PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 401k Plan overview

Plan Name	PACIFIC RETIREMENT SERVICES, INC. 403B PLAN
Plan identification number	002

PACIFIC RETIREMENT SERVICES, INC. 403B PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations. Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations. Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PACIFIC RETIREMENT SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:	PACIFIC RETIREMENT SERVICES, INC.
Employer identification number (EIN):	931067253
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Additional information about PACIFIC RETIREMENT SERVICES, INC.

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	1990-11-20
Company Identification Number:	22564181
Legal Registered Office Address:	1 WEST MAIN ST STE 303 MEDFORD United States of America (USA) 97501

More information about PACIFIC RETIREMENT SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC RETIREMENT SERVICES, INC. 403B PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	JOSH BLACKSON
002	2016-01-01	SHERI LOYA
002	2015-01-01	SHERI LOYA
002	2014-01-01	BRIAN MCLEMORE
002	2013-01-01	BRIAN MCLEMORE
002	2012-01-01	BRIAN MCLEMORE
002	2011-01-01	BRIAN MCLEMORE
002	2010-01-01	BRIAN MCLEMORE
002	2009-01-01	BRIAN MCLEMORE
002	2009-01-01	BRIAN MCLEMORE

Plan Statistics for PACIFIC RETIREMENT SERVICES, INC. 403B PLAN

401k plan membership statisitcs for PACIFIC RETIREMENT SERVICES, INC. 403B PLAN

Measure	Date	Value
2021: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	650
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	480
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	611
Number of retired or separated participants receiving benefits	2020-01-01	23
Number of other retired or separated participants entitled to future benefits	2020-01-01	16
Total of all active and inactive participants	2020-01-01	650
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	650
Number of participants with account balances	2020-01-01	455
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	510
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	242
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	238
Total of all active and inactive participants	2019-01-01	480
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	480
Number of participants with account balances	2019-01-01	480
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	533
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	265
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	237
Total of all active and inactive participants	2018-01-01	502
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	502
Number of participants with account balances	2018-01-01	502
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	782
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	415
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	345
Total of all active and inactive participants	2017-01-01	760
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	760
Number of participants with account balances	2017-01-01	746
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	822
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	436
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	347
Total of all active and inactive participants	2016-01-01	783
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	783
Number of participants with account balances	2016-01-01	777
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	546
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	347
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	177
Total of all active and inactive participants	2015-01-01	524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	524
Number of participants with account balances	2015-01-01	523
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	7
Number of other retired or separated participants entitled to future benefits	2014-01-01	191
Total of all active and inactive participants	2014-01-01	198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	2
Total participants	2014-01-01	200
Number of participants with account balances	2014-01-01	200
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	396
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	10
Number of other retired or separated participants entitled to future benefits	2013-01-01	210
Total of all active and inactive participants	2013-01-01	220
Total participants	2013-01-01	220
Number of participants with account balances	2013-01-01	220
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,049
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of retired or separated participants receiving benefits	2012-01-01	9
Number of other retired or separated participants entitled to future benefits	2012-01-01	387
Total of all active and inactive participants	2012-01-01	396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	396
Number of participants with account balances	2012-01-01	396
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,027
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	900
Number of retired or separated participants receiving benefits	2011-01-01	8
Number of other retired or separated participants entitled to future benefits	2011-01-01	141
Total of all active and inactive participants	2011-01-01	1,049
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,049
Number of participants with account balances	2011-01-01	477
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,033
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	879
Number of retired or separated participants receiving benefits	2010-01-01	9
Number of other retired or separated participants entitled to future benefits	2010-01-01	139
Total of all active and inactive participants	2010-01-01	1,027
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,027
Number of participants with account balances	2010-01-01	475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	997
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	918
Number of retired or separated participants receiving benefits	2009-01-01	6
Number of other retired or separated participants entitled to future benefits	2009-01-01	109
Total of all active and inactive participants	2009-01-01	1,033
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,033
Number of participants with account balances	2009-01-01	462
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PACIFIC RETIREMENT SERVICES, INC. 403B PLAN

Measure	Date	Value
2021 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$1,919,255
Total of all expenses incurred	2021-12-31	$20,519,281
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$20,471,687
Value of total assets at end of year	2021-12-31	$0
Value of total assets at beginning of year	2021-12-31	$18,600,026
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$47,594
Total interest from all sources	2021-12-31	$93,140
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$46,002
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$46,002
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$60,740
Administrative expenses (other) incurred	2021-12-31	$2,160
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-18,600,026
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$18,600,026
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$1,187
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$11,800,910
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,231,156
Interest on participant loans	2021-12-31	$6,091
Interest earned on other investments	2021-12-31	$87,049
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$387,443
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$387,443
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$3,119,777
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$829,634
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,780,113
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$19,642,053
Contract administrator fees	2021-12-31	$44,247
Did the plan have assets held for investment	2021-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MOSS ADAMS
Accountancy firm EIN	2021-12-31	910018931
2020 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,886,812
Total of all expenses incurred	2020-12-31	$2,151,128
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,107,367
Expenses. Certain deemed distributions of participant loans	2020-12-31	$2,047
Value of total assets at end of year	2020-12-31	$18,600,026
Value of total assets at beginning of year	2020-12-31	$18,864,342
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$41,714
Total interest from all sources	2020-12-31	$94,420
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$145,914
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$145,914
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Participant contributions at end of year	2020-12-31	$60,740
Participant contributions at beginning of year	2020-12-31	$148,747
Administrative expenses (other) incurred	2020-12-31	$1,112
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-264,316
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$18,600,026
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$18,864,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$11,800,910
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$12,216,444
Value of interest in pooled separate accounts at end of year	2020-12-31	$3,231,156
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$3,096,296
Interest on participant loans	2020-12-31	$6,098
Interest earned on other investments	2020-12-31	$88,322
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$387,443
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$391,009
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$391,009
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$3,119,777
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$3,011,846
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$183,015
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,646,478
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,924,352
Contract administrator fees	2020-12-31	$40,602
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MOSS ADAMS
Accountancy firm EIN	2020-12-31	910018931
2019 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$3,045,966
Total of all expenses incurred	2019-12-31	$2,557,190
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,514,878
Value of total assets at end of year	2019-12-31	$18,864,342
Value of total assets at beginning of year	2019-12-31	$18,375,566
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$42,312
Total interest from all sources	2019-12-31	$93,955
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$276,712
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$276,712
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Participant contributions at end of year	2019-12-31	$148,747
Participant contributions at beginning of year	2019-12-31	$169,876
Administrative expenses (other) incurred	2019-12-31	$242
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$488,776
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$18,864,342
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$18,375,566
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$12,216,444
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$12,154,061
Value of interest in pooled separate accounts at end of year	2019-12-31	$3,096,296
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$2,795,511
Interest on participant loans	2019-12-31	$9,069
Interest earned on other investments	2019-12-31	$84,603
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$391,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$74,529
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$74,529
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$283
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,011,846
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$3,181,589
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,675,299
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,514,878
Contract administrator fees	2019-12-31	$42,070
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MOSS ADAMS
Accountancy firm EIN	2019-12-31	910018931
2018 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$-934,623
Total of all expenses incurred	2018-12-31	$2,272,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,229,773
Value of total assets at end of year	2018-12-31	$18,375,566
Value of total assets at beginning of year	2018-12-31	$21,582,477
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$42,515
Total interest from all sources	2018-12-31	$100,178
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$366,436
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$366,436
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Participant contributions at end of year	2018-12-31	$169,876
Participant contributions at beginning of year	2018-12-31	$212,513
Administrative expenses (other) incurred	2018-12-31	$1,426
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-3,206,911
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$18,375,566
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$21,582,477
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$12,154,061
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$13,747,854
Value of interest in pooled separate accounts at end of year	2018-12-31	$2,795,511
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$4,254,613
Interest on participant loans	2018-12-31	$11,923
Interest earned on other investments	2018-12-31	$87,993
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$74,529
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$64,494
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$64,494
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$262
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$3,181,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,303,003
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,401,237
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,229,773
Contract administrator fees	2018-12-31	$41,089
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MOSS ADAMS
Accountancy firm EIN	2018-12-31	910189318
2017 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$2,778,716
Total of all expenses incurred	2017-12-31	$1,565,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,523,650
Value of total assets at end of year	2017-12-31	$21,582,477
Value of total assets at beginning of year	2017-12-31	$20,368,768
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$41,357
Total interest from all sources	2017-12-31	$104,635
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$325,900
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$325,900
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at end of year	2017-12-31	$212,513
Participant contributions at beginning of year	2017-12-31	$222,947
Administrative expenses (other) incurred	2017-12-31	$10
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$1,213,709
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$21,582,477
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$20,368,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$13,747,854
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$12,526,902
Value of interest in pooled separate accounts at end of year	2017-12-31	$4,254,613
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,222,857
Interest on participant loans	2017-12-31	$12,214
Interest earned on other investments	2017-12-31	$92,311
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$64,494
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$46,930
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$46,930
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$110
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$3,303,003
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$3,349,132
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,348,181
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,523,650
Contract administrator fees	2017-12-31	$41,347
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MOSS ADAMS
Accountancy firm EIN	2017-12-31	910189318
2016 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,460,578
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,799,900
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,767,260
Value of total corrective distributions	2016-12-31	$612
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$145,104
Value of total assets at end of year	2016-12-31	$20,368,768
Value of total assets at beginning of year	2016-12-31	$20,708,090
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$32,028
Total interest from all sources	2016-12-31	$106,431
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$233,300
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$233,300
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$222,947
Participant contributions at beginning of year	2016-12-31	$285,864
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$96,930
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$854
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-339,322
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$20,368,768
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$20,708,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$12,526,902
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$12,567,948
Value of interest in pooled separate accounts at end of year	2016-12-31	$4,222,857
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,736,955
Interest on participant loans	2016-12-31	$14,348
Interest earned on other investments	2016-12-31	$92,062
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$46,930
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$57,774
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$57,774
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$21
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$3,349,132
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$3,059,549
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$697,142
Net investment gain/loss from pooled separate accounts	2016-12-31	$278,601
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$48,174
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,767,260
Contract administrator fees	2016-12-31	$31,174
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MOSS ADAMS
Accountancy firm EIN	2016-12-31	910189318
2015 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$16,083,990
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$65,087
Total income from all sources (including contributions)	2015-12-31	$1,145,683
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,199,869
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,193,323
Expenses. Certain deemed distributions of participant loans	2015-12-31	$-1,099
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$669,997
Value of total assets at end of year	2015-12-31	$20,708,090
Value of total assets at beginning of year	2015-12-31	$5,743,373
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$7,645
Total interest from all sources	2015-12-31	$62,763
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$193,020
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$193,020
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Participant contributions at end of year	2015-12-31	$285,864
Participant contributions at beginning of year	2015-12-31	$171,261
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$11,977
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$669,997
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$65,087
Administrative expenses (other) incurred	2015-12-31	$5,034
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,054,186
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$20,708,090
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,678,286
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$12,567,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,194,305
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,736,955
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$6,145
Interest earned on other investments	2015-12-31	$56,615
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$57,774
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$6,452
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$6,452
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,059,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,359,378
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$219,903
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,193,323
Contract administrator fees	2015-12-31	$2,611
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MOSS ADAMS
Accountancy firm EIN	2015-12-31	910189318
2014 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$33,990
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$65,087
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$70,836
Total income from all sources (including contributions)	2014-12-31	$381,163
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,053,636
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,043,090
Expenses. Certain deemed distributions of participant loans	2014-12-31	$5,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$68,392
Value of total assets at end of year	2014-12-31	$5,743,373
Value of total assets at beginning of year	2014-12-31	$6,455,585
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,990
Total interest from all sources	2014-12-31	$57,382
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$55,598
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	$55,598
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Participant contributions at end of year	2014-12-31	$171,261
Participant contributions at beginning of year	2014-12-31	$281,274
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	$11,977
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$10,298
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$68,392
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$65,087
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$70,836
Other income not declared elsewhere	2014-12-31	$2,272
Administrative expenses (other) incurred	2014-12-31	$1,685
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
Value of net income/loss	2014-12-31	$-672,473
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,678,286
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,384,749
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,194,305
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$4,784,347
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	$9,259
Interest earned on other investments	2014-12-31	$48,122
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$6,452
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$7,291
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$7,291
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,359,378
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,372,375
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$197,519
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
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,043,090
Contract administrator fees	2014-12-31	$3,305
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Qualified
Accountancy firm name	2014-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2014-12-31	910189318
2013 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$1,314,669
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$70,836
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$2,465,907
Total income from all sources (including contributions)	2013-12-31	$1,457,104
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$3,540,049
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$3,528,006
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$44,130
Value of total assets at end of year	2013-12-31	$6,455,585
Value of total assets at beginning of year	2013-12-31	$12,248,270
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$12,043
Total interest from all sources	2013-12-31	$28,340
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$106,418
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	$106,418
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$0
Participant contributions at end of year	2013-12-31	$281,274
Participant contributions at beginning of year	2013-12-31	$346,473
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	$10,298
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$11,099
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$44,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$70,836
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$2,465,907
Other income not declared elsewhere	2013-12-31	$71
Administrative expenses (other) incurred	2013-12-31	$4,854
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
Value of net income/loss	2013-12-31	$-2,082,945
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,384,749
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$9,782,363
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
Investment advisory and management fees	2013-12-31	$7,189
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$4,784,347
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$9,662,920
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	$0
Interest on participant loans	2013-12-31	$9,831
Interest earned on other investments	2013-12-31	$18,488
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$7,291
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	$21
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,372,375
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,215,162
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,278,145
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
Contributions received in cash from employer	2013-12-31	$0
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$12,616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$3,528,006
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Qualified
Accountancy firm name	2013-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2013-12-31	910189318
2012 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$5,338,747
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$2,465,907
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$29,442
Total income from all sources (including contributions)	2012-12-31	$3,000,632
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,048,979
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,016,580
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,327
Value of total corrective distributions	2012-12-31	$14,925
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,260,745
Value of total assets at end of year	2012-12-31	$12,248,270
Value of total assets at beginning of year	2012-12-31	$14,198,899
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$15,147
Total interest from all sources	2012-12-31	$80,856
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$176,676
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$176,676
Administrative expenses professional fees incurred	2012-12-31	$140
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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	$823,232
Participant contributions at end of year	2012-12-31	$346,473
Participant contributions at beginning of year	2012-12-31	$210,121
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$41,934
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$11,099
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$9,211
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$60,106
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$2,465,907
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$29,442
Other income not declared elsewhere	2012-12-31	$2,028
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$951,653
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$9,782,363
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$14,169,457
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
Investment advisory and management fees	2012-12-31	$15,007
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$9,662,920
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$7,180,754
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$4,924,589
Interest on participant loans	2012-12-31	$11,040
Interest earned on other investments	2012-12-31	$69,816
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,215,162
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,791,863
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,480,327
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
Contributions received in cash from employer	2012-12-31	$377,407
Employer contributions (assets) at end of year	2012-12-31	$12,616
Employer contributions (assets) at beginning of year	2012-12-31	$40,427
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,016,580
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Qualified
Accountancy firm name	2012-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2012-12-31	910189318
2011 : PACIFIC RETIREMENT SERVICES, INC. 403B 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	$29,442
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$25,562
Total income from all sources (including contributions)	2011-12-31	$1,651,711
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$854,789
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$725,342
Expenses. Certain deemed distributions of participant loans	2011-12-31	$111,600
Value of total corrective distributions	2011-12-31	$1,467
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,864,753
Value of total assets at end of year	2011-12-31	$14,198,899
Value of total assets at beginning of year	2011-12-31	$13,398,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$16,380
Total interest from all sources	2011-12-31	$62,570
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$147,981
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$147,981
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$1,160,492
Participant contributions at end of year	2011-12-31	$210,121
Participant contributions at beginning of year	2011-12-31	$219,128
Participant contributions at end of year	2011-12-31	$41,934
Participant contributions at beginning of year	2011-12-31	$6,897
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$9,211
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$11,205
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$112,731
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$29,442
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$25,562
Other income not declared elsewhere	2011-12-31	$309
Administrative expenses (other) incurred	2011-12-31	$16,380
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	$796,922
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$14,169,457
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$13,372,535
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$7,180,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$6,703,014
Value of interest in pooled separate accounts at end of year	2011-12-31	$4,924,589
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$5,045,479
Interest on participant loans	2011-12-31	$7,884
Interest earned on other investments	2011-12-31	$54,438
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$248
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,791,863
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,402,009
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-279,573
Net investment gain/loss from pooled separate accounts	2011-12-31	$-144,329
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
Contributions received in cash from employer	2011-12-31	$591,530
Employer contributions (assets) at end of year	2011-12-31	$40,427
Employer contributions (assets) at beginning of year	2011-12-31	$10,365
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$725,342
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Qualified
Accountancy firm name	2011-12-31	MICHAEL L PIELS, CPA'S LLP
Accountancy firm EIN	2011-12-31	931226907
2010 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$61,667
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$25,562
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$3,086,438
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$986,914
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$963,053
Expenses. Certain deemed distributions of participant loans	2010-12-31	$13,531
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,804,663
Value of total assets at end of year	2010-12-31	$13,398,097
Value of total assets at beginning of year	2010-12-31	$11,334,678
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$10,330
Total interest from all sources	2010-12-31	$55,863
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$123,381
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$123,381
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,130,733
Participant contributions at end of year	2010-12-31	$219,128
Participant contributions at beginning of year	2010-12-31	$97,652
Participant contributions at end of year	2010-12-31	$6,897
Participant contributions at beginning of year	2010-12-31	$37,154
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$11,205
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$102,542
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$87,540
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$25,562
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$3,025
Administrative expenses (other) incurred	2010-12-31	$6,175
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$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	2010-12-31	No
Value of net income/loss	2010-12-31	$2,099,524
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$13,372,535
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$11,334,678
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$4,155
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$6,703,014
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,568,428
Value of interest in pooled separate accounts at end of year	2010-12-31	$5,045,479
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$4,137,326
Interest on participant loans	2010-12-31	$5,360
Interest earned on other investments	2010-12-31	$50,241
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$262
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,402,009
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,372,599
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$507,225
Net investment gain/loss from pooled separate accounts	2010-12-31	$592,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$586,390
Employer contributions (assets) at end of year	2010-12-31	$10,365
Employer contributions (assets) at beginning of year	2010-12-31	$18,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$963,053
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Qualified
Accountancy firm name	2010-12-31	MICHAEL L PIELS, CPA'S LLP
Accountancy firm EIN	2010-12-31	931226907
2009 : PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for PACIFIC RETIREMENT SERVICES, INC. 403B PLAN

2021: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PACIFIC RETIREMENT SERVICES, INC. 403B 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: PACIFIC RETIREMENT SERVICES, INC. 403B 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: PACIFIC RETIREMENT SERVICES, INC. 403B 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 – 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: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
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: PACIFIC RETIREMENT SERVICES, INC. 403B 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 – 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: PACIFIC RETIREMENT SERVICES, INC. 403B 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: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
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 – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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 – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: PACIFIC RETIREMENT SERVICES, INC. 403B PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	7
Insurance contract or identification number VF5995 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $58 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 $58 Insurance broker organization code? 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $1,765 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 $1,765 Insurance broker organization code? 4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $30 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 $30 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	3
Insurance contract or identification number 70857 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $537 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $171 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	4
Insurance contract or identification number 70857 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	5
Insurance contract or identification number VE8131 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $747 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 $540 Insurance broker organization code? 3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	6
Insurance contract or identification number VE8132 Number of Individuals Covered 0 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $1,263 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 $782 Insurance broker organization code? 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 18 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,029 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 $2,029 Insurance broker organization code? 4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 45 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $23 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 $23 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	3
Insurance contract or identification number 70857 Number of Individuals Covered 319 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $486 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $135 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	4
Insurance contract or identification number 70857 Number of Individuals Covered 192 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	5
Insurance contract or identification number VE8131 Number of Individuals Covered 56 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $681 Are there contracts with allocated funds for types other than group deferred annuity or individual? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Other information about contract GROUP PENSION FUNDING Commission paid to Insurance Broker USD $494 Insurance broker organization code? 3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	6
Insurance contract or identification number VE8132 Number of Individuals Covered 55 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $1,220 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 $771 Insurance broker organization code? 3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	7
Insurance contract or identification number VF5995 Number of Individuals Covered 8 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $112 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 $112 Insurance broker organization code? 3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	6
Insurance contract or identification number VE8132 Number of Individuals Covered 56 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $1,246 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 $476 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	4
Insurance contract or identification number 70857 Number of Individuals Covered 201 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	5
Insurance contract or identification number VE8131 Number of Individuals Covered 58 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $662 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 $280 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	80857
Policy instance	3
Insurance contract or identification number 80857 Number of Individuals Covered 344 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $578 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $230 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 51 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $12 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 $12 Insurance broker organization code? 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 20 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $2,423 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 $2,423 Insurance broker organization code? 4
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	7
Insurance contract or identification number VF5995 Number of Individuals Covered 8 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $108 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 $108 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 52 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	7
Insurance contract or identification number VF5995 Number of Individuals Covered 8 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	6
Insurance contract or identification number VE8132 Number of Individuals Covered 61 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,376 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 $912 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	4
Insurance contract or identification number 70857 Number of Individuals Covered 201 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	5
Insurance contract or identification number VE8131 Number of Individuals Covered 60 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $682 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 $492 Insurance broker organization code? 3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	80857
Policy instance	3
Insurance contract or identification number 80857 Number of Individuals Covered 368 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $812 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $350 Insurance broker organization code? 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 26 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $3,263 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 $3,263 Insurance broker organization code? 4
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	7
Insurance contract or identification number VF5995 Number of Individuals Covered 8 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $91 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 $91 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	6
Insurance contract or identification number VE8132 Number of Individuals Covered 66 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,849 Contracts With Unallocated Funds Deposit Administration 1 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 $708 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	5
Insurance contract or identification number VE8131 Number of Individuals Covered 66 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $918 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 $374 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	4
Insurance contract or identification number 70857 Number of Individuals Covered 205 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	80857
Policy instance	3
Insurance contract or identification number 80857 Number of Individuals Covered 399 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $507 Contracts With Unallocated Funds Deposit Administration 1 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $167 Insurance broker organization code? 3 Insurance broker name OSBORNE, JOLIET K
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 63 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 30 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $4,237 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 $4,237 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	8
Insurance contract or identification number VE8132 Number of Individuals Covered 76 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $3,376 Total amount of fees paid to insurance company USD $710 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 Commission paid to Insurance Broker USD $2,542 Amount paid for insurance broker fees 710 Additional information about fees paid to insurance broker SUPPLEMENTAL CASH PAID Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	7
Insurance contract or identification number VE8131 Number of Individuals Covered 75 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $780 Total amount of fees paid to insurance company USD $84 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 Commission paid to Insurance Broker USD $443 Insurance broker organization code? 3 Amount paid for insurance broker fees 84 Additional information about fees paid to insurance broker SUPPLEMENTAL CASH PAID Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	70857
Policy instance	6
Insurance contract or identification number 70857 Number of Individuals Covered 48 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	4
Insurance contract or identification number 45090-002 Number of Individuals Covered 0 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	3
Insurance contract or identification number 45090-001 Number of Individuals Covered 0 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0837395
Policy instance	2
Insurance contract or identification number 0837395 Number of Individuals Covered 93 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $18 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 Commission paid to Insurance Broker USD $18 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number	CR34087
Policy instance	1
Insurance contract or identification number CR34087 Number of Individuals Covered 35 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $300 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 Commission paid to Insurance Broker USD $300 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VF5995
Policy instance	9
Insurance contract or identification number VF5995 Number of Individuals Covered 10 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $50 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 Commission paid to Insurance Broker USD $50 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	80857
Policy instance	5
Insurance contract or identification number 80857 Number of Individuals Covered 480 Insurance policy start date 2015-09-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $203 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 Commission paid to Insurance Broker USD $162 Insurance broker organization code? 3 Insurance broker name HART, MICHAEL S
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	1
Insurance contract or identification number 45090-002 Number of Individuals Covered 73 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $323 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 1 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? No Commission paid to Insurance Broker USD $133 Insurance broker organization code? 3 Insurance broker name HART, MICHAEL S
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	2
Insurance contract or identification number 45090-001 Number of Individuals Covered 7 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	3
Insurance contract or identification number VE8131 Number of Individuals Covered 87 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $900 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 1 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? No Commission paid to Insurance Broker USD $475 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	4
Insurance contract or identification number VE8132 Number of Individuals Covered 89 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,538 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 1 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? No Commission paid to Insurance Broker USD $891 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	4
Insurance contract or identification number VE8132 Number of Individuals Covered 122 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $2,027 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 1 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? No Commission paid to Insurance Broker USD $1,181 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	1
Insurance contract or identification number 45090-002 Number of Individuals Covered 80 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $5,571 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 1 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? No Commission paid to Insurance Broker USD $3,462 Insurance broker organization code? 3 Insurance broker name ARENDSEN, KATHRYN
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	2
Insurance contract or identification number 45090-001 Number of Individuals Covered 8 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	3
Insurance contract or identification number VE8131 Number of Individuals Covered 121 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,095 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 1 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? No Commission paid to Insurance Broker USD $613 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	2
Insurance contract or identification number 45090-001 Number of Individuals Covered 18 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $311 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 1 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? No Commission paid to Insurance Broker USD $156 Insurance broker organization code? 3 Insurance broker name HART, MICHAEL S
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	3
Insurance contract or identification number VE8131 Number of Individuals Covered 125 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $2,240 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 1 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? No Commission paid to Insurance Broker USD $1,247 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	4
Insurance contract or identification number VE8132 Number of Individuals Covered 127 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $5,194 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 1 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? No Commission paid to Insurance Broker USD $3,516 Insurance broker organization code? 3 Insurance broker name FORCHT, BRENDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	1
Insurance contract or identification number 45090-002 Number of Individuals Covered 201 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $19,536 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 1 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? No Commission paid to Insurance Broker USD $14,105 Insurance broker organization code? 3 Insurance broker name AWAN, ASIM I
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	1
Insurance contract or identification number 45090-002 Number of Individuals Covered 186 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $11,009 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	4
Insurance contract or identification number VE8132 Number of Individuals Covered 130 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $3,931 Total amount of fees paid to insurance company USD $7 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	3
Insurance contract or identification number VE8131 Number of Individuals Covered 126 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $1,620 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 1 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? No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	2
Insurance contract or identification number 45090-001 Number of Individuals Covered 18 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $220 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 1 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? No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-001
Policy instance	2
Insurance contract or identification number 45090-001 Number of Individuals Covered 19 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $134 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8132
Policy instance	4
Insurance contract or identification number VE8132 Number of Individuals Covered 129 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $2,953 Total amount of fees paid to insurance company USD $36 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 1 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? No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number	VE8131
Policy instance	3
Insurance contract or identification number VE8131 Number of Individuals Covered 127 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $1,775 Total amount of fees paid to insurance company USD $40 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 1 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? No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45090-002
Policy instance	1
Insurance contract or identification number 45090-002 Number of Individuals Covered 185 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $8,187 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 1 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? No

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