12-31$500,000
Total contributions received or receivable from participants2023-12-31$227,869
Other income received2023-12-31$820,549
Net income (gross income less expenses)2023-12-31$1,056,460
Net plan assets at end of year (total assets less liabilities)2023-12-31$5,455,182
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$4,398,722
Assets. Value of participant loans2023-12-31$20,546
Total contributions received or receivable from employer(s)2023-12-31$102,273
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$14,618
2022 : ICRM, PC 401(K) PLAN 2022 401k financial data
Total income from all sources2022-12-31$-477,147
Expenses. Total of all expenses incurred2022-12-31$26,782
Benefits paid (including direct rollovers)2022-12-31$12,679
Total plan assets at end of year2022-12-31$4,398,722
Total plan assets at beginning of year2022-12-31$4,902,651
Value of fidelity bond covering the plan2022-12-31$490,266
Total contributions received or receivable from participants2022-12-31$201,263
Other income received2022-12-31$-780,456
Net income (gross income less expenses)2022-12-31$-503,929
Net plan assets at end of year (total assets less liabilities)2022-12-31$4,398,722
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$4,902,651
Assets. Value of participant loans2022-12-31$18,129
Total contributions received or receivable from employer(s)2022-12-31$102,046
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$14,103
2021 : ICRM, PC 401(K) PLAN 2021 401k financial data
Total income from all sources2021-12-31$1,126,408
Expenses. Total of all expenses incurred2021-12-31$140,013
Benefits paid (including direct rollovers)2021-12-31$127,238
Total plan assets at end of year2021-12-31$4,902,651
Total plan assets at beginning of year2021-12-31$3,916,256
Value of fidelity bond covering the plan2021-12-31$490,266
Total contributions received or receivable from participants2021-12-31$181,265
Contributions received from other sources (not participants or employers)2021-12-31$14,536
Other income received2021-12-31$846,013
Net income (gross income less expenses)2021-12-31$986,395
Net plan assets at end of year (total assets less liabilities)2021-12-31$4,902,651
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$3,916,256
Assets. Value of participant loans2021-12-31$7,249
Total contributions received or receivable from employer(s)2021-12-31$84,594
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$12,775
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : ICRM, PC 401(K) PLAN 2020 401k financial data
Total income from all sources2020-12-31$734,815
Expenses. Total of all expenses incurred2020-12-31$184,645
Benefits paid (including direct rollovers)2020-12-31$174,934
Total plan assets at end of year2020-12-31$3,916,256
Total plan assets at beginning of year2020-12-31$3,366,086
Value of fidelity bond covering the plan2020-12-31$391,626
Total contributions received or receivable from participants2020-12-31$170,640
Other income received2020-12-31$493,481
Net income (gross income less expenses)2020-12-31$550,170
Net plan assets at end of year (total assets less liabilities)2020-12-31$3,916,256
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$3,366,086
Total contributions received or receivable from employer(s)2020-12-31$70,694
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$9,711
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : ICRM, PC 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$934,433
Expenses. Total of all expenses incurred2019-12-31$28,683
Benefits paid (including direct rollovers)2019-12-31$20,052
Total plan assets at end of year2019-12-31$3,366,086
Total plan assets at beginning of year2019-12-31$2,460,336
Value of fidelity bond covering the plan2019-12-31$250,000
Total contributions received or receivable from participants2019-12-31$175,891
Contributions received from other sources (not participants or employers)2019-12-31$48,052
Other income received2019-12-31$634,984
Net income (gross income less expenses)2019-12-31$905,750
Net plan assets at end of year (total assets less liabilities)2019-12-31$3,366,086
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,460,336
Assets. Value of participant loans2019-12-31$0
Total contributions received or receivable from employer(s)2019-12-31$75,506
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$8,631
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : ICRM, PC 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$79,209
Expenses. Total of all expenses incurred2018-12-31$30,514
Benefits paid (including direct rollovers)2018-12-31$22,927
Total plan assets at end of year2018-12-31$2,460,336
Total plan assets at beginning of year2018-12-31$2,411,641
Value of fidelity bond covering the plan2018-12-31$250,000
Total contributions received or receivable from participants2018-12-31$168,417
Other income received2018-12-31$-162,117
Net income (gross income less expenses)2018-12-31$48,695
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,460,336
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,411,641
Assets. Value of participant loans2018-12-31$29,539
Total contributions received or receivable from employer(s)2018-12-31$72,909
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$7,587
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : ICRM, PC 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$598,948
Expenses. Total of all expenses incurred2017-12-31$52,251
Benefits paid (including direct rollovers)2017-12-31$46,176
Total plan assets at end of year2017-12-31$2,411,641
Total plan assets at beginning of year2017-12-31$1,864,944
Value of fidelity bond covering the plan2017-12-31$250,000
Total contributions received or receivable from participants2017-12-31$152,657
Contributions received from other sources (not participants or employers)2017-12-31$25,977
Other income received2017-12-31$354,790
Net income (gross income less expenses)2017-12-31$546,697
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,411,641
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,864,944
Assets. Value of participant loans2017-12-31$16,323
Total contributions received or receivable from employer(s)2017-12-31$65,524
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$6,075
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : ICRM, PC 401(K) PLAN 2016 401k financial data
Total income from all sources2016-12-31$374,686
Expenses. Total of all expenses incurred2016-12-31$55,924
Benefits paid (including direct rollovers)2016-12-31$50,913
Total plan assets at end of year2016-12-31$1,864,944
Total plan assets at beginning of year2016-12-31$1,546,182
Value of fidelity bond covering the plan2016-12-31$250,000
Total contributions received or receivable from participants2016-12-31$152,173
Other income received2016-12-31$160,320
Net income (gross income less expenses)2016-12-31$318,762
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,864,944
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,546,182
Assets. Value of participant loans2016-12-31$5,832
Total contributions received or receivable from employer(s)2016-12-31$62,193
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$5,011
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : ICRM, PC 401(K) PLAN 2015 401k financial data
Total income from all sources2015-12-31$158,011
Expenses. Total of all expenses incurred2015-12-31$197,719
Benefits paid (including direct rollovers)2015-12-31$192,829
Total plan assets at end of year2015-12-31$1,546,182
Total plan assets at beginning of year2015-12-31$1,585,890
Value of fidelity bond covering the plan2015-12-31$250,000
Total contributions received or receivable from participants2015-12-31$131,091
Contributions received from other sources (not participants or employers)2015-12-31$5,000
Other income received2015-12-31$-27,807
Net income (gross income less expenses)2015-12-31$-39,708
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,546,182
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,585,890
Assets. Value of participant loans2015-12-31$9,147
Total contributions received or receivable from employer(s)2015-12-31$49,727
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$4,890
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : ICRM, PC 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$1,324,749
Total income from all sources2014-12-31$274,643
Expenses. Total of all expenses incurred2014-12-31$13,502
Benefits paid (including direct rollovers)2014-12-31$10,362
Total plan assets at end of year2014-12-31$1,585,890
Value of fidelity bond covering the plan2014-12-31$250,000
Total contributions received or receivable from participants2014-12-31$116,141
Other income received2014-12-31$110,316
Net income (gross income less expenses)2014-12-31$261,141
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,585,890
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Assets. Value of participant loans2014-12-31$52,993
Total contributions received or receivable from employer(s)2014-12-31$48,186
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$3,140
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0

Form 5500 Responses for ICRM, PC 401(K) PLAN

2023: ICRM, PC 401(K) PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: ICRM, PC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ICRM, PC 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 filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
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: ICRM, PC 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: ICRM, PC 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
2018: ICRM, PC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: ICRM, PC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ICRM, PC 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ICRM, PC 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ICRM, PC 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan 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 number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered5
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $15
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 $15
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12
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 $12
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $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 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 $2
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370210-01
Policy instance 1
Insurance contract or identification number370210-01
Number of Individuals Covered18
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1
Total amount of fees paid to insurance companyUSD $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 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 $1
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES

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