Retirement Planning Guide - DoctorsManagement...Retirement Planning Guide Unless otherwise noted:...

Retirement Planning Guide

Unless otherwise noted: Not a Deposit | Not FDIC Insured | Not Guaranteed by Any Bank | Not Insured by Any Federal Government Agency | Funds May Lose Value

Doctors Management, LLC 401(k) Profit Sharing Plan

Are You Ready For A Bright Financial Future?Thanks to your employer’s decision to automatically enroll you in this retirement plan, you’re off to a great start. If you haven’t already,

you will soon receive a letter at your home address that includes your Personal Identification Number (PIN)1, your current paycheck

contribution, and the fund(s) your employer selected for those contributions.

All you have to do is read through this guide and register your account on your plan’s website.2

Follow these steps to register your account online.

Step 1: Visit www.empower-retirement.com/participant and click Register in the Login box.2

Step 2: If you

• Choose I have a PIN.

• Enter your Social Security Number and PIN and click Continue.

• Provide your contact information and create a username and password.

Click Register.

If you

• Choose I do not have a PIN.

• Complete the requested personal information and click Continue.

• Provide your contact information and create a username and password. Click Register.

Step 3: Select your beneficiary. Here is the information you’ll need to provide when choosing your beneficiaries:

• Your personal information

• Personal information for your primary beneficiary

• Personal information for your contingent beneficiary (if applicable)

Note: If you don’t have all the necessary information for your beneficiaries at this time, you can still register your account,

but you should choose your beneficiaries as soon as possible once you have the information needed.

1 The account owner is responsible for keeping the assigned PIN confidential. Please contact Empower Retirement immediately if you suspect any unauthorized use.

2 Access to the voice response system and/or any website may be limited or unavailable during periods of peak demand, market volatility, systems upgrades/maintenance or other reasons.

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Quick Tip

Being automatically enrolled, you now have the opportunity to get the most out of this valuable

employer-provided benefit with a higher contribution amount. The more you save today means potentially

more for your future. Get the retirement income you want and deserve so you can continue your current

lifestyle when you’re retired by contributing as much as you can.

Important Reminder

Let us know if you have assets from a previous employer’s plan or

an IRA. If your employer allows rollovers, we can help you roll that

money into your current plan for a simplified, one-stop retirement

planning strategy.3

For More InformationVisit2

www.empower-retirement.com/participant

Call2

1-800-338-4015

Remember:

You can make changes to your plan at any time by visiting

www.empower-retirement.com/participant.2

3 You are encouraged to discuss rolling money from one account to another with your financial advisor/planner, considering any potential fees and/or limitation of investment options.

PT#249608 (12/2015)

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Doctors Management, LLC 401(k) Profit Sharing PlanFeatures and Highlights

Read these highlights to learn more about your Plan. If thereare any discrepancies between this document and the PlanDocument, the Plan Document will govern.

About the 401(k) PlanA 401(k) plan is a retirement savings plan designed toallow eligible employees to supplement any existing retirementand pension benefits by saving and investing through avoluntary salary contribution. Contributions and any earnings oncontributions are tax-deferred until money is withdrawn.

Eligibility RequirementsTo enroll in the Plan, employees must meet the following criteria:

• Age 21 or older

• Completed 1 year(s) of service

• Completed at least 1000 hours of service

Eligible employees may enroll quarterly, January 1, April 1, July1, October 1 of each year.

Please contact your Plan Administrator for information regardingexcluded employees.

EnrollmentOnce you are eligible to participate in the Plan, you will beautomatically enrolled at 3% unless you select a differentdeferral amount or choose to opt out of the Automatic Enrollmentduring the time-frame specified. Please contact your PlanAdministrator if you have any questions.

Contribution LimitsBefore-tax Contributions

In 2017, the before-tax contribution amount is between 1% and100% of your compensation or $18,000.00, whichever is less.

Participants turning age 50 or older in 2017, may contribute anadditional $6,000.00.

Roth Contributions

The Roth option will give you the flexibility to designate all or partof your 401(k) elective deferrals as Roth contributions.

Roth contributions are made with after-tax dollars, as opposed tothe pre-tax dollars you contribute to a traditional 401(k). In otherwords, with the Roth option, you've already paid taxes on moneyyou contribute. With the traditional 401(k), your contribution ismade on a pre-tax basis and you pay taxes only when you takea distribution.

Employer ContributionsDiscretionary Match

Your Plan may contribute a discretionary match. Thiscontribution will only apply to a participant's deferrals that do notexceed a dollar amount or percentage of included compensationthat is determined by the employer.

To be eligible for the discretionary match contribution into thePlan, employees must meet the following criteria:

• Completed 1000 hours or more

Vesting ScheduleVesting refers to the percentage of your account you are entitledto receive upon the occurrence of a distributable event. Thevalue of your contributions to the Plan and any earnings theygenerate are always 100% vested (including rollovers fromprevious employers).

The value of employer discretionary match contributions to thePlan, and any earnings they generate, are vested as follows:

Years ofService

Vested Percentage ofEmployer Contributions

0 - 2 Year(s) 0%

2 - 3 Year(s) 20%

3 - 4 Year(s) 40%

4 - 5 Year(s) 60%

5 - 6 Year(s) 80%

6 Years and over 100%

Investment Options¹A wide array of core investment options are available throughyour Plan. Each option is explained in further detail in yourPlan's fund sheets. Once you have enrolled, investmentoption information is also available through the Web siteat www.empower-retirement.com/participant or call the VoiceResponse System toll free at 1-800-338-4015. The Web site andthe Voice Response System are available to you 24 hours a day,7 days a week.²

¹All information contained on the Web site, in prospectuses and otherinvestment option documents is offered in English. Please have thisinformation translated for your understanding.

²Access to the Voice Response System and the Web site may belimited or unavailable during periods of peak demand, market volatility,systems upgrades and maintenance, or other reasons. The accountowner is responsible for keeping the assigned PIN confidential. Pleasecontact a client service representative immediately if you suspect anyunauthorized use.

Transfers and Allocation ChangesUse your Personal Identification Number (PIN) and Usernameto access the Web site or you can use your Social Securitynumber and PIN to access the Voice Response System. Youcan move all or a portion of your existing balances betweeninvestment options (subject to Plan rules) and change how yourpayroll contributions are invested.

RolloversOnly Plan Administrator approved balances from an eligiblegovernmental 457(b), 401(k), 403(b) or 401(a) plan or anIndividual Retirement Account (IRA) may be rolled over to thePlan. Some plans may only allow rollovers from other 401(k)plans. Distributions you receive prior to age 59 1/2 may besubject to the 10% early withdrawal federal tax penalty.

WithdrawalsQualifying distribution events are as follows:

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• Retirement

• Permanent disability

• Financial hardship (as defined by the Internal Revenue Codeand your Plan's provisions)

• Severance of employment (as defined by the InternalRevenue Code provisions)

• Death (your beneficiary receives your benefits)

Traditional Accounts and MatchingContributionsOrdinary income tax will apply to each distribution. Distributionsreceived prior to age 59 1/2 may also be assessed a 10% earlywithdrawal federal tax penalty. Refer to your Summary PlanDescription for more information about distributions.

Plan FeesRecordkeeping or Administrative Fees

There is a quarterly Asset Based fee of 0.0425% that iscalculated and deducted quarterly.

Distribution Fees

The benefit disbursement fee is $ .00.

Investment Option Fees

Each investment option has an investment management fee thatvaries by investment option. These fees are deducted by eachinvestment option's management company before the daily priceor performance is calculated. Fees pay for trading of securitieswithin the investment option and other management expenses.

Funds may impose redemption fees on certain transfers,redemptions or exchanges.

LoansYour Plan allows you to borrow the lesser of $50,000.00 or50% of your total vested account balance. The minimum loanamount is $1000.00 and you have up to 60 months to repay yourgeneral purpose loan or up to 180 months if the money is usedto purchase your primary residence.

There is also a $225.00 origination fee for each loan, plus anongoing annual $50.00 fee.

How do I get more information?Visit the Web site at www.empower-retirement.com/participantor call the Voice Response System, toll free at 1-800-338-4015for more information. The Web site provides informationregarding your Plan, as well as financial education information,financial calculators and other tools to help you manage youraccount.

Securities, when offered, are offered through GWFSEquities, Inc. and/or other broker dealers. GWFSEquities, Inc. is a wholly owned subsidiary ofGreat-West Life & Annuity Insurance Company and an affiliateof FASCore, LLC (FASCore Administrators, LLC in California)and Great-West Life & Annuity Insurance Company of New York,New York, New York. Empower Retirement refers to products andservices provided by Great-West Life & Annuity Insurance Company,FASCore, LLC (FASCore Administrators, LLC in California),Great-West Life & Annuity Insurance Company of NewYork, New York, New York and their subsidiaries andaffiliates. Great-West Life & Annuity Insurance Company is notlicensed to conduct business in New York. Insurance productsand related services are sold in New York by its subsidiary,Great-West Life & Annuity Insurance Company of New York. Otherproducts and services may be sold in New York by FASCore, LLC.

The Plan information contained in this document was provided by thePlan's third party administrator. Empower Retirement is not responsiblefor any content provided by the Plan's third party administrator.

©2015 Great-West Life & Annuity Insurance Company.

All rights reserved. Form# 332968-01PH PT# 214855 (01/2015)

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DOC_TYPE: FEEDSP_STDDOC ID: 399955402IND ID:

01:060716 401K GP19

EV ID:Page 1 of 8

Notice of Investment Returns & Fee Comparison332968-01 Doctors Management, LLC 401(k) Profit Sharing Plan

www.empower-retirement.com/participant

Your employer's retirement plan may be one of the most valuable investments you'll make for your future. It may be alarge part of the retirement income you�ll need to help keep your current lifestyle. For most people, it will need to last atleast 20 years.

It is important to remember that your retirement account has the potential to grow over time and benefit from being ina tax-deferred plan. In traditional retirement plans you benefit from saving money out of your paycheck before taxesare taken out. Taxes are paid later when you take the money out of the account. Another benefit is that you are payingyourself first and investing for your future by automatically contributing from your paycheck where allowed by your plan.

The goal is to build your account through additional contributions and investment returns in your plan. Fees and expensesrelated to your plan can affect the overall long-term value of your account. The investment options you choose also affectyour account. It is important for you to have a clear understanding of the investment options available through your planand the fees and expenses that are part of your plan.

This notice includes important information to help you compare your Plan investment options and expenses. For moreinvestment information including investment objectives or goals, principal strategies, risks, portfolio turnover rate, returnsand expenses, please visit your Plan�s website listed above. The website also includes education and tools designed tohelp you with making investment decisions. An online calculator is also available and it can assist you in determining thelong-term effect of fees and expenses. A free paper copy of this disclosure is available by calling the Voice ResponseSystem at 1-800-338-4015.

SECTION Document Summary

1

Investment Rate of Return and Expense Information - Shows investment return information foryour plan's investment options. It shows past performance, investment management expenses andGeneral Administrative Services Expenses. The General Administrative Services Expenses tableshows non-investment expenses that pay for operating your Plan.

2Other Investment-Related Fees, Expense Information and Transfer Restrictions - Shows anyfees and expenses that are in addition to the investment management expenses in Section 1. Thissection also shows any investment restrictions.

3

Plan-Related Information - Shows your Plan Related information and Participant Elected ServicesExpenses tables. The Participant Elected Services Expenses table shows expenses for optionalservices available through your Plan that may be charged to your individual account for the servicesyou use.

1 � Investment Rate of Return and Expense Information

Variable Rate of Return Investments TableThis table looks at the rates of return from investments that increase and decrease in value. The table shows how theseinvestments have performed over time. You can compare each investment option to a benchmark. Past performance doesnot guarantee how the investment option will perform in the future. Your investment in these options could lose money.Information about an investment option�s principal risks is available on the Web site listed above.

Variable Return Investments

Averaged Annualized Total Return as of 09/30/2016

Investment Option Ticker 3 mos YTD 1 year 3 year 5 yearSince Start

Date/10yrStart Date

Gross/Net

Investment

Expenses~

Asset Allocation

4.65% 1.07%/0.76%JPMorgan SmartRetirement Income

A1,2 JSRAX 2.46% 5.74% 7.02% 4.19% 6.32% $46.50 per

$1,000

05/15/2006 $10.70 per$1,000 Gross

4.79%

Barclays US Aggregate Bond TRUSD**

0.46% 5.80% 5.19% 4.03% 3.08% $47.90 per$1,000

05/15/2006

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Date/10yrStart Date

Gross/Net

Investment

Expenses~

4.86% 1.07%/0.81%JPMorgan SmartRetirement 2015

A1,2 JSFAX 2.40% 5.55% 7.00% 4.63% 7.72% $48.60 per

$1,000

05/15/2006 $10.70 per$1,000 Gross

4.79%


0.46% 5.80% 5.19% 4.03% 3.08% $47.90 per$1,000

05/15/2006


A1,2 JTTAX 3.05% 6.04% 8.36% 5.52% 9.25% $54.00 per

$1,000

05/15/2006 $11.10 per$1,000 Gross

7.44%

Wilshire 5000 Total Market TRUSD**

4.29% 8.44% 15.35% 10.65% 16.31% $74.40 per$1,000

05/15/2006


A1,2 JNSAX 3.48% 6.01% 8.95% 5.92% 10.42% $50.50 per

$1,000

07/31/2007 $11.20 per$1,000 Gross

6.87%


4.29% 8.44% 15.35% 10.65% 16.31% $68.70 per$1,000

07/31/2007


A1,2 JSMAX 3.77% 5.70% 9.15% 6.05% 11.20% $57.00 per

$1,000

05/15/2006 $11.60 per$1,000 Gross

7.44%


4.29% 8.44% 15.35% 10.65% 16.31% $74.40 per$1,000

05/15/2006


A1,2 SRJAX 4.07% 5.64% 9.45% 6.21% 11.89% $51.40 per

$1,000

07/31/2007 $11.80 per$1,000 Gross

6.87%


4.29% 8.44% 15.35% 10.65% 16.31% $68.70 per$1,000

07/31/2007


A1,2 SMTAX 4.38% 5.70% 9.78% 6.26% 12.07% $59.20 per

$1,000

05/15/2006 $12.20 per$1,000 Gross

7.44%


4.29% 8.44% 15.35% 10.65% 16.31% $74.40 per$1,000

05/15/2006


A1,2 JSAAX 4.44% 5.68% 9.82% 6.27% 12.09% $53.60 per

$1,000

07/31/2007 $12.50 per$1,000 Gross

6.87%


4.29% 8.44% 15.35% 10.65% 16.31% $68.70 per$1,000

07/31/2007


A1,2 JTSAX 4.44% 5.69% 9.77% 6.25% 12.08% $53.80 per

$1,000

07/31/2007 $13.10 per$1,000 Gross

6.87%


4.29% 8.44% 15.35% 10.65% 16.31% $68.70 per$1,000

07/31/2007

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Date/10yrStart Date

Gross/Net

Investment

Expenses~


A1,2 JFFAX 4.42% 5.74% 9.89% 6.32% N/A $95.10 per

$1,000

01/31/2012 $13.10 per$1,000 Gross

13.56%


4.29% 8.44% 15.35% 10.65% N/A $135.60per $1,000

01/31/2012

International Funds

3.92% 0.85%/0.85%American Funds EuroPacific Gr

R41,2 REREX 8.14% 5.12% 8.14% 2.99% 8.73% $39.20 per

$1,000

06/07/2002 $8.50 per$1,000 Gross

3.48%

Morningstar Global Markets ex-USGR USD**

7.07% 7.85% 12.40% 2.01% 7.51% $34.80 per$1,000

06/07/2002

1.40% 0.61%/0.60%

Dreyfus International Stock Index1,2 DIISX 5.94% 2.27% 5.75% 0.06% 7.18% $14.00 per

$1,000

06/30/1997 $6.10 per$1,000 Gross

3.48%

Morningstar Global Markets ex-USGR USD**

7.07% 7.85% 12.40% 2.01% 7.51% $34.80 per$1,000

06/30/1997

3.23% 1.08%/1.05%

Hartford World Bond R42 HWDSX 0.10% 3.09% 2.26% 2.02% 2.83% $32.30 per

$1,000

05/31/2011 $10.80 per$1,000 Gross

6.93%

Morningstar Global Markets ex-USGovernm**

-0.13% 6.69% 7.16% 6.25% 5.17% $69.30 per$1,000

05/31/2011

3.85% 0.97%/0.97%

Prudential Global Real Estate Z1,2 PURZX 0.31% 6.52% 10.26% 6.73% 11.85% $38.50 per

$1,000

05/05/1998 $9.70 per$1,000 Gross

0.68%

Morningstar US Real Estate SectorPR USD**

-2.00% 7.77% 13.93% 8.81% 10.18% $6.80 per$1,000

05/05/1998

5.36% 1.53%/1.49%

Wells Fargo Emerg Mkts Eq Adm1,2 EMGYX 9.16% 20.50% 23.95% -0.21% 2.48% $53.60 per

$1,000

09/06/1994 $15.30 per$1,000 Gross

5.02%

Morningstar Emerging Markets GRUSD**

8.47% 15.87% 17.09% 0.59% 4.03% $50.20 per$1,000

09/06/1994

Specialty

2.47% 1.58%/1.52%

JHancock Alternative Asset Allc I2 JAAIX 1.45% 3.08% 4.06% 1.44% 3.60% $24.70 per

$1,000

12/30/2010 $15.80 per$1,000 Gross

3.89%


0.46% 5.80% 5.19% 4.03% 3.08% $38.90 per$1,000

12/30/2010

Small Cap Funds

7.05% 1.01%/1.01%

Diamond Hill Small Cap I2 DHSIX 3.46% 6.07% 5.19% 5.07% 13.43% $70.50 per

$1,000

04/29/2005 $10.10 per$1,000 Gross

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Date/10yrStart Date

Gross/Net

Investment

Expenses~

8.25%

Morningstar US Small Value TRUSD**

7.65% 15.40% 18.60% 8.64% 16.87% $82.50 per$1,000

04/29/2005

8.45% 0.51%/0.50%Dreyfus Small Cap Stock Index

Fund1,2 DISSX 7.05% 13.33% 17.49% 8.62% 17.46% $84.50 per

$1,000

06/30/1997 $5.10 per$1,000 Gross

8.09%

Morningstar US Small Cap TRUSD**

7.28% 12.43% 15.92% 7.58% 16.20% $80.90 per$1,000

06/30/1997

9.99% 0.98%/0.98%

Lord Abbett Developing Growth A2 LAGWX 10.87% 1.68% -0.02% 0.46% 13.01% $99.90 per

$1,000

10/10/1973 $9.80 per$1,000 Gross

8.29%

Morningstar US Small Growth TRUSD**

7.07% 8.03% 12.67% 5.87% 15.29% $82.90 per$1,000

10/10/1973

Mid Cap Funds

8.65% 0.51%/0.50%

Dreyfus Mid Cap Index Fund1,2 PESPX 4.03% 12.05% 14.83% 8.90% 15.96% $86.50 per

$1,000

06/19/1991 $5.10 per$1,000 Gross

8.55%

Morningstar US Mid Cap TRUSD**

4.79% 10.39% 14.51% 9.94% 16.94% $85.50 per$1,000

06/19/1991

7.84% 1.19%/1.18%

MFS Mid Cap Value R31,2 MVCHX 4.24% 10.26% 13.38% 8.78% 16.47% $78.40 per

$1,000

04/01/2005 $11.90 per$1,000 Gross

8.24%

Morningstar US Mid Value TRUSD**

6.54% 15.47% 20.38% 11.36% 18.83% $82.40 per$1,000

04/01/2005

7.98% 1.05%/1.05%Prudential Jennison Mid Cap

Growth A1,2 PEEAX 2.46% 2.98% 5.73% 5.42% 12.36% $79.80 per

$1,000

12/31/1996 $10.50 per$1,000 Gross

9.07%

Morningstar US Mid Core TRUSD**

3.93% 9.49% 14.38% 11.00% 17.66% $90.70 per$1,000

12/31/1996

Large Cap Funds

6.75% 0.51%/0.50%

Dreyfus S&P 500 Index1,2 PEOPX 3.73% 7.38% 14.80% 10.61% 15.81% $67.50 per

$1,000

01/02/1990 $5.10 per$1,000 Gross

7.16%

Morningstar US Large Cap TRUSD**

3.82% 7.11% 14.98% 11.05% 16.18% $71.60 per$1,000

01/02/1990

8.09% 1.11%/0.94%

JPMorgan US Equity A1,2 JUEAX 5.02% 5.39% 12.78% 10.05% 16.14% $80.90 per

$1,000

09/10/2001 $11.10 per$1,000 Gross

7.16%

Morningstar US Large Cap TRUSD**

3.82% 7.11% 14.98% 11.05% 16.18% $71.60 per$1,000

09/10/2001

6.94% 0.90%/0.87%

MFS Value R31,2 MEIHX 2.28% 9.05% 15.10% 9.62% 15.97% $69.40 per

$1,000

04/01/2005 $9.00 per$1,000 Gross

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Date/10yrStart Date

Gross/Net

Investment

Expenses~

4.49%

Morningstar US Large Value TRUSD**

2.24% 10.37% 17.93% 9.54% 14.31% $44.90 per$1,000

04/01/2005

9.53% 0.79%/0.79%T. Rowe Price New America

Growth1,2 PRWAX 5.99% 1.64% 12.22% 10.43% 15.79% $95.30 per

$1,000

09/30/1985 $7.90 per$1,000 Gross

8.42%

Morningstar US Large Growth TRUSD**

4.13% 2.11% 9.88% 12.05% 16.69% $84.20 per$1,000

09/30/1985

Bond Funds

5.91% 0.30%/0.30%

Baird Core Plus Bond Inst1,2 BCOIX 1.10% 7.27% 6.39% 4.74% 4.37% $59.10 per

$1,000

09/29/2000 $3.00 per$1,000 Gross

5.02%

Morningstar US Core Bond TRUSD**

0.52% 5.88% 5.40% 4.20% 3.28% $50.20 per$1,000

09/29/2000

Fixed Rate of Return Investments TableThis table looks at the investment options that have a fixed or set rate of return. It shows the current annual rate of returnand the minimum annual rate or return. The table also shows how often the rate of return may change and the term orlength of time you will earn this rate of return, if applicable. The investment provider of the fixed account may change therate in the future. You may visit the Web site listed above or call the Voice Response System to find the current rate.

Fixed Return Investments

as of 10/19/2016

Investment OptionCurrent Fixed

Rate

Gross/Net

Investment

Expenses~

Minimum Rate

Frequency

of Fixed Rate

Setting

Term

1.10% 0.35%/0.35%Key Guaranteed Portfolio

Fund $11.00 per $1,000$3.50 per

$1,000 Gross

0.00% Quarterly 12/31/2016

General Account Fund and Guarantee Provisions:General Account crediting rates are net of cost of capital and expenses covered by the fund and guarantee provisions.

Cost of Capital is the return Great-West Life & Annuity Insurance Company (Great-West) earns on Great-West capital.Great-West is required by regulators to hold capital for the purpose of ensuring Great-West can meet all of its obligationsassociated with the General Account Fund. The amount of Great-West's capital and required return will fluctuate over timebased on regulatory requirements, capital market conditions and the competitive environment.

The Fund Provision covers the range of investment expenses that are netted from the crediting rate, such as investmentand operating expenses. The Fund Provision is calculated annually in aggregate for all General Account fixed fundsoffered by Great-West Retirement Services and does not reflect any product or plan specific underwriting adjustments. At12/31/2014, the General Account Fund Provision is 0.35%. This includes an average annual notional allocation of 0.25%from Great-West's General Account to Great-West's recordkeeping functions. This allocation is not applicable if Great-West is not acting as both the investment provider and recordkeeper.

The Guarantee Provision covers the range of insurance expenses that are netted from the crediting rate, such as assetdefaults, cost of insurance guarantees, and other expenses. The Guarantee Provision is calculated annually in aggregatefor all General Account fixed funds offered by Great-West Retirement Services and does not reflect any product or planspecific underwriting adjustments. At 12/31/2014, the General Account Guarantee Provision is 0.54%. This expensechanges over time as the value of insurance guarantees fluctuate due to both market and policyholder behaviors. Theyalso vary based on the risk management techniques employed by the insurance provider. Because of the variances inthe cost of the expenses, the level of the insurance guarantees as well as differences in risk management practices, thisparagraph is the only section in which these expenses are disclosed.

For more information on the General Account Fixed Funds, including termination options, please see your Group AnnuityContract.

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1 Additional information on this Investment Option can be found in Section 2.

2 Mutual Fund Option. The start/inception date is that of the fund's original share class. Performance returns for mutual fund optionsin your Plan offering a different share class with a more current start/inception date have been adjusted to reflect the fees and chargesassociated with the actual share class.

* Performance returns not available at time of production.

N/A - Performance returns are not applicable.

~ Gross Total Annual Operating Expenses are the gross fees potentially charged to the investment option and are displayed abovein accordance with fee disclosure regulations. The Net Total Annual Operating Expenses, also displayed above as supplementaryinformation, are the actual amounts charged by the investment option and may be different from the Gross Expenses due to certainfee waivers or additional expenses charged by other service providers. Expenses reduce the return of the investment option. Part ofthese fees may be shared with the plan's service providers to help pay for plan administration and/or recordkeeping fees. Part of thesefees may be shared with the plan's service providers and, under an agreement with the applicable plan fiduciaries, may be used to helppay for plan administration and/or recordkeeping fees. The plan's fiduciaries may make changes to the plan's investments at any timesubject to applicable notice requirements. Please see the participant website for more information.

** A benchmark index is not actively managed. It does not have a defined investment objective and does not incur fees or expenses.You cannot invest directly in a benchmark index.

General Administrative Services Expenses TableThis table shows expenses that pay for operating the Plan. These expenses are described below. Fees and expensesfor general plan administrative services (for example, recordkeeping services and custodial services) may be chargedto the Plan. These fees and expenses may be charged to your individual account if not paid by the Plan Sponsor and/or included in investment-related fees and expenses. How the expenses are charged to participant accounts will dependon the nature of the expense. For example, some fees may be charged as a fixed dollar amount per participant or as apercentage amount spread across the account balances. Blank fields in the table can be assumed to be not applicable orzero.

General Administrative Services Expenses

as of 10/19/2016

Fee Type Annual

Amount

Quarterly

Amount

Frequency Description

0.17% 0.0425%

Asset Based Charge$1.70 per $1,000 $.43 per $1,000

Quarterly

This fee is for administrative costs associated with theplan and is deducted from your account balance. Thisfee may not apply to all investments offered under yourplan; please see your plan administrator for additionalinformation.

2 � Other Investment-Related Fees, Expense Information and Transfer Restrictions

Other Investment-Related Fees, Expense Information and RestrictionsThis table looks at fees, expenses and transfer restrictions that are in addition to the Investment Expenses in Section 1.Fees and expenses are only one of many things to think about when deciding to invest. You may also want to think aboutwhether an investment in a particular investment option, along with your other investments, will help you reach yourfinancial goals.

Other Investment-Related Fees and Restrictions

as of 10/19/2016

Investment Option Transfer Rule Shareholder Type Fees^

JPMorgan SmartRetirement Income A 1

JPMorgan SmartRetirement 2015 A 1








Pg 10 of 40


01:060716 401K GP19

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Investment Option Transfer Rule Shareholder Type Fees^


American Funds EuroPacific Gr R4 2

Dreyfus International Stock Index 4,5

Prudential Global Real Estate Z 3

Wells Fargo Emerg Mkts Eq Adm 2,3

Dreyfus Small Cap Stock Index Fund 4

Dreyfus Mid Cap Index Fund 5

MFS Mid Cap Value R3 2

Prudential Jennison Mid Cap Growth A 3

Dreyfus S&P 500 Index 4

JPMorgan US Equity A 1

MFS Value R3 2

T. Rowe Price New America Growth 6

Baird Core Plus Bond Inst 3

Key Guaranteed Portfolio Fund

Should the Plan Sponsor terminate the group annuity contract,transfer restrictions and/or possible termination fees may apply. Ifyour Plan Sponsor terminates the group annuity contract, pleasecall Great-West Retirement Services for more information.

Rule #1 - Fund company restriction: A transfer into this fund will not be permitted if a prior transfer was made out of this fund in the last30 days.

Rule #2 - Fund company restriction: A transfer of $5000 or more into this fund will not be permitted if a prior transfer of $5000 or morewas made out of this fund in the last 30 days.

Rule #3 - Due to the frequent trading policy and procedures regarding market timing and excessive trading, if 2 round trips have beenprocessed INTO the fund there may be transfer restrictions. Given the fund's frequent trading policy and procedures and previouswarnings, you may be restricted from transferring money into this fund for 30 days.




^ Shareholder/Shareholder-Type Fees are fees paid directly from your investment in this option (e.g., sales loads, sales charges,deferred sales charges, redemption fees, exchange fees, account fees, purchase fees, transfer or withdrawal fees).

NOTE: More current information about the Plan's investment options, including fees, expenses and performanceupdates, may be available at your plan's Web site.

3 � Plan-Related Information

Plan-Related Information is an explanation of general plan information. It includes a description of non-investmentmanagement fees and expenses that may be charged to your account. This section also includes a list of the ParticipantElected Services Expenses.

General Information

Non-Investment Management Fees and Expenses: Includes recordkeeping, accounting, legal or other administrativefees that may be charged to your account. The dollar amount actually charged to your account during the previous quarterfor such administrative or individual expenses will be reported to you on your quarterly statement. If you have additionalquestions related to fees on your account, please contact the Voice Response System or your Plan Administrator.

Investment Instructions: Your plan lets you direct the investment of your account in the investment options listed inSection 1. You may make changes to your investment options via the plan�s Web site or by calling the Voice ResponseSystem.

Pg 11 of 40


01:060716 401K GP19

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Limitations on Investments: Limits on making changes to your investment choices may be imposed by the PlanAdministrator or by a manager of an investment option. Any limits or restrictions made by a fund manager are describedin the prospectus for the fund. They include restrictions intended to prevent �market timing� (i.e., rapid trading in and out ofa fund). If these restrictions apply then they will be listed in Section 2. In addition to the limits and restrictions described inthe prospectus, the Plan Administrator may have other restrictions on making changes to your investment choices. If thePlan Administrator has additional limits, they will be described in a separate document that will be provided to you by yourPlan Administrator.

Voting, Tender, and Similar Rights: The appropriate Plan fiduciaries, or an individual or an institution designated bythe Plan fiduciaries, will exercise any voting or other rights associated with ownership of the Designated InvestmentAlternatives offered in your Plan.

Participant Elected Services Expenses TableThis table shows expenses for optional services available through your plan. Certain fees may be charged to yourindividual account for optional services you use.

Participant Elected Services Expenses

as of 10/19/2016

Service Fee Amount Frequency Description

Loan Maintenance Fee $12.50 QuarterlyThis fee is for annual maintenance of your existing loan. If you have morethan one loan, you will be assessed the fee for each outstanding loan.

Loan Origination Fee$75 for GWRS

$150 for your TPAPer Loan

This fee is for the processing of your loan. This fee is applied each timeyou request a loan from your retirement account and is taken from theproceeds prior to distribution.

Benefit Disbursement Fee$50 for GWRS

$75 for your TPAPer Distribution

This fee is for the processing of a distribution from your account. This feeis applied each time you request a distribution/withdrawal from the Plan.

ACH Special HandlingCharge

$15.00 Per DistributionAutomated Clearing House. This fee is for transferring your distributiondirectly into your bank account.

EXPRESS SpecialHandling Charge

$25.00 Per Distribution This fee is for sending your distribution via 1- to 2-day express delivery.

WIRE Special HandlingCharge

$40.00 Per DistributionThis fee is for sending your distribution to your bank account viaelectronic wire.

Fees and expenses do add up and can have a big impact on your retirement savings. Fees and expenses are only two ofmany other factors to think about when you make investment decisions.

You can visit the Department of Labor website for an example showing the long-term effect of fees and expenses - http://www.dol.gov/ebsa/publications/401k_employee.html.

Visit your plan's website listed in the title for a glossary of investment terms relevant to the investment optionsunder this plan. To request additional Plan information, or a paper copy of certain information available online,free of charge, contact a representative at Empower Retirement, PO Box 173764, Denver, CO 80217-3764.

Pg 12 of 40

Investment Objective & Strategy ◆JPMorganThe investment seeks current income and some capital appreciation. The fund isa ‘‘fund of funds’’ that invests in other J.P. Morgan Funds (underlying funds), andSmartRetirement is generally intended for investors who are retired or about to retire soon. It isdesigned to provide exposure to a variety of asset classes through investmentsin underlying funds, with an emphasis on fixed income funds over equity fundsIncome Aand other funds.

Fund Manager: Team Managed Risk and Return ProfilePeriod Ending: 09/30/2016

This investment option may be most appropriate for someone willing to acceptFund Operating Expenses:some risk, but seeking to preserve capital and is willing to accept lower potentialGross 1.07%, Net 0.76%returns in exchange. Investors choosing this option want to invest in a mixture ofdiverse investments suiting their needs but do not have the time, desire, orRisk/Potential Return Meterknowledge to select and manage their own portfolios. Asset allocation and

übalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock valuesfluctuate in response to the activities of the general market, individual companies

FOR ILLUSTRATIVE PURPOSES ONLY and economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.JSRAX-JSRAX_2

Higher

Lower

Investment Objective & Strategy ◆JPMorgan The investment seeks total return with a shift to current income and some capitalappreciation over time as the fund approaches and passes the target retirementSmartRetirement date. The fund is a ‘‘fund of funds’’ that invests in other J.P. Morgan Funds(underlying funds), and is generally intended for investors expecting to retirearound the year 2015 (target retirement date). It is designed to provide exposure2015 Ato a variety of asset classes through investments in underlying funds, and overtime the fund’s asset allocation strategy will change.

Fund Manager: Team ManagedPeriod Ending: 09/30/2016 Risk and Return ProfileFund Operating Expenses:

This investment option may be most appropriate for someone willing to acceptGross 1.07%, Net 0.81%some risk, but seeking to preserve capital and is willing to accept lower potentialreturns in exchange. Investors choosing this option want to invest in a mixture ofRisk/Potential Return Meterdiverse investments suiting their needs but do not have the time, desire, or

üknowledge to select and manage their own portfolios. Asset allocation andbalanced investment options are subject to the risks of the underlying funds,which can be a mix of stocks/stock funds and bonds/bond funds. Stock values

FOR ILLUSTRATIVE PURPOSES ONLY fluctuate in response to the activities of the general market, individual companiesand economic conditions. Bond values fluctuate in response to the financialcondition of individual issuers, general market and economic conditions, andchanges in interest rates. In general, when interest rates rise, bond values falland investors may lose principal value.JSFAX-JSFAX_2

Higher

Lower

Investment Objective & Strategy ◆JPMorgan The investment seeks high total return with a shift to current income and somecapital appreciation over time as the fund approaches and passes the targetSmartRetirement retirement date. The fund is a ‘‘fund of funds’’ that invests in other J.P. MorganFunds (underlying funds), and is generally intended for investors expecting toretire around the year 2020 (target retirement date). It is designed to provide2020 Aexposure to a variety of asset classes through investments in underlying funds,and over time the fund’s asset allocation strategy will change.


This investment option may be most appropriate for someone willing to acceptGross 1.11%, Net 0.86%some degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and

ümanage their own portfolios. Asset allocation and balanced investment optionsare subject to the risks of the underlying funds, which can be a mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in response to the

FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.JTTAX-JTTAX_2

Higher

Lower

Pg 13 of 40

Investment Objective & Strategy ◆JPMorganThe investment seeks high total return with a shift to current income and somecapital appreciation over time as the fund approaches and passes the targetSmartRetirement retirement date. The fund is a ‘‘fund of funds’’ that invests in other J.P. MorganFunds (underlying funds), and is generally intended for investors expecting toretire around the year 2025 (target retirement date). It is designed to provide2025 Aexposure to a variety of asset classes through investments in underlying funds,and over time the fund’s asset allocation strategy will change.


This investment option may be most appropriate for someone willing to acceptGross 1.12%, Net 0.89%some degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and


FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.JNSAX-JNSAX_2

Higher

Lower



This investment option may be most appropriate for someone willing to accept aGross 1.16%, Net 0.91%moderate degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and


FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.JSMAX-JSMAX_2

Higher

Lower



This investment option may be most appropriate for someone willing to accept aGross 1.18%, Net 0.93%moderate degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and


FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.SRJAX-SRJAX_2

Higher

Lower

Pg 14 of 40



This investment option may be most appropriate for someone willing to accept aGross 1.22%, Net 0.94%moderately higher degree of risk in exchange for potentially higher long-termreturns. Investors choosing this option want to invest in a mixture of diverseRisk/Potential Return Meterinvestments suiting their needs but do not have the time, desire, or knowledge to

üselect and manage their own portfolios. Asset allocation and balancedinvestment options are subject to the risks of the underlying funds, which can bea mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in

FOR ILLUSTRATIVE PURPOSES ONLY response to the activities of the general market, individual companies andeconomic conditions. Bond values fluctuate in response to the financial conditionof individual issuers, general market and economic conditions, and changes ininterest rates. In general, when interest rates rise, bond values fall and investorsmay lose principal value.SMTAX-SMTAX_2

Higher

Lower



This investment option may be most appropriate for someone willing to accept aGross 1.25%, Net 0.94%moderately higher degree of risk in exchange for potentially higher long-termreturns. Investors choosing this option want to invest in a mixture of diverseRisk/Potential Return Meterinvestments suiting their needs but do not have the time, desire, or knowledge to

üselect and manage their own portfolios. Asset allocation and balancedinvestment options are subject to the risks of the underlying funds, which can bea mix of stocks/stock funds and bonds/bond funds. Stock values fluctuate in

FOR ILLUSTRATIVE PURPOSES ONLY response to the activities of the general market, individual companies andeconomic conditions. Bond values fluctuate in response to the financial conditionof individual issuers, general market and economic conditions, and changes ininterest rates. In general, when interest rates rise, bond values fall and investorsmay lose principal value.JSAAX-JSAAX_2

Higher

Lower



This investment option may be most appropriate for someone willing to accept aGross 1.31%, Net 0.94%higher degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and


FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.JTSAX-JTSAX_2

Higher

Lower

Pg 15 of 40



This investment option may be most appropriate for someone willing to accept aGross 1.31%, Net 0.94%higher degree of risk in exchange for potentially higher long-term returns.Investors choosing this option want to invest in a mixture of diverse investmentsRisk/Potential Return Metersuiting their needs but do not have the time, desire, or knowledge to select and


FOR ILLUSTRATIVE PURPOSES ONLY activities of the general market, individual companies and economic conditions.Bond values fluctuate in response to the financial condition of individual issuers,general market and economic conditions, and changes in interest rates. Ingeneral, when interest rates rise, bond values fall and investors may loseprincipal value.JFFAX-JFFAX_2

Higher

Lower

Investment Objective & Strategy ◆American Funds The investment seeks long-term growth of capital. The fund invests primarily incommon stocks of issuers in Europe and the Pacific Basin that the investmentEuroPacific Gr R4 adviser believes have the potential for growth. Growth stocks are stocks that theinvestment adviser believes have the potential for above-average capitalappreciation. It normally will invest at least 80% of its net assets in securities ofFund Manager: Team Managedissuers in Europe and the Pacific Basin. The fund may invest a portion of itsPeriod Ending: 09/30/2016assets in common stocks and other securities of companies in emergingFund Operating Expenses:markets.Gross 0.85%, Net 0.85%

Risk/Potential Return Meter Risk and Return ProfileInternational investments may be most appropriate for someone looking forü

greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and political

FOR ILLUSTRATIVE PURPOSES ONLY

developments.REREX_2

Higher

Lower

Investment Objective & Strategy ◆Dreyfus International The investment seeks to match the performance of the Morgan Stanley CapitalInternational Europe, Australasia, Far East Index (MSCI EAFEd). The fundStock Index generally is fully invested in stocks included in the MSCI EAFEd Index and infutures whose performance is tied to certain countries included in the index. Itgenerally invests in all stocks included in the index. The fund’s investments areFund Manager: Durante/Brown/Wongselected to match the benchmark composition along individual name, country,Period Ending: 09/30/2016and industry weighting, and other benchmark characteristics. It maintainsFund Operating Expenses:approximately the same weighting for each stock as the index does. The fund isGross 0.61%, Net 0.60%non-diversified. The MSCI EAFE Index (Europe, Australasia, Far East) is a free

Risk/Potential Return Meter float-adjusted market capitalization index that is designed to measure developedmarket equity performance, excluding the US & Canada.ü

Risk and Return ProfileInternational investments may be most appropriate for someone looking for


greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and politicaldevelopments.DIISX_2

Higher

Lower

Pg 16 of 40

Investment Objective & Strategy ◆Hartford WorldThe investment seeks capital appreciation with income as a secondary goal. Thefund normally invests at least 80% of its net assets in a broad range of fixedBond R4 income securities, including U.S. and non-U.S. government and corporate debt,mortgage-related and other asset-backed securities, loan participations, inflation-protected securities, structured securities, variable, floating, and inverse floatingFund Manager: Sullivanrate instruments and preferred stock. It will invest at least 75% of its net assets inPeriod Ending: 09/30/2016investment grade debt securities; however, the fund has the ability to invest up toFund Operating Expenses:50% of its net assets in securities rated below investment grade. It is non-Gross 1.08%, Net 1.05%diversified.

Risk/Potential Return MeterRisk and Return Profileü

International investments may be most appropriate for someone looking forgreater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.


Foreign funds involve special risks, including currency fluctuations and politicaldevelopments. Bond investments may be most appropriate for someone seekinghigher potential income than with a money market or stable value investment. Abond fund’s yield, share price and total return change daily and are based onchanges in interest rates, market conditions, economic and political news andthe quality and maturity of its investments. In general, bond prices fall wheninterest rates rise and vice versa.HWDSX_2

Higher

Lower

Investment Objective & Strategy ◆Prudential Global The investment seeks capital appreciation and income. The fund normally investsat least 80% of its investable assets (net assets plus any borrowings made forReal Estate Z investment purposes) in the equity-related securities of real estate companies,principally real estate investment trusts (REITs), and other real estate securities.Equity-related securities may also include common stock, convertible securities,Fund Manager: Team Managednonconvertible preferred stock, American Depositary Receipts (ADRs), warrantsPeriod Ending: 09/30/2016and other rights that can be exercised to obtain stock, investments in variousFund Operating Expenses:types of business ventures and similar securities. It is non-diversified.Gross 0.97%, Net 0.97%


greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Foreign funds involve special risks, including currency fluctuations and political


developments.PURZX_2

Higher

Lower

Investment Objective & Strategy ◆Wells Fargo Emerg The investment seeks long-term capital appreciation. The fund normally investsat least 80% of its net assets in emerging market equity securities. It investsMkts Eq Adm principally in equity or other listed securities of emerging market companies. Thefund’s managers consider emerging market companies to include companiesthat are traded in, have their primary operations in, are domiciled in or derive aFund Manager: Zhang/Irwin/Peckmajority of their revenue from emerging market countries as defined by the MSCIPeriod Ending: 09/30/2016Emerging Markets Index. It may have exposure to stocks across anyFund Operating Expenses:capitalizations and styles and will be diversified across countries and sectors.Gross 1.53%, Net 1.49%


greater potential returns and willing to accept a higher degree of risk.International investment may provide diversification for a domestic portfolio.Equity securities of companies located in emerging markets involve greater risks


than investing in more established markets, including currency fluctuations,political developments and share illiquidity.EMGYX_2

Higher

Lower

Pg 17 of 40

Investment Objective & Strategy ◆JHancock AlternativeThe investment seeks long-term growth of capital. The fund allocates its assetsamong other affiliated and unaffiliated underlying funds, including exchange-Asset Allc I traded funds (ETFs), that emphasize alternative or nontraditional asset categoriesor investment strategies such as international small-cap stocks, emerging-marketequity, commodities, market neutral (long/short), global real estate, naturalFund Manager: Boyda/Daher/Thooftresources, TIPS (Treasury Inflation-Protected Securities), global bonds, highPeriod Ending: 09/30/2016yield, bank loans, foreign currency trading strategies, absolute return strategies,Fund Operating Expenses:managed futures, arbitrage strategies, tactical investment strategies, andGross 1.58%, Net 1.52%emerging-market debt.


The investment may be most appropriate for someone looking for greaterpotential returns and willing to accept a high degree of risk. Specialty funds thatinvest in a specific industry sector, geographic region, or one or more


commodities may be more volatile than funds with more diversified investments.Additionally, funds that use unique investing strategies, such as short funds orhedge funds, may be more volatile than funds that use traditional investingstrategies.JAAIX_2

Higher

Lower

Investment Objective & Strategy ◆Diamond Hill The investment seeks to provide long-term capital appreciation. The fundnormally invests at least 80% of its net assets in U.S. equity securities with smallSmall Cap I market capitalizations that the Adviser believes are undervalued. Small capcompanies are defined as companies with market capitalizations at the time ofpurchase below $3 billion or in the range of those market capitalizations ofFund Manager: Downey/Schindler/Welchcompanies included in the Russell 2000 Index at the time of purchase. ThePeriod Ending: 09/30/2016Adviser focuses on estimating a company’s value independent of its currentFund Operating Expenses:stock price.Gross 1.01%, Net 1.01%

Risk/Potential Return Meter Risk and Return ProfileSmall-cap investments may be most appropriate for someone willing to accept aü

high degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may be


more volatile than securities of larger, more established companies.DHSIX_2

Higher

Lower

Investment Objective & Strategy ◆Dreyfus Small Cap The investment seeks to match the performance of the S&P SmallCap 600d

Index. To pursue its goal, the fund generally is fully invested in a representativeStock Index Fund sample of stocks included in the S&P SmallCap 600d Index and in futures whoseperformance is tied to the index. The adviser expects to invest in approximately500 or more of the stocks in the index. However, at times, it may be fullyFund Manager: Durante/Brown/Wonginvested in all the stocks that comprise the index. Under these circumstances,Period Ending: 09/30/2016the fund maintains approximately the same weighting for each stock as the indexFund Operating Expenses:does. The fund is non-diversified. The S&P SmallCap 600 Index is anGross 0.51%, Net 0.50%unmanaged, market-weighted index that consists of 600 U.S. companies that

Risk/Potential Return Meter have market capitalization less than $1 billion representing about 3% of the totalU.S. equities market.ü

Risk and Return ProfileSmall-cap investments may be most appropriate for someone willing to accept a


high degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may bemore volatile than securities of larger, more established companies.DISSX_2

Higher

Lower

Pg 18 of 40

Investment Objective & Strategy ◆Lord AbbettThe investment seeks long-term growth of capital through a diversified andactively managed portfolio consisting of developing growth companies, many ofDeveloping Growth A which are traded over the counter. To pursue its objective, the fund investsprimarily in the common stocks of companies demonstrating above-average,long-term growth potential. It invests at least 65% of its net assets in equityFund Manager: Weise/O’Halloransecurities of small companies. In selecting investments, the fund may invest inPeriod Ending: 09/30/2016U.S. and foreign (including emerging market) companies.Fund Operating Expenses:

Gross 0.98%, Net 0.98%Risk and Return Profile

Risk/Potential Return Meter Small-cap investments may be most appropriate for someone willing to accept ahigh degree of market volatility in exchange for greater potential returns overü

time. Stock investments tend to be more volatile than bond, stable value ormoney market investments. Equity securities of small-sized companies may bemore volatile than securities of larger, more established companies.


LAGWX-LAGWX_2

Higher

Lower

Investment Objective & Strategy ◆Dreyfus Mid CapThe investment seeks to match the performance of the S&P MidCap 400d Index.To pursue its goal, the fund generally is fully invested in stocks included in theIndex Fund S&P MidCap 400d Index and in futures whose performance is tied to the index. Itgenerally invests in all 400 stocks in the S&P MidCap 400d Index in proportion totheir weighting in the index. The S&P MidCap 400d Index is an unmanagedFund Manager: Durante/Brown/Wongindex of 400 common stocks of medium-size companies. The fund is non-Period Ending: 09/30/2016diversified. The S&P MidCap 400 Index is an unmanaged, market-weighted indexFund Operating Expenses:that consists of 400 U.S. companies that have market capitalization from $1Gross 0.51%, Net 0.50%billion to $5 billion representing about 7% of the total U.S. equities market.


Mid-cap investments may be most appropriate for someone willing to accept ahigher degree of market volatility in exchange for greater potential returns overtime. Stock investments tend to be more volatile than bond, stable value or


money market investments. Equity securities of medium-sized companies maybe more volatile than securities of larger, more established companies.PESPX_2

Higher

Lower

Investment Objective & Strategy ◆MFS Mid Cap The investment seeks capital appreciation. The fund normally invests at least80% of the fund’s net assets in issuers with medium market capitalizations. TheValue R3 adviser generally defines medium market capitalization issuers as issuers withmarket capitalizations similar to those of issuers included in the Russell Midcapd

Value Index over the last 13 months at the time of purchase. It normally investsFund Manager: Schmitz/Taylorthe fund’s assets primarily in equity securities.Period Ending: 09/30/2016

Fund Operating Expenses:Risk and Return ProfileGross 1.19%, Net 1.18%

Mid-cap investments may be most appropriate for someone willing to accept aRisk/Potential Return Meter higher degree of market volatility in exchange for greater potential returns over

time. Stock investments tend to be more volatile than bond, stable value orü

money market investments. Equity securities of medium-sized companies maybe more volatile than securities of larger, more established companies.


MVCHX_2

Higher

Lower

Investment Objective & Strategy ◆Prudential Jennison The investment seeks long-term capital appreciation. The fund normally investsat least 80% of its investable assets in equity and equity-related securities ofMid Cap Growth A medium-sized companies with the potential for above-average growth. The fund’sinvestable assets will be less than its total assets to the extent that it hasborrowed money for non-investment purposes, such as to meet anticipatedFund Manager: Mullman/Rabinowitzredemptions.Period Ending: 09/30/2016

Fund Operating Expenses:Risk and Return ProfileGross 1.06%, Net 1.06%

Mid-cap investments may be most appropriate for someone willing to accept aRisk/Potential Return Meter higher degree of market volatility in exchange for greater potential returns over

time. Stock investments tend to be more volatile than bond, stable value orü

money market investments. Equity securities of medium-sized companies maybe more volatile than securities of larger, more established companies.


PEEAX_2

Higher

Lower

Pg 19 of 40

Investment Objective & Strategy ◆Dreyfus S&P 500The investment seeks to match the performance of the S&P 500d Index. Topursue its goal, the fund generally is fully invested in stocks included in the S&PIndex 500d Index and in futures whose performance is tied to the index. It generallyinvests in all 500 stocks in the S&P 500d Index in proportion to their weighting inthe index. The S&P 500d Index is an unmanaged index of 500 common stocksFund Manager: Durante/Brown/Wongchosen to reflect the industries of the U.S. economy and is often considered aPeriod Ending: 09/30/2016proxy for the stock market in general. The fund is non-diversified. The S&P 500Fund Operating Expenses:Index is an unmanaged, market-weighted index that consists of the 500 largestGross 0.51%, Net 0.50%publicly traded companies and is considered representative of the broad U.S.

Risk/Potential Return Meter stock market.

üRisk and Return ProfileLarge-cap investments may be most appropriate for someone willing to acceptsome degree of market volatility in return for potential long-term capital growth.


Stock investments tend to be more volatile than bond, stable value or moneymarket investments.PEOPX_2

Higher

Lower

Investment Objective & Strategy ◆JPMorgan USThe investment seeks to provide high total return from a portfolio of selectedequity securities. Under normal circumstances, the fund invests at least 80% ofEquity A its assets in equity securities of U.S. companies. ‘‘Assets’’ means net assets,plus the amount of borrowings for investment purposes. In implementing itsstrategy, the fund primarily invests in common stocks of large- and medium-Fund Manager: Team Managedcapitalization U.S. companies but it may also invest up to 20% of its assets inPeriod Ending: 09/30/2016common stocks of foreign companies, including depositary receipts.Fund Operating Expenses:


Risk/Potential Return Meter Large-cap investments may be most appropriate for someone willing to acceptsome degree of market volatility in return for potential long-term capital growth.ü

Stock investments tend to be more volatile than bond, stable value or moneymarket investments.


JUEAX_2

Higher

Lower

Investment Objective & Strategy ◆MFS Value R3 The investment seeks capital appreciation. The fund normally invests the fund’sassets primarily in equity securities. Equity securities include common stocks

Fund Manager: Chitkara/Gorham and other securities that represent an ownership interest (or right to acquire anPeriod Ending: 09/30/2016 ownership interest) in a company or other issuer. MFS focuses on investing theFund Operating Expenses: fund’s assets in the stocks of companies it believes are undervalued compared

Gross 0.90%, Net 0.87% to their perceived worth (value companies).

Risk/Potential Return Meter Risk and Return Profileü Large-cap investments may be most appropriate for someone willing to accept

some degree of market volatility in return for potential long-term capital growth.Stock investments tend to be more volatile than bond, stable value or money

FOR ILLUSTRATIVE PURPOSES ONLY market investments.MEIHX-MEIHX_2

Higher

Lower

Investment Objective & Strategy ◆T. Rowe Price New The investment seeks to provide long-term capital growth. The fund investsprimarily (at least 65% of its total assets) in common stocks of U.S. companiesAmerica Growth operating in those sectors of the economy that, in the view of T. Rowe Price, arethe fastest growing or have the greatest growth potential. It may invest in foreignstocks in keeping with the fund’s objectives. The fund may sell securities for aFund Manager: Whitevariety of reasons, such as to secure gains, limit losses, or redeploy assets intoPeriod Ending: 09/30/2016more promising opportunities.Fund Operating Expenses:


Risk/Potential Return Meter Large-cap investments may be most appropriate for someone willing to acceptsome degree of market volatility in return for potential long-term capital growth.ü

Stock investments tend to be more volatile than bond, stable value or moneymarket investments.


PRWAX_2

Higher

Lower

Pg 20 of 40

Investment Objective & Strategy ◆Baird Core PlusThe investment seeks an annual rate of total return, before fund expenses,greater than the annual rate of total return of the Barclays U.S. Universal BondBond Inst Index. The fund normally invests at least 80% of its net assets in the followingtypes of U.S. dollardenominated debt obligations: U.S. government and otherpublicsector entities; assetbacked and mortgagebacked obligations of U.S. andFund Manager: Team Managedforeign issuers; corporate debt of U.S. and foreign issuers. It invests primarily inPeriod Ending: 09/30/2016investment-grade debt obligations, but may invest up to 20% of its net assets inFund Operating Expenses:non-investment grade debt obligations (sometimes referred to as ‘‘high yield’’ orGross 0.30%, Net 0.30%‘‘junk’’ bonds).‘‘


This investment may be most appropriate for someone seeking greater potentialincome than with a money market or stable value investment and willing toaccept a higher degree of risk. The investor may also desire to balance more


aggressive investments with one providing potentially steady income. A bondfund’s yield, share price and total return change daily and are based on changesin interest rates, market conditions, economic and political news, and the qualityand maturity of its investments. In general, bond prices fall when interest ratesrise and vice versa.BCOIX_2

Higher

Lower

Investment ObjectiveKey Guaranteed As a general account product offered through a group annuity contract,participant principal and interest are fully guaranteed by the entire generalPortfolio Fund account assets of GWL&A, which as of June 30, 2015 were $31.0 billion andinclude $1.9 billion in shareholder equity and accumulated surplus. GeneralAccount liabilities as of June 30, 2015 were $29.0 billion. This means thatPeriod Ending: 06/30/2016GWL&A holds an additional 6.6% in capital for every dollar of liability we have.Fund Operating Expenses:These assets are primarily high-quality, fixed income bonds, with 99% ratedGross 0.00%, Net 0.00%investment-grade and 16.2% rated AAA as of June 30, 2015.


The investment may be most appropriate for someone wanting to safeguardprincipal value or to balance a portfolio which contains more aggressiveinvestments. The investor may be requiring stability and asset liquidity.


KGPF-KGPF_2

Higher

Lower

Pg 21 of 40

Although data is gathered from reliable sources, including but not limited to Morningstar, Inc., the

completeness or accuracy of the data shown cannot be guaranteed. Where data is obtained from

Morningstar: ©2016 Morningstar, Inc. All Rights Reserved. The information contained herein: (1) is

proprietary to Morningstar and/or its content providers; (2) may not be copied or distributed; and (3) is not

warranted to be accurate, complete or timely. Neither Morningstar nor its content providers are responsible

for any damages or losses arising from any use of this information.

◆ Unless otherwise noted: Not a Deposit. Not FDIC Insured. Not Bank Guaranteed. Funds May Lose Value.

Not Insured by Any Federal Government Agency.

A benchmark index is not actively managed, does not have a defined investment objective, and does not

incur fees or expenses. Therefore, performance of a fund will generally be less than its benchmark index. You

cannot invest directly in a benchmark index.

Funds may impose redemption fees and/or transfer restrictions, if assets are held for less than the published

holding period. For more information, see the fund's prospectus and/or disclosure documents.

©2016 Great-West Life & Annuity Insurance Company. All rights reserved.

Holdings and composition of holdings are subject to change. Due to rounding or other factors, asset

allocations and/or largest holdings may not equal 100.0%.

The Net expense ratio shown is net of any fee waivers or expense reimbursements.

Asset allocation funds are generally subject to a fund operating expense at the fund level, as well as

prorated fund operating expenses of each underlying fund in which they invest. For more information, please

refer to the fund prospectus and/or disclosure document.

The date in a target date fund's name represents an approximate date when an investor is expected to retire

(which is assumed to be at age 65) and/or begins withdrawing money. The principal value of the funds is not

guaranteed at any time, including the target date. For more information, please refer to the fund prospectus

and/or disclosure document.

Pg 22 of 40

Paycheck Contribution Election401(k) Plan

STD FSALDF ][08/10/16)( 332968-01NO_GRPG 45769/][GU19)(/][GP19

DOC ID: 393676691)(

Page 1 of 2

Doctors Management, LLC 401(k) Profit Sharing Plan 332968-01

Use black or blue ink when completing this form. For questions regarding this form, visit the Web site at www.empower-retirement.com/participant or contact Service Provider at 1-800-338-4015.

A Participant Information

Account extension, if applicable, identifies fundstransferred to a beneficiary due to participant'sdeath, alternate payee due to divorce or aparticipant with multiple accounts.

- -

Account Extension Social Security Number (Must provide all 9 digits)

Last Name First Name M.I.

( )

Daytime Phone Number

( )

Alternate Phone Number

B Payroll Election(s)

Paycheck Contribution Election (Payroll Deductions)

Select One: Start Restart Change Stop Decline

I elect to contribute to the Plan the following percentage(s) of my eligible compensation indicated below (per pay period):

Before-Tax Contributions __________________% (1% - 100%)

Roth Contributions __________________% (1% - 100%)

Payroll Effective Date (mm/dd/yyyy) / / Date of Hire (mm/dd/yyyy) / /

The total annual before-tax and Roth contributions cannot exceed $18,000.00 of my eligible compensation in the 2016 tax year.

Age 50 Catch-Up Election

I elect to contribute to the Plan additional Age 50 Catch-Up percentage(s) of my eligible compensation as indicated below (per pay period):

Before-Tax Contributions __________________%

Roth Contributions __________________%

Payroll Effective Date (mm/dd/yyyy) / /

The total before-tax and Roth Age 50 Catch-Up amount cannot exceed $6,000.00 of my eligible compensation in the 2016 tax year. I must beage 50 or older during this calendar year and I must be currently deferring the maximum amount allowable under the Internal Revenue Codeand applicable regulations and/or my Plan. If I stop my deferrals and/or do not defer the maximum amount during this calendar year, the Age 50Catch-Up amount I have elected to contribute will not be considered a Catch-Up deferral. The Catch-Up contributions will be allocated in the samemanner as my regular contributions.

I elect to cancel my Catch-Up contribution election.

C Signatures and Consent (Signatures must be on the lines provided.)

Participant Consent (Please sign on the 'Participant Signature' line below.)

My signature acknowledges that I have read, understand and agree to all pages of this form and affirms that all information that I have providedis true and correct. I also understand that:

� Until cancelled, superseded or I cease to be an eligible employee, all election(s) shall apply to all eligible compensation allowed by the Planpaid from the effective date specified unless a different effective date is required under the terms of the Plan and cancels all previous elections.

� If I am increasing or decreasing my payroll deductions, all existing future deferrals will be cancelled.� If I am stopping payroll deductions, all existing deferrals will be cancelled.� I may change the percentage of compensation contributed as allowed under the terms of the Plan.� It is my responsibility to comply with any Internal Revenue Code deferral limits and that I may be responsible for any costs, including taxes

and penalties that I may incur as a result of excess contributions.� My Plan Administrator may take any action that may be necessary to ensure that my participation is in compliance with any applicable

requirement of the Plan Document and the Internal Revenue Code.� I authorize the payroll deduction as indicated on this form.

Any person who presents false or fraudulent information is subject to criminal and civil penalties.

Participant Signature Date (Required)

A handwritten signature is required on this form. An electronic signature will not be accepted and will result in a significant delay.

Pg 23 of 40

332968-01

Last Name First Name M.I. Social Security Number Number

STD FSALDF ][08/10/16)( 332968-01NO_GRPG 45769/][GU19)(/][GP19

DOC ID: 393676691)(

Page 2 of 2


Authorized Plan Administrator Signature (Please sign on the 'Authorized Plan Administrator Signature' line below.)

I authorize the election indicated by the participant above.

AuthorizedPlan Administrator Signature Date (Required)

Print Full Name

D Mailing Instructions

Participant forward this form to Employer

Employer DO NOT send this form to Service Provider. Please retain for your records.

Core securities, when offered, are offered through GWFS Equities, Inc. and/or other broker dealers.GWFS Equities, Inc., Member FINRA/SIPC, is a wholly owned subsidiary of Great-West Life & Annuity Insurance Company.

Empower Retirement refers to the products and services offered in the retirement markets by Great-West Life & Annuity Insurance Company (GWL&A),Corporate Headquarters: Greenwood Village, CO; Great-West Life & Annuity Insurance Company of New York, Home Office: NY, NY; and their subsidiariesand affiliates. The trademarks, logos, service marks, and design elements used are owned by their respective owners and are used by permission.

Pg 24 of 40

C401K FENRAP ][11/16/16)( 332968-01 ADD NUPARTADMIN FORMAT

][GP19/DOC ID: 405565972)(

Page 1 of 3

Participant Enrollment401(k) Plan


Participant Information

Last Name First Name MI Social Security Number

Mailing Address E-Mail Address

City State Zip Code Mo Day Year Female Male

( ) ( ) Date of Birth Married Unmarried

Home Phone Work Phone

Check box if you prefer to receive quarterly account statements inSpanish.

Do you have a retirement savings account with a previous employer or an IRA? Yes No

Would you like help consolidating your other retirement accounts into your account with Empower Retirement?* Yes, I would like a representativeto call me at phone # - - to review my options and assist me with the process. The best time to call is to A.M./P.M. (circle one - available 8:00 A.M. to 6:00 P.M. MST). *Rollovers are subject to your Plan's provisions.

Payroll Information

I elect to contribute ________% (1% - 100%) per pay period of my compensation as before-tax contributions to the 401(k) Plan until such timeas I revoke or amend my election.

I elect to contribute ________% (1% - 100%) per pay period of my compensation after-tax as a designated Roth contribution to the 401(k) Planuntil such time as I revoke or amend my election.

Note: The total of your before-tax and Roth deferrals cannot exceed 100% or $18,000.00. Your before-tax and Roth deferrals must be specifiedconsistently (both as a percent). If I am 50 years of age or older and I am eligible for a catch-up contribution, I understand I may exceed this total.

I decline to make contributions to the Plan at this time.

Payroll Effective Date: Date of Hire:Mo Day Year Mo Day Year

Age 50 Catch-Up Election

I elect to contribute ________% per pay period of my compensation as before-tax contributions to the 401(k) Plan as additional Age 50 Catch-Upof my eligible compensation.

I elect to contribute ________% per pay period of my compensation after-tax as a designated Roth contribution to the 401(k) Plan as additionalAge 50 Catch-Up of my eligible compensation.

The total before-tax and Roth Age 50 Catch-Up amount cannot exceed $6,000.00 of my eligible compensation in the 2016 tax year. I must be age 50or older during this calendar year and I must be currently deferring the maximum amount allowable under the Internal Revenue Code and applicableregulations and/or my Plan. If I stop my deferrals and/or do not defer the maximum amount during this calendar year, the Age 50 Catch-Up amount Ihave elected to contribute will not be considered a Catch-Up deferral. The Catch-Up contributions will be allocated in the same manner as my regularcontributions.

Investment Option Information (applies to all contributions) - Please refer to your enrollment packet for investment descriptions.

I understand that funds may impose redemption fees on certain transfers, redemptions or exchanges if assets are held less than the period stated in thefund's prospectus or other disclosure documents. I will refer to the fund's prospectus and/or disclosure documents for more information.

See below for Participation Agreement and Required Signatures

INVESTMENT OPTION

NAME TICKER CODE %JPMorgan SmartRetirement Income A. . . . . . . . . . . JSRAX JSRAX _____

JPMorgan SmartRetirement 2015 A. . . . . . . . . . . . . JSFAX JSFAX _____

JPMorgan SmartRetirement 2020 A. . . . . . . . . . . . . JTTAX JTTAX _____

JPMorgan SmartRetirement 2025 A. . . . . . . . . . . . . JNSAX JNSAX _____

JPMorgan SmartRetirement 2030 A. . . . . . . . . . . . . JSMAX JSMAX _____

JPMorgan SmartRetirement 2035 A. . . . . . . . . . . . . SRJAX SRJAX _____

JPMorgan SmartRetirement 2040 A. . . . . . . . . . . . . SMTAX SMTAX _____

JPMorgan SmartRetirement 2045 A. . . . . . . . . . . . . JSAAX JSAAX _____

INVESTMENT OPTION

NAME TICKER CODE %Wells Fargo Emerg Mkts Eq Adm. . . . . . . . . . . . . . . EMGYX EMGYX _____

JHancock Alternative Asset Allc I. . . . . . . . . . . . . . . JAAIX JAAIX _____

Diamond Hill Small Cap I. . . . . . . . . . . . . . . . . . . . . . . DHSIX DHSIX _____

Dreyfus Small Cap Stock Index Fund. . . . . . . . . . . . DISSX DISSX _____

Lord Abbett Developing Growth A. . . . . . . . . . . . . . LAGWX LAGWX _____

Dreyfus Mid Cap Index Fund. . . . . . . . . . . . . . . . . . . . PESPX PESPX _____

MFS Mid Cap Value R3. . . . . . . . . . . . . . . . . . . . . . . . . MVCHX MVCHX _____

Prudential Jennison Mid Cap Growth A. . . . . . . . . PEEAX PEEAX _____

Pg 25 of 40

332968-01


C401K FENRAP ][11/16/16)( 332968-01 ADD NUPARTNO_GRPG 45771/][GP19

DOC ID: 405565972)(

Page 2 of 3

NAME TICKER CODE %JPMorgan SmartRetirement 2050 A. . . . . . . . . . . . . JTSAX JTSAX _____

JPMorgan SmartRetirement 2055 A. . . . . . . . . . . . . JFFAX JFFAX _____

American Funds EuroPacific Gr R4. . . . . . . . . . . . . REREX REREX _____

Dreyfus International Stock Index. . . . . . . . . . . . . . . DIISX DIISX _____

Hartford World Bond R4. . . . . . . . . . . . . . . . . . . . . . . . . HWDSX HWDSX _____

Prudential Global Real Estate Z. . . . . . . . . . . . . . . . . . PURZX PURZX _____

NAME TICKER CODE %Dreyfus S&P 500 Index. . . . . . . . . . . . . . . . . . . . . . . . . . PEOPX PEOPX _____

JPMorgan US Equity A. . . . . . . . . . . . . . . . . . . . . . . . . . JUEAX JUEAX _____

MFS Value R3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MEIHX MEIHX _____

T. Rowe Price New America Growth. . . . . . . . . . . . PRWAX PRWAX _____

Baird Core Plus Bond Inst. . . . . . . . . . . . . . . . . . . . . . . BCOIX BCOIX _____

Key Guaranteed Portfolio Fund. . . . . . . . . . . . . . . . . . N/A KGPF _____

MUST INDICATE WHOLE PERCENTAGES =100%

Plan Beneficiary Designation

This designation is effective upon execution and delivery to Service Provider at the address below. I have the right to change the beneficiary. If anyinformation is missing, additional information may be required prior to recording my beneficiary designation. If my primary and contingent beneficiariespredecease me or I fail to designate beneficiaries, amounts will be paid pursuant to the terms of the Plan Document or applicable law.

You may only designate one primary and one contingent beneficiary on this form. However, the number of primary or contingent beneficiariesyou name is not limited. If you wish to designate more than one primary and/or contingent beneficiary, do not complete the section below.Instead, complete and forward the Beneficiary Designation form.

Primary Beneficiary

100.00%

% of Account Balance Social Security Number Primary Beneficiary Name Relationship Date of Birth

( )

Phone Number (Optional)

Contingent Beneficiary

100.00%

% of Account Balance Social Security Number Contingent Beneficiary Name Relationship Date of Birth

( )


Spousal Consent for Beneficiary Designation

The date your spouse signs below must match the date on which his or her signature was notarized.

For Residents of all states (except California), please have your notary complete the section below.Notice to California Notaries using the California Affidavit and Jurat Form the following items must be completed by the notary on the statenotary form: the title of the form, the plan name, the plan number, the document date, the participant’s name and participant spouse’s name. The notaryforms not containing this information will be rejected and it will delay this request.

I, (name of spouse) , the current spouse of the participant, hereby voluntarily consent to theparticipant's primary beneficiary designation above and understand its effect. I understand that my spouse's beneficiary designation means that I willnot receive 100% of his or her vested account balance under the Plan and that my spouse's election is not valid unless I consent to it. I understand thatmy consent is irrevocable unless my spouse changes the beneficiary designation, or designates me to receive 100% of his or her vested account balance.

Spouse's Signature Date

Statement of Notary

NOTE: Notary seal must be visible, if applicable.

State of ) The consent to this request was subscribed and sworn to (or affirmed) before me on this day of ,

)ss. year , by (name of spouse) proved to me on the basis

County of ) of satisfactory evidence to be the person who appeared before me, who affirmed that such consent represents

his/her free and voluntary act.

SEAL

Notary Public My commission expires

Pg 26 of 40

332968-01


C401K FENRAP ][11/16/16)( 332968-01 ADD NUPARTNO_GRPG 45771/][GP19

DOC ID: 405565972)(

Page 3 of 3

Participation Agreement

Withdrawal Restrictions - I understand that the Internal Revenue Code (the "Code") and/or my employer's Plan Document may impose restrictionson transfers and/or distributions. I understand that I must contact the Plan Administrator to determine when and/or under what circumstances I ameligible to receive distributions or make transfers.

Investment Options - I understand that by signing and submitting this Participant Enrollment form for processing, I am requesting to have investmentoptions established under the Plan as specified in the Investment Option Information section. I understand and agree that this account is subject to theterms of the Plan Document. I understand and acknowledge that all payments and account values, when based on the experience of the investmentoptions, may not be guaranteed and may fluctuate, and, upon redemption, shares may be worth more or less than their original cost. I acknowledge thatinvestment option information, including prospectuses, disclosure documents and Fund Profile sheets, have been made available to me and I understandthe risks of investing.

Compliance With Plan Document and/or the Code - I agree that my employer or Plan Administrator may take any action that may be necessary toensure that my participation in the Plan is in compliance with any applicable requirement of the Plan Document and/or the Code. I understand that themaximum annual limit on contributions is determined under the Plan Document and/or the Code. I understand that it is my responsibility to monitormy total annual contributions to ensure that I do not exceed the amount permitted. If I exceed the contribution limit, I assume sole liability for anytax, penalty, or costs that may be incurred.

Incomplete Forms - I understand that in the event my Participant Enrollment form is incomplete or is not received by Service Provider at the addressbelow prior to the receipt of any deposits, I specifically consent to Service Provider retaining all monies received and allocating them to the defaultinvestment option selected by the Plan. If no default investment option is selected, funds will be returned to the payor as required by law. Once myaccount has been established, I understand that I must call 1-800-338-4015 or access the Web site in order to transfer monies from the default investmentoption. Also, I understand all contributions received after my account is established will be applied to the investment options I have most recentlyselected.

Account Corrections - I understand that it is my obligation to review all confirmations and quarterly statements for discrepancies or errors. Correctionswill be made only for errors which I communicate within 90 calendar days of the last calendar quarter. After this 90 days, account information shallbe deemed accurate and acceptable to me. If I notify Service Provider of an error after this 90 days, the correction will be only processed from thedate of notification forward and not on a retroactive basis.

Required Signature(s) - I have completed, understand and agree to all pages of this Participant Enrollment form. I understand that Service Provideris required to comply with the regulations and requirements of the Office of Foreign Assets Control, Department of the Treasury ("OFAC"). As a result,Service Provider cannot conduct business with persons in a blocked country or any person designated by OFAC as a specially designated national orblocked person. For more information, please access the OFAC Web site at:http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Important Notice: If you are married and the Plan is subject to spousal consent requirements under ERISA and/or the Plan Document, you must haveyour spouse’s signature notarized to designate a primary beneficiary other than your spouse or in addition to your spouse.

Participant Signature Date

A handwritten signature is required on this form. An electronic signature will notbe accepted and will result in a significant delay.

Authorized Plan Administrator/Trustee Date

Print Full Name

Participant forward to Plan Administrator/TrusteePlan Administrator forward to Service Provider at:Empower RetirementPO Box 173764Denver, CO 80217-3764Express Address:8515 E. Orchard Road, Greenwood Village, CO 80111Phone#: 1-800-338-4015Fax#: 1-866-633-5212



Pg 27 of 40

This page left intentionally blank

Beneficiary Designation401(k) Plan

STD FBENED ][09/06/16)( 332968-01 CHG NUPARTNO_GRPG 45768/][GU19)(/][LDOM

DOC ID: 395753937)(

Page 1 of 5


For My Information

� For questions regarding this form, visit the website at www.empower-retirement.com/participant or contact Service Provider at 1-800-338-4015.

� Use black or blue ink when completing this form.

A Participant Information

Account extension, if applicable, identifies fundstransferred to a beneficiary due to participant'sdeath, alternate payee due to divorce or aparticipant with multiple accounts.

- -

Account Extension Social Security Number (Must provide all 9 digits)

Last Name First Name M.I.

Email Address

Married Unmarried

/ /

Date of Birth

( )

Daytime Phone Number

( )

Alternate Phone Number

B Beneficiary Designation (Attach an additional sheet to name additional beneficiaries.)

Primary Beneficiary Designation (Primary beneficiary designations must total 100% - percentage can be made out to two decimal places.)

� If I am married, my Plan requires my spouse to be named as primary beneficiary for 100% of my account balance, or my spouse must consentto my beneficiary designation.

� See the attached examples on how to complete the below beneficiary designations if the beneficiary is a non-individual, such as a trust, charityor estate.

% / /

% of Account Balance Primary Beneficiary Name(Name of Individual, Trust, Charity, etc.)

Relationship Social Security or TaxpayerIdentification Number

Date of Birthor Trust Date

Street Address City State Zip Code( )


% / /






% / /






Contingent Beneficiary Designation (Contingent beneficiary designations must total 100% - percentage can be made out to two decimal places.)

% / /

% of Account Balance Contingent Beneficiary Name(Name of Individual, Trust, Charity, etc.)





Pg 29 of 40

332968-01



DOC ID: 395753937)(

Page 2 of 5

B Beneficiary Designation (Attach an additional sheet to name additional beneficiaries.)

Contingent Beneficiary Designation (Contingent beneficiary designations must total 100% - percentage can be made out to two decimal places.)

% / /






% / /







Participant Consent for Beneficiary Designation (Please sign on the 'Participant Signature' line below.)

I have completed, understand and agree to all pages of this Beneficiary Designation form. Subject to and in accordance with the terms of thePlan, I am making the above beneficiary designations for my vested account in the event of my death. If I have more than one primary beneficiary,the account will be divided as specified. If a primary beneficiary predeceases me, his or her benefit will be allocated to the surviving primarybeneficiaries. Contingent beneficiaries will receive a benefit only if there is no surviving primary beneficiary, as specified. If a contingent beneficiarypredeceases me, his or her benefit will be allocated to the surviving contingent beneficiaries. If I fail to designate beneficiaries, amounts will be paidpursuant to the terms of the Plan or applicable law. This designation is effective upon execution and delivery to Service Provider. If any informationis missing, additional information may be required prior to recording my designation.

This designation supersedes all prior designations. Beneficiaries will share equally if percentages are not provided and any amounts unpaid upondeath will be divided equally. Primary and contingent beneficiaries must separately total 100%. The percentages can be divided up to twodecimal points (Example: 33.33%).

I understand that Service Provider is required to comply with the regulations and requirements of the Office of Foreign Assets Control, Departmentof the Treasury ("OFAC"). As a result, Service Provider cannot conduct business with persons in a blocked country or any person designated byOFAC as a specially designated national or blocked person. For more information, please access the OFAC website at: http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Important Notice: In accordance with ERISA and/or Plan Document, if I am married and I elect a primary beneficiary other than my spouse or inaddition to my spouse, my spouse must consent by signing the Spousal Consent for Beneficiary Designation section of this form.

Any person who presents a false or fraudulent claim is subject to criminal and civil penalties.

Participant Signature Date (Required)

A handwritten signature is required on this form. An electronic signature will not be accepted and will result in a significant delay.

Pg 30 of 40

332968-01



DOC ID: 395753937)(

Page 3 of 5


Spousal Consent for Beneficiary Designation (If applicable, please have the Spouse sign on the 'Spouse's Signature' line below.)

I, (name of spouse) _______________________________, the current spouse of the participant, hereby voluntarily consent to the participant'sprimary beneficiary designation above and understand its effect. I understand that my spouse's beneficiary designation means that I will not receive100% of his or her vested account balance under the Plan and that my spouse's election is not valid unless I consent to it. I understand that myconsent is irrevocable unless my spouse changes the beneficiary designation, or designates me to receive 100% of his or her vested accountbalance.

Spouse's Signature Date (Required)

For Residents of all states (except California), please have your notary complete the section below.

Notice to California Notaries using the California Affidavit and Jurat Form the following items must be completed by the notary on the statenotary form: the title of the form, the plan name, the plan number, the document date, my name and my spouse�s name. The notary forms notcontaining this information will be rejected and it will delay this request.

My signature must be notarized by a Notary Public. The date I sign this form in the �My Consent� section must match the date on which my signatureis notarized in this section.

Statement of Notary NOTE: Notary seal must be visible.

State of )

)ss.

County of )

The consent to this request was subscribed and sworn (or affirmed)

to before me on this day of , year , by

(name of spouse)

proved to me on the basis of satisfactory evidence to be the personwho appeared before me, who affirmed that such consent representshis/her free and voluntary act.

SEAL

Notary Public My commission expires / /

Authorized Plan Administrator Signature (Please sign on the 'Authorized Plan Administrator Signature' line below.)

I accept the information provided by the participant on this form.

AuthorizedPlan Administrator Signature Date (Required)

Print Full Name

D Mailing Instructions

After all signatures have been obtained, this form can be sent by

Fax to:Empower Retirement1-866-633-5212

OR Regular Mail to:Empower RetirementPO Box 173764Denver, CO 80217-3764

OR Express Mail to:Empower Retirement8515 E. Orchard RoadGreenwood Village, CO 80111



Pg 31 of 40


DOC ID: 395753937)(

Page 4 of 5

This page is for informational purposes only - Do not return with the Beneficiary Designation form

EXAMPLE BENEFICIARY DESIGNATIONS

Example 1: Multiple Individuals as Beneficiaries

Beneficiary Designation (Attach an additional sheet to name additional beneficiaries.)B




33.33 % John M. Doe Brother XXX-XX-XXXX 01/06/1954% of Account Balance Primary Beneficiary

(Name of Individual, Trust, Charity, etc.)



111 Elm Street Anytown MO 60000Street Address City State Zip Code

(XXX) XXX-XXXXPhone Number (Optional)

33.33 % Don M. Doe Brother XXX-XX-XXXX 01/06/1954% of Account Balance Primary Beneficiary




222 North Avenue Anytown CA 90000Street Address City State Zip Code


33.34 % Michelle L. Doe Sister XXX-XX-XXXX 01/06/1957% of Account Balance Primary Beneficiary




333 West Blvd Anytown CO 80000Street Address City State Zip Code


Example 2: Trust as Beneficiary





100 % Trust of Jane Doe Trust XX-XXXXXXX 06/30/2015% of Account Balance Primary Beneficiary




150 Main Street Anytown MO 60000Street Address City State Zip Code

(XXX) XXX-XXXX


Example 3: Estate as Beneficiary





100 % Estate of Anne Doe Estate / /% of Account Balance Primary Beneficiary




45 East Road Anytown MO 60000Street Address City State Zip Code


Pg 32 of 40


DOC ID: 395753937)(

Page 5 of 5

Example 4: Charity as Beneficiary





100 % ABC Charity Charity XX-XXXXXXX / /% of Account Balance Primary Beneficiary




75 South Place Anytown CO 80000Street Address City State Zip Code

(XXX) XXX-XXXX


Pg 33 of 40


C401K FRLCNT ][11/16/16)( 332968-01 CHG NUPARTNO_GRPG 45772/][GP19

DOC ID: 405565973)(

Page 1 of 3

Incoming Direct Rollover401(k) Plan


Participant Information

Last Name First Name MI Social Security Number

Address - Number & Street E-Mail Address

City State Zip Code Mo Day Year Female Male

( ) ( ) Date of Birth Married Unmarried

Home Phone Work Phone

Direct Rollover Information

Current Plan Administrator must authorize by signing in the Required Signatures section.

Previous Plan Administrator must sign this form if Designated Roth Account is being directly rolled over.

I am choosing a:

Direct Rollover, as allowed by your Plan, from a qualified:

401(a) Plan

401(k) Plan

Non-Roth: $ (all contributions and earnings, excluding Roth contributions and earnings)

Roth: $ (employee contributions and earnings)

Governmental 457(b) Plan

403(b) Plan

Non-Roth: $ (all contributions and earnings, excluding Roth contributions and earnings)

Roth: $ (employee contributions and earnings)

Direct Rollover from a Traditional IRA, as allowed by your Plan (Non-deductible contributions/basis may not be rolled over)

Previous Provider Information:

Company Name Account Number

Mailing Address

( )

City/State/Zip Code Phone Number

Previous Plan Administrator must provide the following information for Designated Roth Account Rollovers:

Roth first contribution date:

Roth contributions (no earnings): $ Roth earnings: $

Previous Plan Authorized Plan Administrator/Trustee Signature Date

Amount of Direct Rollover: $ (Enter approximate amount if exact amount is not known.)

Investment Option Information - Please refer to your communication materials for investment option designations.

I understand that funds may impose redemption fees on certain transfers, redemptions or exchanges if assets are held less than the period stated in thefund's prospectus or other disclosure documents. I will refer to the fund's prospectus and/or disclosure documents for more information.

Select either existing ongoing allocations (A) or your own investment options (B).

(A) Existing Ongoing Allocations

I wish to allocate this rollover the same as my existing ongoing allocations.

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(B) Select Your Own Investment Options

Please Note: For automatic dollar-cost averaging, call Client Service Department or access our Web site.

INVESTMENT OPTION

NAME TICKER CODE %JPMorgan SmartRetirement Income A. . . . . . . . . . . JSRAX JSRAX _____

JPMorgan SmartRetirement 2015 A. . . . . . . . . . . . . JSFAX JSFAX _____

JPMorgan SmartRetirement 2020 A. . . . . . . . . . . . . JTTAX JTTAX _____

JPMorgan SmartRetirement 2025 A. . . . . . . . . . . . . JNSAX JNSAX _____

JPMorgan SmartRetirement 2030 A. . . . . . . . . . . . . JSMAX JSMAX _____

JPMorgan SmartRetirement 2035 A. . . . . . . . . . . . . SRJAX SRJAX _____

JPMorgan SmartRetirement 2040 A. . . . . . . . . . . . . SMTAX SMTAX _____

JPMorgan SmartRetirement 2045 A. . . . . . . . . . . . . JSAAX JSAAX _____

JPMorgan SmartRetirement 2050 A. . . . . . . . . . . . . JTSAX JTSAX _____

JPMorgan SmartRetirement 2055 A. . . . . . . . . . . . . JFFAX JFFAX _____

American Funds EuroPacific Gr R4. . . . . . . . . . . . . REREX REREX _____

Dreyfus International Stock Index. . . . . . . . . . . . . . . DIISX DIISX _____

Hartford World Bond R4. . . . . . . . . . . . . . . . . . . . . . . . HWDSX HWDSX _____

Prudential Global Real Estate Z. . . . . . . . . . . . . . . . . PURZX PURZX _____

Wells Fargo Emerg Mkts Eq Adm. . . . . . . . . . . . . . . EMGYX EMGYX _____

INVESTMENT OPTION

NAME TICKER CODE %JHancock Alternative Asset Allc I. . . . . . . . . . . . . . . JAAIX JAAIX _____

Diamond Hill Small Cap I. . . . . . . . . . . . . . . . . . . . . . . DHSIX DHSIX _____

Dreyfus Small Cap Stock Index Fund. . . . . . . . . . . DISSX DISSX _____

Lord Abbett Developing Growth A. . . . . . . . . . . . . . LAGWX LAGWX _____

Dreyfus Mid Cap Index Fund. . . . . . . . . . . . . . . . . . . . PESPX PESPX _____

MFS Mid Cap Value R3. . . . . . . . . . . . . . . . . . . . . . . . . MVCHX MVCHX _____

Prudential Jennison Mid Cap Growth A. . . . . . . . . PEEAX PEEAX _____

Dreyfus S&P 500 Index. . . . . . . . . . . . . . . . . . . . . . . . . . PEOPX PEOPX _____

JPMorgan US Equity A. . . . . . . . . . . . . . . . . . . . . . . . . . JUEAX JUEAX _____

MFS Value R3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MEIHX MEIHX _____

T. Rowe Price New America Growth. . . . . . . . . . . . PRWAX PRWAX _____

Baird Core Plus Bond Inst. . . . . . . . . . . . . . . . . . . . . . . BCOIX BCOIX _____

Key Guaranteed Portfolio Fund. . . . . . . . . . . . . . . . . . N/A KGPF _____

MUST INDICATE WHOLE PERCENTAGES = 100%

Participation Agreement

General Information - I understand that only certain types of distributions are eligible for rollover treatment and that it is solely my responsibilityto ensure such eligibility. By signing below, I affirm that the funds I am rolling are in fact eligible for such treatment. I authorize these funds to betransferred into my employer's Plan and to be invested according to the information specified in the Investment Option Information section. I understandand agree that this account is subject to the terms of the Plan Document.

If the investment option information is missing or incomplete, I authorize Service Provider to allocate the direct rollover assets ("assets") the same asmy ongoing contributions (if I have an account established) or to the default investment option selected by my Plan (if I do not have an investmentelection on file). If no default investment option is selected by my Plan, the funds will be returned to the payor as required by law. If additional assetsfrom the same provider are received more than 180 calendar days after Service Provider receives this Incoming Direct Rollover form (this "form"),I authorize Service Provider to allocate all monies received the same as my ongoing allocation election on file with Service Provider. I understand Imust call the Voice Response System at 1-800-338-4015 or access Web site at www.empower-retirement.com/participant in order to make changesor transfer monies from the default investment option. If my initial rollover assets are received more than 1 year after Service Provider receives andapproves this Incoming Direct Rollover form, I understand Service Provider will require the submission of a new form for approval. I understand thatthis completed form must be received by Service Provider at the address provided on this form.

I understand that the current Custodian/Provider may require that I furnish additional information before processing the transaction requested on thisform, and Service Provider is not responsible for determining the status of any transaction that I have requested. It is entirely my responsibility toprovide the current Custodian/Provider with any information that they may require, and/or to notify Service Provider of any information that the currentCustodian/Provider may wish to obtain in order to effect the transaction.

Withdrawal Restrictions - I understand that the Internal Revenue Code and/or my employer's Plan Document may impose restrictions on directrollovers and/or distributions. I understand that I must contact the Plan Administrator/Trustee, if applicable, to determine when and/or under whatcircumstances I am eligible to receive distributions or make direct rollovers.

Investment Options - I understand and acknowledge that all payments and account values, when based on the experience of the investment options, maynot be guaranteed and may fluctuate, and, upon redemption, shares may be worth more or less than their original cost. I acknowledge that investmentoption information, including prospectuses, disclosure documents and Fund Profile sheets, have been made available to me and I understand the risksof investing.

Account Corrections - I understand that it is my obligation to review all confirmations and quarterly statements for discrepancies or errors. Correctionswill be made only for errors which I communicate within 90 calendar days of the last calendar quarter. After this 90 days, account information shallbe deemed accurate and acceptable to me. If I notify Service Provider of an error after this 90 days the correction will only be processed from the dateof notification forward and not on a retroactive basis.

Outstanding Loan Balance - An outstanding loan balance cannot be included in the direct rollover. However, you may pay off the outstanding loanbalance before this direct rollover is submitted. After the loan is paid off, you may submit this direct rollover request. If you do not pay off the outstandingloan balance, you may direct rollover only the cash value (not including the loan) from the contract that has the outstanding loan.

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Payment Instructions

Make check payable to:Great-West Trust Company, LLC

Include the following information on the check:Participant Name, Social Security Number,Plan Number, Plan Name

Regular mail address for thecheck and form (if mailed together):Great-West Trust Company, LLCPO Box 561148Denver, CO 80256-1148

Wire instructions:Account of: Great-West Trust Company, LLCBank: US BankAccount no: 103656586049Routing transit no: 102000021Attention: Financial ControlReference: Participant Name, Social Security Number,Plan Number, Plan Name

Overnight mail address for thecheck and form (if mailed together):US Bank10035 East 40th Avenue Suite 100Dept 1148Denver, CO 80238Contact: Empower RetirementPhone#: 1-800-338-4015

If sending the "form" only, please fax to 1-866-633-5212 or follow mailing instructions above. Funds received will not be invested unlessaccompanied by a completed Incoming Direct Rollover form. Funds will be invested on the day that both a completed Incoming Direct Rolloverform and funds are received prior to market close.

Required Signatures - My signature indicates that I have read, understand the effect of my election and agree to all pages of this Incoming DirectRollover form. I affirm that all information provided is true and correct. I understand that Service Provider is required to comply with the regulationsand requirements of the Office of Foreign Assets Control, Department of the Treasury ("OFAC"). As a result, Service Provider cannot conduct businesswith persons in a blocked country or any person designated by OFAC as a specially designated national or blocked person. For more information,please access the OFAC Web site at:http://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Participant Signature Date

A handwritten signature is required on this form. An electronic signature will notbe accepted and will result in a significant delay.

Participant forward to Plan Administrator/TrusteePlan Administrator forward or fax as shown above in thePayment Instructions section

I acknowledge and agree that the Plan Administrator/Trustee for the PreviousEmployer's plan is released from and the Plan Administrator/Trustee for the CurrentEmployer's Plan shall assume all obligations associated with any amounts transferredunder this Incoming Direct Rollover form.

Authorized Plan Administrator/Trustee Signature DateFor Current Employer's Plan

Print Full Name



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