401k Plan data: GUARANTEE INSURANCE GROUP 401(K) PLAN plan

GUARANTEE INSURANCE GROUP 401(K) PLAN 401k Plan overview

Plan Name	GUARANTEE INSURANCE GROUP 401(K) PLAN
Plan identification number	001

GUARANTEE INSURANCE GROUP 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PATRIOT NATIONAL INSURANCE GROUP has sponsored the creation of one or more 401k plans.

Company Name: PATRIOT NATIONAL INSURANCE GROUP

Employer identification number (EIN): 731665490

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GUARANTEE INSURANCE GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 TRICIA KEYES
001 2016-01-01 KAREN GOOD
001 2015-07-15 DAVID SKUP DAVID SKUP 2016-09-23
001 2014-01-01 JAMIE O'CONNOR
001 2013-01-01 JAMIE O'CONNOR
001 2012-01-01 JOHN BRANT
001 2011-01-01 JOHN BRANT

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	TRICIA KEYES
001	2016-01-01	KAREN GOOD
001	2015-07-15	DAVID SKUP	DAVID SKUP	2016-09-23
001	2014-01-01	JAMIE O'CONNOR
001	2013-01-01	JAMIE O'CONNOR
001	2012-01-01	JOHN BRANT
001	2011-01-01	JOHN BRANT

Plan Statistics for GUARANTEE INSURANCE GROUP 401(K) PLAN

401k plan membership statisitcs for GUARANTEE INSURANCE GROUP 401(K) PLAN

Measure Date Value
2017: GUARANTEE INSURANCE GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 46
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 33
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 16
Total of all active and inactive participants 2017-01-01 49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 49
Number of participants with account balances 2017-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 7
2016: GUARANTEE INSURANCE GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 43
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 3
Total of all active and inactive participants 2016-01-01 46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 46
Number of participants with account balances 2016-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: GUARANTEE INSURANCE GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-15 28
Total number of active participants reported on line 7a of the Form 5500 2015-07-15 28
Number of retired or separated participants receiving benefits 2015-07-15 0
Number of other retired or separated participants entitled to future benefits 2015-07-15 3
Total of all active and inactive participants 2015-07-15 31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-15 0
Total participants 2015-07-15 31
Number of participants with account balances 2015-07-15 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-15 1
2014: GUARANTEE INSURANCE GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 513
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 563
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 65
Total of all active and inactive participants 2014-01-01 628
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 628
Number of participants with account balances 2014-01-01 563
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 57
2013: GUARANTEE INSURANCE GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 316
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 463
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 50
Total of all active and inactive participants 2013-01-01 513
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 513
Number of participants with account balances 2013-01-01 409
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 27
2012: GUARANTEE INSURANCE GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 261
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 55
Total of all active and inactive participants 2012-01-01 316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 316
Number of participants with account balances 2012-01-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: GUARANTEE INSURANCE GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 280
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 234
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 60
Total of all active and inactive participants 2011-01-01 294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 294
Number of participants with account balances 2011-01-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2017: GUARANTEE INSURANCE GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	46
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	33
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	16
Total of all active and inactive participants	2017-01-01	49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	49
Number of participants with account balances	2017-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	7
2016: GUARANTEE INSURANCE GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	43
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	3
Total of all active and inactive participants	2016-01-01	46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	46
Number of participants with account balances	2016-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: GUARANTEE INSURANCE GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-15	28
Total number of active participants reported on line 7a of the Form 5500	2015-07-15	28
Number of retired or separated participants receiving benefits	2015-07-15	0
Number of other retired or separated participants entitled to future benefits	2015-07-15	3
Total of all active and inactive participants	2015-07-15	31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-15	0
Total participants	2015-07-15	31
Number of participants with account balances	2015-07-15	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-15	1
2014: GUARANTEE INSURANCE GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	513
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	563
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	65
Total of all active and inactive participants	2014-01-01	628
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	628
Number of participants with account balances	2014-01-01	563
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	57
2013: GUARANTEE INSURANCE GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	316
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	463
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	50
Total of all active and inactive participants	2013-01-01	513
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	513
Number of participants with account balances	2013-01-01	409
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	27
2012: GUARANTEE INSURANCE GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	261
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	55
Total of all active and inactive participants	2012-01-01	316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	316
Number of participants with account balances	2012-01-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: GUARANTEE INSURANCE GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	280
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	234
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	60
Total of all active and inactive participants	2011-01-01	294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	294
Number of participants with account balances	2011-01-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on GUARANTEE INSURANCE GROUP 401(K) PLAN

Measure	Date	Value
2017 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$663,330
Expenses. Total of all expenses incurred	2017-12-31	$639,357
Benefits paid (including direct rollovers)	2017-12-31	$636,748
Total plan assets at end of year	2017-12-31	$1,855,576
Total plan assets at beginning of year	2017-12-31	$1,831,603
Value of fidelity bond covering the plan	2017-12-31	$3,000,000
Assets. Value of tangible personal property	2017-12-31	$0
Total contributions received or receivable from participants	2017-12-31	$268,529
Assets. Value of loans (other than to participants)	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$17,493
Other income received	2017-12-31	$276,135
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$23,973
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$1,855,576
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,831,603
Assets. Value of participant loans	2017-12-31	$58,059
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$0
Assets. Value of real-estate (other than employer real property)	2017-12-31	$0
Assets. Value of employer securities	2017-12-31	$0
Assets. Value of employer real property	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$101,173
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$2,071
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$538
2016 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$598,085
Expenses. Total of all expenses incurred	2016-12-31	$40,922
Benefits paid (including direct rollovers)	2016-12-31	$40,616
Total plan assets at end of year	2016-12-31	$1,831,603
Total plan assets at beginning of year	2016-12-31	$1,274,440
Value of fidelity bond covering the plan	2016-12-31	$3,000,000
Total contributions received or receivable from participants	2016-12-31	$276,195
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$67,058
Other income received	2016-12-31	$152,772
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$557,163
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,831,603
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,274,440
Assets. Value of participant loans	2016-12-31	$75,925
Total contributions received or receivable from employer(s)	2016-12-31	$102,060
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$306
2015 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$1,225,711
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$73,870
Expenses. Total of all expenses incurred	2015-12-31	$25,141
Benefits paid (including direct rollovers)	2015-12-31	$25,016
Total plan assets at end of year	2015-12-31	$1,274,440
Total plan assets at beginning of year	2015-12-31	$0
Value of fidelity bond covering the plan	2015-12-31	$3,000,000
Total contributions received or receivable from participants	2015-12-31	$104,525
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-63,012
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$48,729
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,274,440
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Assets. Value of participant loans	2015-12-31	$25,425
Total contributions received or receivable from employer(s)	2015-12-31	$32,357
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$125
2014 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$3,510,741
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$543,623
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$539,567
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$3,148,004
Value of total assets at end of year	2014-12-31	$9,110,906
Value of total assets at beginning of year	2014-12-31	$6,143,788
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,056
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$8,295
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$503,688
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$503,688
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,777,319
Participant contributions at end of year	2014-12-31	$299,210
Participant contributions at beginning of year	2014-12-31	$173,554
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$697,041
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$4,056
Liabilities. Value of operating payables at end of year	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$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	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$2,967,118
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,110,906
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,143,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$8,736,699
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,942,425
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$8,295
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$0
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$74,997
Value of interest in common/collective trusts at beginning of year	2014-12-31	$27,809
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-149,731
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$485
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$673,644
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$539,567
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BDO, USA, LLP
Accountancy firm EIN	2014-12-31	135381590
2013 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$3,164,237
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,243,836
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,242,542
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$2,344,730
Value of total assets at end of year	2013-12-31	$6,143,788
Value of total assets at beginning of year	2013-12-31	$4,223,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,294
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$5,484
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$267,762
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$267,762
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Administrative expenses professional fees incurred	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,328,649
Participant contributions at end of year	2013-12-31	$173,554
Participant contributions at beginning of year	2013-12-31	$99,626
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$799,049
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$1,749
Administrative expenses (other) incurred	2013-12-31	$1,294
Liabilities. Value of operating payables at end of year	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$1,920,401
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,143,788
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$4,223,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,942,425
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$3,751,799
Interest on participant loans	2013-12-31	$4,737
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$747
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$27,809
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$371,962
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$390,931
Net investment gain/loss from pooled separate accounts	2013-12-31	$153,102
Net investment gain or loss from common/collective trusts	2013-12-31	$479
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$217,032
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,242,542
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BDO, USA, LLP
Accountancy firm EIN	2013-12-31	135381590
2012 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,318,499
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$506,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$476,287
Expenses. Certain deemed distributions of participant loans	2012-12-31	$27,492
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$892,127
Value of total assets at end of year	2012-12-31	$4,223,387
Value of total assets at beginning of year	2012-12-31	$3,411,282
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,615
Total interest from all sources	2012-12-31	$11,759
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$748,189
Participant contributions at end of year	2012-12-31	$99,626
Participant contributions at beginning of year	2012-12-31	$52,071
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$143,938
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$812,105
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,223,387
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,411,282
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$3,751,799
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$2,591,056
Interest on participant loans	2012-12-31	$3,534
Interest earned on other investments	2012-12-31	$8,225
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$474,980
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$474,980
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$371,962
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$293,175
Net investment gain/loss from pooled separate accounts	2012-12-31	$414,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$476,287
Contract administrator fees	2012-12-31	$2,615
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	BDO, USA, LLP
Accountancy firm EIN	2012-12-31	135381590
2011 : GUARANTEE INSURANCE GROUP 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$723,568
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$335,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$314,513
Expenses. Certain deemed distributions of participant loans	2011-12-31	$14,340
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$830,917
Value of total assets at end of year	2011-12-31	$3,411,282
Value of total assets at beginning of year	2011-12-31	$3,022,880
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,313
Total interest from all sources	2011-12-31	$9,002
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$6,313
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$601,774
Participant contributions at end of year	2011-12-31	$52,071
Participant contributions at beginning of year	2011-12-31	$104,819
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$229,143
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$388,402
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,411,282
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,022,880
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$2,591,056
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,715,765
Interest on participant loans	2011-12-31	$6,685
Interest earned on other investments	2011-12-31	$5,902
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$474,980
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$-3,585
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$293,175
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$202,296
Net investment gain/loss from pooled separate accounts	2011-12-31	$-116,351
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$314,513
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	BDO SIEDMAN
Accountancy firm EIN	2011-12-31	135381590

Form 5500 Responses for GUARANTEE INSURANCE GROUP 401(K) PLAN

2017: GUARANTEE INSURANCE GROUP 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	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GUARANTEE INSURANCE GROUP 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: GUARANTEE INSURANCE GROUP 401(K) PLAN 2015 form 5500 responses
2015-07-15	Type of plan entity	Single employer plan
2015-07-15	First time form 5500 has been submitted	Yes
2015-07-15	Submission has been amended	No
2015-07-15	This submission is the final filing	No
2015-07-15	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-07-15	Plan is a collectively bargained plan	No
2015-07-15	Plan funding arrangement – Trust	Yes
2015-07-15	Plan benefit arrangement - Trust	Yes
2014: GUARANTEE INSURANCE GROUP 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: GUARANTEE INSURANCE GROUP 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: GUARANTEE INSURANCE GROUP 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: GUARANTEE INSURANCE GROUP 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91670036

Policy instance

Insurance contract or identification number	91670036
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-01-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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?	Yes

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91670036

Policy instance

Insurance contract or identification number	91670036
Number of Individuals Covered	179
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $10,390
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,468
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ALLEN, CLU CHARLES E

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91670036

Policy instance

Insurance contract or identification number	91670036
Number of Individuals Covered	161
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $9,045
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PATRIOT NATIONAL INSURANCE GROUP
Employer identification number (EIN):	731665490
NAIC Classification:	621610
NAIC Description:	Home Health Care Services