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JVA, INC. PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameJVA, INC. PROFIT SHARING PLAN & TRUST
Plan identification number 001

JVA, INC. PROFIT SHARING PLAN & TRUST Benefits

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

JVA, INC. has sponsored the creation of one or more 401k plans.

Company Name:JVA, INC.
Employer identification number (EIN):840638689
NAIC Classification:541330
NAIC Description:Engineering Services

Additional information about JVA, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1973-04-27
Company Identification Number: 19871257319
Legal Registered Office Address: 1319 Spruce St

Boulder
United States of America (USA)
80302

More information about JVA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JVA, INC. PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01CINDERA WARD2024-09-09 CINDERA WARD2024-09-09
0012022-01-01CINDERA WARD2023-10-05 CINDERA WARD2023-10-05
0012021-05-01CINDERA WARD2022-10-13 CINDERA WARD2022-10-13
0012020-05-01
0012019-05-01
0012018-05-01
0012017-05-01
0012016-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012015-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012014-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012013-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012012-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012011-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012010-05-01CINDERA WARD2022-02-18 CINDERA WARD2022-02-18
0012007-05-01
0012006-05-01
0012005-05-01

Plan Statistics for JVA, INC. PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for JVA, INC. PROFIT SHARING PLAN & TRUST

Measure Date Value
2023: JVA, INC. PROFIT SHARING PLAN & TRUST 2023 401k membership
Total participants, beginning-of-year2023-01-01170
Total number of active participants reported on line 7a of the Form 55002023-01-01134
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0136
Total of all active and inactive participants2023-01-01170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01170
Number of participants with account balances2023-01-01158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-011
2022: JVA, INC. PROFIT SHARING PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-01162
Total number of active participants reported on line 7a of the Form 55002022-01-01134
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0136
Total of all active and inactive participants2022-01-01170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01170
Number of participants with account balances2022-01-01159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: JVA, INC. PROFIT SHARING PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year2021-05-01155
Total number of active participants reported on line 7a of the Form 55002021-05-01130
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-0132
Total of all active and inactive participants2021-05-01162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-05-010
Total participants2021-05-01162
Number of participants with account balances2021-05-01150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-05-012
2020: JVA, INC. PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year2020-05-01153
Total number of active participants reported on line 7a of the Form 55002020-05-01126
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-0129
Total of all active and inactive participants2020-05-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-05-010
Total participants2020-05-01155
Number of participants with account balances2020-05-01144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-05-010
2019: JVA, INC. PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year2019-05-01127
Total number of active participants reported on line 7a of the Form 55002019-05-01116
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-0129
Total of all active and inactive participants2019-05-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-05-010
Total participants2019-05-01145
Number of participants with account balances2019-05-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-05-013
2018: JVA, INC. PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-05-01126
Total number of active participants reported on line 7a of the Form 55002018-05-01111
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-0117
Total of all active and inactive participants2018-05-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-05-010
Total participants2018-05-01128
Number of participants with account balances2018-05-01125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-05-010
2017: JVA, INC. PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year2017-05-01121
Total number of active participants reported on line 7a of the Form 55002017-05-01108
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-0116
Total of all active and inactive participants2017-05-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-05-010
Total participants2017-05-01124
Number of participants with account balances2017-05-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-05-011

Financial Data on JVA, INC. PROFIT SHARING PLAN & TRUST

Measure Date Value
2023 : JVA, INC. PROFIT SHARING PLAN & TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$4,764,667
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$815,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$755,915
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$2,019,346
Value of total assets at end of year2023-12-31$18,114,791
Value of total assets at beginning of year2023-12-31$14,165,127
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$59,088
Total interest from all sources2023-12-31$703
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$462,395
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$462,395
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$1,000,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$1,619,830
Participant contributions at end of year2023-12-31$12,465
Participant contributions at beginning of year2023-12-31$20,125
Participant contributions at end of year2023-12-31$139,192
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$41,307
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$3,949,664
Value of net assets at end of year (total assets less liabilities)2023-12-31$18,114,791
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$14,165,127
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$57,420
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$17,093,587
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$13,344,051
Interest on participant loans2023-12-31$703
Value of interest in common/collective trusts at end of year2023-12-31$212,860
Value of interest in common/collective trusts at beginning of year2023-12-31$177,090
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$4,000
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$2,558
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$2,558
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$616,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$621,303
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$2,282,223
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31Yes
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$358,209
Employer contributions (assets) at end of year2023-12-31$36,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$755,915
Contract administrator fees2023-12-31$1,668
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31RUBIN BROWN
Accountancy firm EIN2023-12-31430765316
2022 : JVA, INC. PROFIT SHARING PLAN & TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$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$0
Total income from all sources (including contributions)2022-12-31$-942,420
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,196,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,143,446
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,863,680
Value of total assets at end of year2022-12-31$14,165,127
Value of total assets at beginning of year2022-12-31$16,304,014
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$53,021
Total interest from all sources2022-12-31$1,034
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$601,880
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$601,880
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,413,309
Participant contributions at end of year2022-12-31$20,125
Participant contributions at beginning of year2022-12-31$28,795
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$117,537
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,138,887
Value of net assets at end of year (total assets less liabilities)2022-12-31$14,165,127
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$16,304,014
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$13,344,051
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$15,471,240
Interest on participant loans2022-12-31$1,034
Value of interest in common/collective trusts at end of year2022-12-31$177,090
Value of interest in common/collective trusts at beginning of year2022-12-31$126,848
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$2,558
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,290
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,290
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$621,303
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$675,841
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-3,409,014
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$332,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,143,446
Contract administrator fees2022-12-31$53,021
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31RUBINBROWN
Accountancy firm EIN2022-12-31430765316
2021 : JVA, INC. PROFIT SHARING PLAN & TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$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$2,135,123
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$711,193
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$700,563
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,144,627
Value of total assets at end of year2021-12-31$16,304,014
Value of total assets at beginning of year2021-12-31$14,880,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$10,630
Total interest from all sources2021-12-31$1,051
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$858,285
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$858,285
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$823,325
Participant contributions at end of year2021-12-31$28,795
Participant contributions at beginning of year2021-12-31$34,172
Participant contributions at beginning of year2021-12-31$97,749
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$134,857
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,423,930
Value of net assets at end of year (total assets less liabilities)2021-12-31$16,304,014
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$14,880,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$15,471,240
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$13,360,773
Interest on participant loans2021-12-31$1,051
Value of interest in common/collective trusts at end of year2021-12-31$126,848
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,290
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$9,733
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$9,733
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$675,841
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,284,316
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$131,160
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$186,445
Employer contributions (assets) at beginning of year2021-12-31$93,341
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$700,563
Contract administrator fees2021-12-31$10,630
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31RUBINBROWN
Accountancy firm EIN2021-12-31430765316
Total unrealized appreciation/depreciation of assets2021-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$16,800
Total income from all sources (including contributions)2021-04-30$5,462,804
Total loss/gain on sale of assets2021-04-30$0
Total of all expenses incurred2021-04-30$291,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-04-30$280,112
Value of total corrective distributions2021-04-30$5,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-04-30$1,771,750
Value of total assets at end of year2021-04-30$14,880,084
Value of total assets at beginning of year2021-04-30$9,725,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-04-30$5,918
Total interest from all sources2021-04-30$2,681
Total dividends received (eg from common stock, registered investment company shares)2021-04-30$605,045
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2021-04-30$605,045
Was this plan covered by a fidelity bond2021-04-30Yes
Value of fidelity bond cover2021-04-30$1,000,000
If this is an individual account plan, was there a blackout period2021-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-04-30$0
Were there any nonexempt tranactions with any party-in-interest2021-04-30No
Contributions received from participants2021-04-30$1,059,896
Participant contributions at end of year2021-04-30$34,172
Participant contributions at beginning of year2021-04-30$39,355
Participant contributions at end of year2021-04-30$97,749
Participant contributions at beginning of year2021-04-30$62,659
Income. Received or receivable in cash from other sources (including rollovers)2021-04-30$453,426
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-04-30$16,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Value of net income/loss2021-04-30$5,171,644
Value of net assets at end of year (total assets less liabilities)2021-04-30$14,880,084
Value of net assets at beginning of year (total assets less liabilities)2021-04-30$9,708,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-04-30No
Were any leases to which the plan was party in default or uncollectible2021-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-04-30$13,360,773
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-04-30$8,539,225
Income. Interest from loans (other than to participants)2021-04-30$2,601
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-04-30$9,733
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-04-30$7,542
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-04-30$7,542
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-04-30$80
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-04-30$1,284,316
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-04-30$996,715
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-04-30$3,083,328
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-04-30No
Was there a failure to transmit to the plan any participant contributions2021-04-30Yes
Has the plan failed to provide any benefit when due under the plan2021-04-30No
Contributions received in cash from employer2021-04-30$258,428
Employer contributions (assets) at end of year2021-04-30$93,341
Employer contributions (assets) at beginning of year2021-04-30$79,744
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-04-30$280,112
Contract administrator fees2021-04-30$5,918
Did the plan have assets held for investment2021-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-04-30No
Opinion of an independent qualified public accountant for this plan2021-04-30Disclaimer
Accountancy firm name2021-04-30RUBIN BROWN
Accountancy firm EIN2021-04-30430765316
2020 : JVA, INC. PROFIT SHARING PLAN & TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$16,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$16,800
Total income from all sources (including contributions)2020-04-30$739,307
Total loss/gain on sale of assets2020-04-30$0
Total of all expenses incurred2020-04-30$328,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$323,238
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$1,187,245
Value of total assets at end of year2020-04-30$9,725,240
Value of total assets at beginning of year2020-04-30$9,313,937
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$4,766
Total interest from all sources2020-04-30$2,851
Total dividends received (eg from common stock, registered investment company shares)2020-04-30$718,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-04-30$718,614
Administrative expenses professional fees incurred2020-04-30$4,766
Was this plan covered by a fidelity bond2020-04-30Yes
Value of fidelity bond cover2020-04-30$1,000,000
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$857,019
Participant contributions at end of year2020-04-30$39,355
Participant contributions at beginning of year2020-04-30$52,852
Participant contributions at end of year2020-04-30$62,659
Income. Received or receivable in cash from other sources (including rollovers)2020-04-30$104,731
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-04-30$16,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-04-30$16,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$411,303
Value of net assets at end of year (total assets less liabilities)2020-04-30$9,708,440
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$9,297,137
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-04-30$8,539,225
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-04-30$8,074,906
Income. Interest from loans (other than to participants)2020-04-30$2,771
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-04-30$7,542
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-04-30$6,211
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-04-30$6,211
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-04-30$80
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-04-30$996,715
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-04-30$1,127,592
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-04-30$-1,169,403
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30Yes
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$225,495
Employer contributions (assets) at end of year2020-04-30$79,744
Employer contributions (assets) at beginning of year2020-04-30$52,376
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-04-30$323,238
Did the plan have assets held for investment2020-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30Yes
Opinion of an independent qualified public accountant for this plan2020-04-30Disclaimer
Accountancy firm name2020-04-30RUBIN BROWN
Accountancy firm EIN2020-04-30430765316
2019 : JVA, INC. PROFIT SHARING PLAN & TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$16,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$16,800
Total income from all sources (including contributions)2019-04-30$1,605,587
Total loss/gain on sale of assets2019-04-30$0
Total of all expenses incurred2019-04-30$1,082,890
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-04-30$1,080,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-04-30$1,049,167
Value of total assets at end of year2019-04-30$9,313,937
Value of total assets at beginning of year2019-04-30$8,791,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-04-30$2,453
Total interest from all sources2019-04-30$2,952
Total dividends received (eg from common stock, registered investment company shares)2019-04-30$652,638
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-04-30$652,638
Administrative expenses professional fees incurred2019-04-30$2,453
Was this plan covered by a fidelity bond2019-04-30Yes
Value of fidelity bond cover2019-04-30$1,000,000
If this is an individual account plan, was there a blackout period2019-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-04-30$0
Were there any nonexempt tranactions with any party-in-interest2019-04-30No
Contributions received from participants2019-04-30$709,061
Participant contributions at end of year2019-04-30$52,852
Participant contributions at beginning of year2019-04-30$36,548
Participant contributions at beginning of year2019-04-30$74,059
Income. Received or receivable in cash from other sources (including rollovers)2019-04-30$149,186
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-04-30$16,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-04-30$16,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Value of net income/loss2019-04-30$522,697
Value of net assets at end of year (total assets less liabilities)2019-04-30$9,297,137
Value of net assets at beginning of year (total assets less liabilities)2019-04-30$8,774,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-04-30No
Were any leases to which the plan was party in default or uncollectible2019-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-04-30$8,074,906
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-04-30$7,657,451
Interest on participant loans2019-04-30$2,889
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-04-30$6,211
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-04-30$63
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-04-30$1,127,592
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-04-30$969,562
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-04-30$-99,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-04-30No
Was there a failure to transmit to the plan any participant contributions2019-04-30Yes
Has the plan failed to provide any benefit when due under the plan2019-04-30No
Contributions received in cash from employer2019-04-30$190,920
Employer contributions (assets) at end of year2019-04-30$52,376
Employer contributions (assets) at beginning of year2019-04-30$53,620
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-04-30$1,080,437
Did the plan have assets held for investment2019-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-04-30No
Opinion of an independent qualified public accountant for this plan2019-04-30Disclaimer
Accountancy firm name2019-04-30RUBIN BROWN
Accountancy firm EIN2019-04-30430765316
2018 : JVA, INC. PROFIT SHARING PLAN & TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$16,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$13,697
Total income from all sources (including contributions)2018-04-30$1,644,673
Total loss/gain on sale of assets2018-04-30$0
Total of all expenses incurred2018-04-30$101,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-04-30$96,957
Value of total corrective distributions2018-04-30$3,103
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-04-30$860,972
Value of total assets at end of year2018-04-30$8,791,240
Value of total assets at beginning of year2018-04-30$7,244,840
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-04-30$1,316
Total interest from all sources2018-04-30$1,248
Total dividends received (eg from common stock, registered investment company shares)2018-04-30$587,775
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2018-04-30$587,775
Was this plan covered by a fidelity bond2018-04-30Yes
Value of fidelity bond cover2018-04-30$1,000,000
If this is an individual account plan, was there a blackout period2018-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-04-30$0
Were there any nonexempt tranactions with any party-in-interest2018-04-30No
Contributions received from participants2018-04-30$632,578
Participant contributions at end of year2018-04-30$36,548
Participant contributions at beginning of year2018-04-30$34,002
Participant contributions at end of year2018-04-30$74,059
Participant contributions at beginning of year2018-04-30$66,259
Income. Received or receivable in cash from other sources (including rollovers)2018-04-30$56,194
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-04-30$16,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-04-30$13,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Value of net income/loss2018-04-30$1,543,297
Value of net assets at end of year (total assets less liabilities)2018-04-30$8,774,440
Value of net assets at beginning of year (total assets less liabilities)2018-04-30$7,231,143
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-04-30No
Were any leases to which the plan was party in default or uncollectible2018-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-04-30$7,657,451
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-04-30$6,708,230
Interest on participant loans2018-04-30$1,248
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-04-30$969,562
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-04-30$402,155
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-04-30$194,678
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-04-30No
Was there a failure to transmit to the plan any participant contributions2018-04-30Yes
Has the plan failed to provide any benefit when due under the plan2018-04-30No
Contributions received in cash from employer2018-04-30$172,200
Employer contributions (assets) at end of year2018-04-30$53,620
Employer contributions (assets) at beginning of year2018-04-30$34,194
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-04-30$96,957
Contract administrator fees2018-04-30$1,316
Did the plan have assets held for investment2018-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-04-30No
Opinion of an independent qualified public accountant for this plan2018-04-30Disclaimer
Accountancy firm name2018-04-30RUBINBROWN
Accountancy firm EIN2018-04-30430765316

Form 5500 Responses for JVA, INC. PROFIT SHARING PLAN & TRUST

2023: JVA, INC. PROFIT SHARING PLAN & TRUST 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: JVA, INC. PROFIT SHARING PLAN & TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: JVA, INC. PROFIT SHARING PLAN & TRUST 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: JVA, INC. PROFIT SHARING PLAN & TRUST 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: JVA, INC. PROFIT SHARING PLAN & TRUST 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: JVA, INC. PROFIT SHARING PLAN & TRUST 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: JVA, INC. PROFIT SHARING PLAN & TRUST 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2007: JVA, INC. PROFIT SHARING PLAN & TRUST 2007 form 5500 responses
2007-05-01Type of plan entitySingle employer plan
2007-05-01Submission has been amendedNo
2007-05-01This submission is the final filingNo
2007-05-01This return/report is a short plan year return/report (less than 12 months)No
2007-05-01Plan is a collectively bargained planNo
2006: JVA, INC. PROFIT SHARING PLAN & TRUST 2006 form 5500 responses
2006-05-01Type of plan entitySingle employer plan
2006-05-01Submission has been amendedNo
2006-05-01This submission is the final filingNo
2006-05-01This return/report is a short plan year return/report (less than 12 months)No
2006-05-01Plan is a collectively bargained planNo
2005: JVA, INC. PROFIT SHARING PLAN & TRUST 2005 form 5500 responses
2005-05-01Submission has been amendedNo
2005-05-01This submission is the final filingNo
2005-05-01This return/report is a short plan year return/report (less than 12 months)No
2005-05-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered18
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,343
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered22
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,605
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,605
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered28
Insurance policy start date2021-05-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,056
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,056
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered45
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $2,638
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,638
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered58
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $2,573
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,573
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number455415-01
Policy instance 1
Insurance contract or identification number455415-01
Number of Individuals Covered55
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $2,230
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,230
Insurance broker organization code?3

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