401k Plan data: JUPITER HOLDINGS 401(K) PLAN plan

JUPITER HOLDINGS 401(K) PLAN 401k Plan overview

Plan Name	JUPITER HOLDINGS 401(K) PLAN
Plan identification number	001

JUPITER HOLDINGS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

JUPITER HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: JUPITER HOLDINGS, LLC

Employer identification number (EIN): 571128741

NAIC Classification: 444190
NAIC Description: Other Building Material Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JUPITER HOLDINGS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2020-01-01
001 2019-01-01 CHERYL BORREGARD 2020-10-05
001 2018-01-01 CHERYL BORREGARD 2019-10-06
001 2017-01-01 CHERYL BORREGARD

Plan Statistics for JUPITER HOLDINGS 401(K) PLAN

401k plan membership statisitcs for JUPITER HOLDINGS 401(K) PLAN

Measure Date Value
2022: JUPITER HOLDINGS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 161
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 14
Total of all active and inactive participants 2022-01-01 175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 175
Number of participants with account balances 2022-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: JUPITER HOLDINGS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 160
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 14
Total of all active and inactive participants 2021-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 174
Number of participants with account balances 2021-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: JUPITER HOLDINGS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 155
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 9
Total of all active and inactive participants 2020-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 164
Number of participants with account balances 2020-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: JUPITER HOLDINGS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 151
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 17
Total of all active and inactive participants 2019-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 168
Number of participants with account balances 2019-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: JUPITER HOLDINGS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 170
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 48
Total of all active and inactive participants 2018-01-01 218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 218
Number of participants with account balances 2018-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: JUPITER HOLDINGS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 164
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 42
Total of all active and inactive participants 2017-01-01 206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 206
Number of participants with account balances 2017-01-01 114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1

Measure	Date	Value
2022: JUPITER HOLDINGS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	161
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	14
Total of all active and inactive participants	2022-01-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	175
Number of participants with account balances	2022-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: JUPITER HOLDINGS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	160
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	14
Total of all active and inactive participants	2021-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	174
Number of participants with account balances	2021-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: JUPITER HOLDINGS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	155
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	9
Total of all active and inactive participants	2020-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	164
Number of participants with account balances	2020-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: JUPITER HOLDINGS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	151
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	17
Total of all active and inactive participants	2019-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	168
Number of participants with account balances	2019-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: JUPITER HOLDINGS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	170
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	48
Total of all active and inactive participants	2018-01-01	218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	218
Number of participants with account balances	2018-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: JUPITER HOLDINGS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	164
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	42
Total of all active and inactive participants	2017-01-01	206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	206
Number of participants with account balances	2017-01-01	114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1

Financial Data on JUPITER HOLDINGS 401(K) PLAN

Measure	Date	Value
2022 : JUPITER HOLDINGS 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-458,640
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,222,271
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,170,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$900,276
Value of total assets at end of year	2022-12-31	$7,567,424
Value of total assets at beginning of year	2022-12-31	$9,248,335
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$52,073
Total interest from all sources	2022-12-31	$61
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$302,873
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$302,873
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$606,135
Participant contributions at end of year	2022-12-31	$7,685
Participant contributions at beginning of year	2022-12-31	$2,547
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$4,696
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,680,911
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,567,424
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,248,335
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$27,876
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,164,146
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$8,868,746
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$6,672
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$6,421
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$6,421
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$61
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$385,680
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$364,835
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,661,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$289,445
Employer contributions (assets) at end of year	2022-12-31	$3,241
Employer contributions (assets) at beginning of year	2022-12-31	$5,786
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,170,198
Contract administrator fees	2022-12-31	$24,197
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	SHEHEEN, HANCOCK & GODWIN, LLP
Accountancy firm EIN	2022-12-31	570522539
2021 : JUPITER HOLDINGS 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,092,032
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$254,204
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$196,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$755,313
Value of total assets at end of year	2021-12-31	$9,248,335
Value of total assets at beginning of year	2021-12-31	$7,410,507
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$57,583
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$409,807
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$409,807
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$500,329
Participant contributions at end of year	2021-12-31	$2,547
Participant contributions at beginning of year	2021-12-31	$3,552
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,837,828
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,248,335
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,410,507
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$8,868,746
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$7,078,191
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$6,421
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$6,363
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$6,363
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$364,835
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$320,537
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$926,912
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$254,984
Employer contributions (assets) at end of year	2021-12-31	$5,786
Employer contributions (assets) at beginning of year	2021-12-31	$1,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$196,621
Contract administrator fees	2021-12-31	$57,583
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	SHEHEEN, HANCOCK AND GODWIN, LLP
Accountancy firm EIN	2021-12-31	570522539
2020 : JUPITER HOLDINGS 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,596,418
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$469,349
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$423,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$628,207
Value of total assets at end of year	2020-12-31	$7,410,507
Value of total assets at beginning of year	2020-12-31	$6,283,438
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$46,181
Total interest from all sources	2020-12-31	$154,066
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$814,145
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$814,145
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$407,563
Participant contributions at end of year	2020-12-31	$3,552
Participant contributions at beginning of year	2020-12-31	$6,196
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,127,069
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,410,507
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,283,438
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$7,078,191
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$6,058,294
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$6,363
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$1,507
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$1,507
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$154,066
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$320,537
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$214,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$220,644
Employer contributions (assets) at end of year	2020-12-31	$1,864
Employer contributions (assets) at beginning of year	2020-12-31	$3,051
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$423,168
Contract administrator fees	2020-12-31	$46,181
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	SHEEHAN, HANCOCK & GODWIN, LLP
Accountancy firm EIN	2020-12-31	570522539
2019 : JUPITER HOLDINGS 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$248
Total income from all sources (including contributions)	2019-12-31	$1,812,359
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$143,199
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$102,107
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$619,940
Value of total assets at end of year	2019-12-31	$6,283,438
Value of total assets at beginning of year	2019-12-31	$4,614,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$41,092
Total interest from all sources	2019-12-31	$140
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$184,541
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$184,541
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$413,187
Participant contributions at end of year	2019-12-31	$6,196
Participant contributions at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,669,160
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,283,438
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,614,278
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$6,058,294
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,364,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$1,507
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$14,935
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$14,935
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$140
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$214,390
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$230,820
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,007,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$206,753
Employer contributions (assets) at end of year	2019-12-31	$3,051
Employer contributions (assets) at beginning of year	2019-12-31	$3,856
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$102,107
Contract administrator fees	2019-12-31	$41,092
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$248
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SHEEHAN, HANCOCK & GODWIN, LLP
Accountancy firm EIN	2019-12-31	570522539
2018 : JUPITER HOLDINGS 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$248
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$274,486
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$521,382
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$484,720
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$545,182
Value of total assets at end of year	2018-12-31	$4,614,526
Value of total assets at beginning of year	2018-12-31	$4,861,174
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$36,662
Total interest from all sources	2018-12-31	$159
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$334,946
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$7,213
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$19,028
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-246,896
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,614,278
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,861,174
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$4,364,915
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,623,528
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$14,935
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$13,842
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$13,842
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$159
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$230,820
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$212,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-270,855
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$191,208
Employer contributions (assets) at end of year	2018-12-31	$3,856
Employer contributions (assets) at beginning of year	2018-12-31	$4,203
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$484,720
Contract administrator fees	2018-12-31	$36,662
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2018-12-31	$248
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SHEEHAN, HANCOCK & GODWIN, LLP
Accountancy firm EIN	2018-12-31	570522539
2017 : JUPITER HOLDINGS 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,215,436
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$319,158
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$316,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$453,005
Value of total assets at end of year	2017-12-31	$4,861,174
Value of total assets at beginning of year	2017-12-31	$3,964,896
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,682
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$73,942
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$73,942
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$283,311
Participant contributions at end of year	2017-12-31	$7,213
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$3,541
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$896,278
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,861,174
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,964,896
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,623,528
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,697,614
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$59,429
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$13,842
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$212,388
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$207,853
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$688,489
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$166,153
Employer contributions (assets) at end of year	2017-12-31	$4,203
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$316,476
Contract administrator fees	2017-12-31	$2,682
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	SHEHEEN, HANCOCK & GODWIN, LLP
Accountancy firm EIN	2017-12-31	570522539

Form 5500 Responses for JUPITER HOLDINGS 401(K) PLAN

2022: JUPITER HOLDINGS 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 – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: JUPITER HOLDINGS 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 – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: JUPITER HOLDINGS 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 – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: JUPITER HOLDINGS 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 – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: JUPITER HOLDINGS 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 – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: JUPITER HOLDINGS 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 – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	24
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	28
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	28
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	25
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	22
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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

502974-01

Policy instance

Insurance contract or identification number	502974-01
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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

Potentially related plans

JUPITER HOLDINGS WELFARE BENEFITS PLAN [EIN = 570623277]

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Company Name:	JUPITER HOLDINGS, LLC
Employer identification number (EIN):	571128741
NAIC Classification:	444190
NAIC Description:	Other Building Material Dealers