401k Plan data: CARING CHOICE 401(K) RETIREMENT PLAN plan

CARING CHOICE 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	CARING CHOICE 401(K) RETIREMENT PLAN
Plan identification number	001

CARING CHOICE 401(K) RETIREMENT 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.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CARING CHOICE WOMEN'S CENTER, P.C. has sponsored the creation of one or more 401k plans.

Company Name: CARING CHOICE WOMEN'S CENTER, P.C.

Employer identification number (EIN): 753184902

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARING CHOICE 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 MICHAEL J. SEEBER 2021-02-26
001 2019-01-01 MICHAEL J. SEEBER 2020-07-29
001 2018-01-01 MICHAEL J. SEEBER
001 2017-01-01 MICHAEL J. SEEBER
001 2016-01-01 MICHAEL J. SEEBER
001 2015-01-01 MICHAEL J. SEEBER
001 2014-01-01 MICHAEL J. SEEBER
001 2013-01-01 MICHAEL J. SEEBER
001 2012-01-01 MICHAEL J. SEEBER
001 2011-01-01 MICHAEL J. SEEBER
001 2009-01-01 MICHAEL J. SEEBER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2020-01-01	MICHAEL J. SEEBER	2021-02-26
001	2019-01-01	MICHAEL J. SEEBER	2020-07-29
001	2018-01-01	MICHAEL J. SEEBER
001	2017-01-01	MICHAEL J. SEEBER
001	2016-01-01	MICHAEL J. SEEBER
001	2015-01-01	MICHAEL J. SEEBER
001	2014-01-01	MICHAEL J. SEEBER
001	2013-01-01	MICHAEL J. SEEBER
001	2012-01-01	MICHAEL J. SEEBER
001	2011-01-01	MICHAEL J. SEEBER
001	2009-01-01	MICHAEL J. SEEBER

Plan Statistics for CARING CHOICE 401(K) RETIREMENT PLAN

401k plan membership statisitcs for CARING CHOICE 401(K) RETIREMENT PLAN

Measure Date Value
2018: CARING CHOICE 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 17
Number of other retired or separated participants entitled to future benefits 2018-01-01 4
Total of all active and inactive participants 2018-01-01 21
Total participants 2018-01-01 21
Number of participants with account balances 2018-01-01 21
2017: CARING CHOICE 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 19
Number of other retired or separated participants entitled to future benefits 2017-01-01 1
Total of all active and inactive participants 2017-01-01 20
Total participants 2017-01-01 20
Number of participants with account balances 2017-01-01 20
2016: CARING CHOICE 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 14
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 15
Total participants 2016-01-01 15
Number of participants with account balances 2016-01-01 15
2015: CARING CHOICE 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 12
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 13
Total participants 2015-01-01 13
Number of participants with account balances 2015-01-01 13
2014: CARING CHOICE 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 13
Total of all active and inactive participants 2014-01-01 13
Total participants 2014-01-01 13
Number of participants with account balances 2014-01-01 13
2013: CARING CHOICE 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 12
Total of all active and inactive participants 2013-01-01 12
Total participants 2013-01-01 12
Number of participants with account balances 2013-01-01 12
2012: CARING CHOICE 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 9
Total participants 2012-01-01 9
Number of participants with account balances 2012-01-01 9
2011: CARING CHOICE 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 8
Total participants 2011-01-01 8
2009: CARING CHOICE 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
Total of all active and inactive participants 2009-01-01 6
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6

Measure	Date	Value
2018: CARING CHOICE 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	17
Number of other retired or separated participants entitled to future benefits	2018-01-01	4
Total of all active and inactive participants	2018-01-01	21
Total participants	2018-01-01	21
Number of participants with account balances	2018-01-01	21
2017: CARING CHOICE 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	19
Number of other retired or separated participants entitled to future benefits	2017-01-01	1
Total of all active and inactive participants	2017-01-01	20
Total participants	2017-01-01	20
Number of participants with account balances	2017-01-01	20
2016: CARING CHOICE 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	14
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	15
Total participants	2016-01-01	15
Number of participants with account balances	2016-01-01	15
2015: CARING CHOICE 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	12
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	13
Total participants	2015-01-01	13
Number of participants with account balances	2015-01-01	13
2014: CARING CHOICE 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	13
Total of all active and inactive participants	2014-01-01	13
Total participants	2014-01-01	13
Number of participants with account balances	2014-01-01	13
2013: CARING CHOICE 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	12
Total of all active and inactive participants	2013-01-01	12
Total participants	2013-01-01	12
Number of participants with account balances	2013-01-01	12
2012: CARING CHOICE 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	9
Total participants	2012-01-01	9
Number of participants with account balances	2012-01-01	9
2011: CARING CHOICE 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	8
Total participants	2011-01-01	8
2009: CARING CHOICE 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
Total of all active and inactive participants	2009-01-01	6
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6

Financial Data on CARING CHOICE 401(K) RETIREMENT PLAN

Measure	Date	Value
2018 : CARING CHOICE 401(K) RETIREMENT PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$5,983
Expenses. Total of all expenses incurred	2018-12-31	$10,039
Total plan assets at end of year	2018-12-31	$807,309
Total plan assets at beginning of year	2018-12-31	$811,365
Value of fidelity bond covering the plan	2018-12-31	$125,000
Total contributions received or receivable from participants	2018-12-31	$64,755
Other income received	2018-12-31	$-93,558
Net income (gross income less expenses)	2018-12-31	$-4,056
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$807,309
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$811,365
Total contributions received or receivable from employer(s)	2018-12-31	$34,786
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$10,039
2017 : CARING CHOICE 401(K) RETIREMENT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$218,503
Expenses. Total of all expenses incurred	2017-12-31	$8,701
Benefits paid (including direct rollovers)	2017-12-31	$743
Total plan assets at end of year	2017-12-31	$811,365
Total plan assets at beginning of year	2017-12-31	$601,563
Value of fidelity bond covering the plan	2017-12-31	$125,000
Total contributions received or receivable from participants	2017-12-31	$63,476
Other income received	2017-12-31	$110,379
Net income (gross income less expenses)	2017-12-31	$209,802
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$811,365
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$601,563
Total contributions received or receivable from employer(s)	2017-12-31	$44,648
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$7,958
2016 : CARING CHOICE 401(K) RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$149,312
Expenses. Total of all expenses incurred	2016-12-31	$14,115
Benefits paid (including direct rollovers)	2016-12-31	$8,244
Total plan assets at end of year	2016-12-31	$601,563
Total plan assets at beginning of year	2016-12-31	$466,366
Value of fidelity bond covering the plan	2016-12-31	$50,000
Total contributions received or receivable from participants	2016-12-31	$56,034
Other income received	2016-12-31	$53,447
Net income (gross income less expenses)	2016-12-31	$135,197
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$601,563
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$466,366
Total contributions received or receivable from employer(s)	2016-12-31	$39,831
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$5,871
2015 : CARING CHOICE 401(K) RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$57,983
Expenses. Total of all expenses incurred	2015-12-31	$285
Benefits paid (including direct rollovers)	2015-12-31	$285
Total plan assets at end of year	2015-12-31	$466,366
Total plan assets at beginning of year	2015-12-31	$408,668
Value of fidelity bond covering the plan	2015-12-31	$50,000
Total contributions received or receivable from participants	2015-12-31	$45,613
Other income received	2015-12-31	$-27,630
Net income (gross income less expenses)	2015-12-31	$57,698
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$466,366
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$408,668
Total contributions received or receivable from employer(s)	2015-12-31	$40,000
2014 : CARING CHOICE 401(K) RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$72,675
Expenses. Total of all expenses incurred	2014-12-31	$951
Benefits paid (including direct rollovers)	2014-12-31	$951
Total plan assets at end of year	2014-12-31	$408,668
Total plan assets at beginning of year	2014-12-31	$336,944
Value of fidelity bond covering the plan	2014-12-31	$50,000
Total contributions received or receivable from participants	2014-12-31	$38,207
Other income received	2014-12-31	$-2,941
Net income (gross income less expenses)	2014-12-31	$71,724
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$408,668
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$336,944
Total contributions received or receivable from employer(s)	2014-12-31	$37,409
2013 : CARING CHOICE 401(K) RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$97,723
Expenses. Total of all expenses incurred	2013-12-31	$1,885
Benefits paid (including direct rollovers)	2013-12-31	$1,885
Total plan assets at end of year	2013-12-31	$336,944
Total plan assets at beginning of year	2013-12-31	$241,106
Value of fidelity bond covering the plan	2013-12-31	$50,000
Total contributions received or receivable from participants	2013-12-31	$34,187
Other income received	2013-12-31	$28,596
Net income (gross income less expenses)	2013-12-31	$95,838
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$336,944
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$241,106
Total contributions received or receivable from employer(s)	2013-12-31	$34,940
2012 : CARING CHOICE 401(K) RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$84,867
Expenses. Total of all expenses incurred	2012-12-31	$1,845
Benefits paid (including direct rollovers)	2012-12-31	$1,845
Total plan assets at end of year	2012-12-31	$241,106
Total plan assets at beginning of year	2012-12-31	$158,084
Value of fidelity bond covering the plan	2012-12-31	$50,000
Total contributions received or receivable from participants	2012-12-31	$30,304
Other income received	2012-12-31	$21,896
Net income (gross income less expenses)	2012-12-31	$83,022
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$241,106
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$158,084
Total contributions received or receivable from employer(s)	2012-12-31	$32,667
2011 : CARING CHOICE 401(K) RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$25,078
Expenses. Total of all expenses incurred	2011-12-31	$3,246
Benefits paid (including direct rollovers)	2011-12-31	$3,142
Total plan assets at end of year	2011-12-31	$158,084
Total plan assets at beginning of year	2011-12-31	$136,252
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$26,582
Other income received	2011-12-31	$-19,004
Net income (gross income less expenses)	2011-12-31	$21,832
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$158,084
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$136,252
Total contributions received or receivable from employer(s)	2011-12-31	$17,500
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$104
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$3,142
2010 : CARING CHOICE 401(K) RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$72,974
Expenses. Total of all expenses incurred	2010-12-31	$9,001
Benefits paid (including direct rollovers)	2010-12-31	$8,003
Total plan assets at end of year	2010-12-31	$136,252
Total plan assets at beginning of year	2010-12-31	$72,279
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$27,550
Other income received	2010-12-31	$12,370
Net income (gross income less expenses)	2010-12-31	$63,973
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$136,252
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$72,279
Total contributions received or receivable from employer(s)	2010-12-31	$33,054
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$998
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$13

Form 5500 Responses for CARING CHOICE 401(K) RETIREMENT PLAN

2018: CARING CHOICE 401(K) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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: CARING CHOICE 401(K) RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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
2016: CARING CHOICE 401(K) RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CARING CHOICE 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CARING CHOICE 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CARING CHOICE 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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: CARING CHOICE 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CARING CHOICE 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CARING CHOICE 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	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

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	0
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $14
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14
Insurance broker organization code?	3
Insurance broker name	JAMES IZETT - IFG LLC

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

Policy contract number

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	13
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,578
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,091
Insurance broker organization code?	3
Insurance broker name	JAMES IZETT - IFG LLC

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

Policy contract number

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	12
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,145
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,145
Insurance broker organization code?	3
Insurance broker name	JAMES IZETT

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

Policy contract number

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	9
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $765
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $608
Insurance broker organization code?	3
Insurance broker name	ROBERT WHITE

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

Policy contract number

641799

Policy instance

Insurance contract or identification number	641799
Number of Individuals Covered	0
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $52
Total amount of fees paid to insurance company	USD $0
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 guaranteed investment?	Yes
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

944162-01

Policy instance

Insurance contract or identification number	944162-01
Number of Individuals Covered	8
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,052
Total amount of fees paid to insurance company	USD $0
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 guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

641799

Policy instance

Insurance contract or identification number	641799
Number of Individuals Covered	8
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $208
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $104
Insurance broker organization code?	3
Insurance broker name	JAMES IZETT

Potentially related plans

CARING CHOICES INC 401K PROFIT SHARING PLAN [EIN = 680337307]

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Company Name:	CARING CHOICE WOMEN'S CENTER, P.C.
Employer identification number (EIN):	753184902
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)