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Empower RetirementClarity in a Complex World:
Plan Fee Disclosure for Plan Fiduciaries
Fee Disclosure
Swim Atlanta 401(k) Plan331538-01As of November 30, 2015
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IntroductionThis report is designed to help you better understand the costs to you and the employees covered by yourRetirement Plan. In order to achieve this goal, we have summarized the most relevant cost components ina straightforward presentation and provided an explanation of the services provided for those costs, withsupporting details to explain how costs were derived.
Great-West Financial ("Great-West") retained the communications expert DALBAR, INC. to work with us toproduce the most effective communication for you. DALBAR, INC. is the nation's leading financial services marketresearch firm and performs a variety of ratings and evaluations of practices and communications that arecommitted to raising the standards of excellence in the financial services and healthcare industries.
Regulatory Requirements
In response to the need for improved clarity about fees and expenses, the United States Department of Labor(“DOL”) has introduced a requirement (See DOL 408(b)(2) fee disclosure requirements; www.dol.gov/ebsa/newsroom/fsmain.html) for certain service providers that receive more than $1,000 in compensation to makeexplicit disclosures to ERISA retirement plans that they serve.
The DOL requires that the disclosure contain four essential elements:4 Who the service provider is4 A description of the services provided4 A declaration of the fiduciary status of the provider4 The fee or expense charged by the provider
What This Report Contains
As you read through this document, it will progress from a high-level summary of fees and get increasinglymore detailed throughout each subsequent section, ultimately getting down to an itemized level. Theinformation shown is in dollar figure estimates, and to simplify the readability, superscript letters identify dollarfigures that carry over from one section and appear in another section as a line item.
As a general contractor, we make payments to other parties on behalf of your Plan. We are not responsible forthe disclosures of any unrelated service providers.
The services reflected may not be applicable to all plans but are representative of available services.
Report Sections
A. Summary of Fee and Expense Estimates
B. Explanation of Services
C. Estimated Cash Flow Summary
D. Disclosures
E. Itemized Services and Costs
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A. Summary of Fee and Expense EstimatesEstimates presented are based on information as of November 30, 2015 on the following:
Total Assets $5,416,608Unallocated Plan Assets $1,659Participant Assets $5,372,496Loan Balances $42,453
Number of Participants 87
As the fees and expenses contained in this disclosure are estimates based on the above information at a pointin time, they will not necessarily match the actual amounts paid or the amounts contained in any financialreport, such as an Annual Plan Summary.
Total Assets are the sum of Unallocated Assets, Participant Assets and Loan Balances. Plan UnallocatedAssets consist of plan assets that are not allocated to plan participants. This might include unclaimedparticipant balances, amounts received but not yet allocated to participants, forfeitures, and amounts set asidefor plan expenses. Participant Assets are amounts held in participants’ accounts. Loan Balances equalthe outstanding loan amounts for participants. Number of Participants includes participants with an accountbalance as of the month-end.
In this document, estimates provided may not match amounts billed to the Plan Sponsor or debited fromparticipant accounts and may not match financial reports. These annual estimates are generally based onmonth-end projections that are annualized over a 12-month period and rounded to the nearest dollar.
CATEGORY OF SERVICEANNUAL
ESTIMATE
ESTIMATEDAVERAGE COST
PER PARTICIPANT
ESTIMATEDPERCENTAGE OFTOTAL ASSETS
Payments to Investment Providers (IP) (Q)$21,607 $248 0.40%
Payments to Recordkeeper (RK) (X)$11,556 $133 0.21%
Payments to Others (Z)$25,686 $295 0.47%
Total Estimate (K)$58,849 $676 1.08%
Superscript letters in parentheses (x) denote the flow of fee totals throughout this document.Great-West Financial and its affiliates do not provide fiduciary services, except in the case(s) where the fiduciary status isspecifically and affirmatively disclosed below.
If Advised Assets Group, LLC provides services to the Plan under an agreement with Plan Sponsor, it may be a fiduciary andRegistered Investment Advisor to the Plan to the extent provided in such agreement.
If Great-West Trust Company, LLC provides trustee services to the Plan under a Trust Agreement with Plan Sponsor, it is a fiduciaryto the Plan with respect to such services.
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B. Explanation of ServicesThe services reflected may not be applicable to all plans, but are representative of available services.
SERVICECODE
Investment Providers (IP)
1.1 Investment Management Services: Includes all Plan investments selected by Plan Sponsor for which theRecordkeeper provides recordkeeping services.
SERVICECODE
Recordkeeper (RK)
2.1 Plan Services: Performing the duties necessary for the plan to comply with legal, regulatory and the plan'sown requirements. Some of these duties include plan document service, compliance service and distributiontax reporting. Plan services would also include plan communication, education, enrollment, website andvoice response system.
2.2 Participant Services: Creating and maintaining records of all participant and beneficiary accounts and thetransactions and changes affecting them. This may include participant loan initiation, loan maintenance, fundtransfers, distributions or hardship withdrawals. Participant services would include communications to theparticipant - quarterly statements and newsletters.
2.3 Additional Services: These plan level transactional services are available to the Plan Sponsor and can berequested in writing to the Recordkeeper.
SERVICECODE
Others
3.1 Financial Professional Services: A Financial professional provides services for participants on variousfinancial issues.
3.2 Trustee and Custodial Services: Services include the holding of plan assets pursuant to a trust or custodialagreement.
3.3 Participant Advice: Investment advice to help manage investments or management of the investments forparticipant or beneficiary.
For a listing of your Plan services please refer to your Service Agreement and/or Schedule of Services.
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C. Estimated Cash Flow SummaryThis section lists each investment manager and service provider that collects fees directly or indirectly fromyour Retirement Plan, from Participants or from the employer, and all remittances paid out on behalf of yourPlan.
Payments to Investment Providers (IP)
SERVICECODE
INVESTMENT PROVIDERESTIMATED
GROSS PAYMENTSTO IP
ESTIMATED PAYMENTSFROM IP
ESTIMATEDNET PAYMENTS
TO IP1.1 American Century Investments $0 ($0) $0
American Funds $17,932 ($11,350) $6,582
Artisan $3,125 ($919) $2,206
BlackRock $3,015 ($1,565) $1,450
Dodge & Cox $1,142 ($220) $922
Federated $148 ($74) $74
Fidelity Investments $210 ($114) $96
Franklin Templeton Investments $359 ($142) $217
Great-West Funds $425 ($183) $242
Great-West General Account $1,333 ($952) $381
JPMorgan $4,082 ($1,945) $2,137
Lazard $1,185 ($302) $883
Metropolitan West Funds $663 ($414) $249
Neuberger Berman $3,502 ($1,534) $1,968
Prudential Investments $1,951 ($930) $1,021
Thornburg $1,192 ($575) $617
Vanguard $2,562 ($0) $2,562
Total Estimate $42,826 (V)($21,219) (Q)$21,607
Payments to Recordkeeper (RK)ESTIMATED DIRECTPAYMENTS TO RK
ESTIMATED PAYMENTSFROM IP TO RK
ESTIMATEDPAYMENTS TO RKSERVICE
CODESERVICE PROVIDED
[A] [B] [A + B =C]
2.1 Plan Services (Y)$13,977 (V)$21,219 $35,196
2.2 Participant Services (W)$2,046 $2,046
2.3 Additional Services $0 $0
Payments to Others (Z)($25,686)Total Estimate (X)$11,556
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Payments to OthersSERVICE
CODESERVICE PROVIDED ESTIMATED NET PAYMENTS TO OTHERS
3.1 Financial Professional Services $24,603
3.2 Trustee and Custodial Services $750
3.3 Participant Advice $333
Total Estimate (Z)$25,686
Note: This section may include amounts that are not paid to or by the Recordkeeper, but paid toanother party through the recordkeeping system.
Total Annual Net Cost Estimate (K)$58,849
Superscript letters in parentheses (x) denote the flow of fee totals throughout this document.
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D. DisclosuresThis document contains estimates of plan expenses and is intended to provide a detailed summary offees being charged to the plan or its participants to the extent such information is in the Recordkeeper’spossession. While it is intended to provide information regarding all material fees, this document may not becomprehensive, and it may not include full information on fees associated with some specially negotiatedservices or with certain investment options, such as Self-Directed Brokerage Accounts, Life Insurance,Employer Stock, etc. For further fee information, please refer to the relevant service agreements and/orprospectuses, including information that may be needed to comply with Participant Disclosure obligations.As your Recordkeeper, we make no representation as to the completeness or accuracy of materials, such asprospectuses, created and/or provided by a third-party investment provider.
Gain/Loss Disclosure:If the Recordkeeper makes an error that results in an investment transaction gain or loss, and it is broughtto the Recordkeeper’s attention within ninety (90) days after the Participant statement date following theoccurrence of the error, the Recordkeeper will retroactively correct the error by putting the Participant backin the financial position where the Participant would have been had the error not occurred. However, if thePlan or affected Participant knew or should have known of the error but failed to bring it to the Recordkeeper’sattention within ninety (90) days after the statement date following the occurrence of the error, the error will becorrected prospectively. If a correction is made at the Recordkeeper’s expense and results in a net loss, theRecordkeeper will bear the loss. However, if the correction results in an unintended net gain, the Recordkeeperwill retain the gain as compensation for services provided to the plan and to defray reasonable expenses of theplan including offsetting net losses as described above.
Under special circumstances, the Recordkeeper may consider an exception to the above and make acorrection at the Recordkeeper’s expense. If Plan Sponsor requests such an exception based on thecircumstances identified, a correction will not be unreasonably denied, based on industry standards.
In no event will the Recordkeeper be responsible for the expense of retroactive correction caused by anerror or miscommunication committed by a Participant, Plan Sponsor, or other third party. In such case, PlanSponsor will instruct the Recordkeeper how it wishes any resulting gain to be allocated or loss to be funded.
Bank Credit Disclosure:If the Plan’s assets pass through a bank account held by Great-West Financial ("Great-West") or its affiliates/subsidiaries (Great-West Trust Company LLC and EMJAY Corporation), it may earn credits and/or intereston Plan assets awaiting investment or pending distribution. Any credits or interest earned by Great-Westare aggregated with credits and/or interest earned by Great-West affiliates/subsidiaries and will be used todefray the aggregate expenses for the maintenance of bank accounts. Great-West will not retain credits and/orinterest earned in excess of such maintenance expenses.
Credits and/or interest are earned from the use of (i) uninvested contributions received too late in the day ornot received in good order to be invested same-day and (ii) proceeds from investment option redemptionswhere Plan distribution checks have not been presented for payment by Plan participants. Credits and/orinterest (i) begin to accrue on contributions, on the date such amounts are deposited into the bank accountand end on the date such amounts are invested pursuant to Plan participant or Plan representative instructionsand (ii) begin to accrue on distributions, on the date the check is written or on the wire date, as applicable andend on the date the check is presented for payment or when the wire clears again the account, as applicable. Earnings of credits and/or interest are at the rate the bank provides from time to time.
Investments
Mutual Fund Expense Ratio & Collective Investment Trust (CIT) Expense:
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The Service Provider has entered into agreements with certain mutual funds/CITs (or their service providers,including advisors, administrators or transfer agents, and underwriters) whereby the Service Provider providesshareholder and/or distribution services and receives compensation from the mutual fund/CIT (or their serviceproviders) based on the value of the plan's investment in the fund/CIT. This compensation may include fees foradministrative and other expenses and/or fees paid under a plan of distribution under SEC Rule 12b-1 ("12b-1fees"). The fees received by the Service Provider are included in the expense ratio described in the applicablefund’s prospectus or similar disclosure document, and reduce the investment option’s net asset value (NAV). Generally, fees and expenses included in the expense ratio are deducted at regular intervals based on apercentage of the investment option’s average daily net assets. For CITs, an investment company may includeother fees that are not disclosed in this fee disclosure document but are provided in a separate disclosureunder separate cover.
Redemption Fees:Redemption fees are charged by mutual fund companies to discourage investors from making a short-term“round trip” (i.e. a purchase, typically a transfer, followed by a sale within a short period of time). Most mutualfund companies that charge redemption fees will impose the fee upon the purchase and subsequent saleoccurring within a specified time frame. Please refer to your mutual fund prospectuses for specific redemptionfee details.
Additional Fund Compensation:The Service Provider may receive additional revenue as a finder’s fee from non-affiliated fund companies asshown in the prospectus and other regulatory documents for each of the funds held by the plan. The ServiceProvider may also receive additional revenue in the form of conference sponsorship fees from non-affiliatedfund companies to defray training and educational costs of staff.
Millennium Trust Company (MTC) Automatic Rollover Program:If the plan participates in Millennium Trust Company’s (MTC) automatic rollover program, Great-West mayreceive payments of up to $10 per rollover account under a separate agreement for the performance ofservices by Employer Retirement for MTC. Any such payments are not fees for distribution services to the planunder the plan’s administrative services agreement with Great-West.
General Account Fund and Guarantee Provisions:General Account crediting rates are net of cost of capital and expenses covered by the fund and guaranteeprovisions.
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 canmeet all of its obligations associated with the General Account Fund. The amount of Great-West's capital andrequired return will fluctuate over time based on regulatory requirements, capital market conditions and thecompetitive environment.
The Fund Provision covers the range of investment expenses that are netted from the crediting rate, suchas investment and operating expenses. The Fund Provision is calculated annually in aggregate for allGeneral Account fixed funds offered by Great-West Retirement Services and does not reflect any product orplan specific underwriting adjustments. At 12/31/2014, the General Account Fund Provision is 0.35%. Thisincludes an average annual notional allocation of 0.25% from Great-West's General Account to Great-West'srecordkeeping functions. This allocation is not applicable if Great-West is not acting as both the investmentprovider and recordkeeper.
The Guarantee Provision covers the range of insurance expenses that are netted from the crediting rate, suchas asset defaults, cost of insurance guarantees, and other expenses. The Guarantee Provision is calculatedannually in aggregate for all General Account fixed funds offered by Great-West Retirement Services anddoes not reflect any product or plan specific underwriting adjustments. At 12/31/2014, the General Account
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Guarantee Provision is 0.54%. This expense changes over time as the value of insurance guarantees fluctuatedue to both market and policyholder behaviors. They also vary based on the risk management techniquesemployed by the insurance provider. Because of the variances in the cost of the expenses, the level of theinsurance guarantees as well as differences in risk management practices, this paragraph is the only section inwhich these expenses are disclosed.
For more information on the General Account Fixed Funds, including termination options, please see yourGroup Annuity Contract.
5500 Schedule C
As applicable, the disclosures herein are intended to satisfy the eligible indirect compensation (“EIC”)requirements for Form 5500 Schedule C purposes.
Direct Compensation:As your Recordkeeper, Great-West Financial tracks and reports all direct fee compensation (such as thestandard fees and non-standard fees that are paid from plan assets during the plan year) as part of theplan-level reporting in your Annual Plan Summary. A detailed list of direct fees are provided in the Fee andWithdrawal report as well as summarized in the supplemental report section containing the Information forCompleting Form 5500 Schedule C.
Indirect Compensation:The listed expenses and costs are the types of eligible indirect compensation that may have been receivedeither by (i) the Recordkeeper for their services or (ii) mutual fund companies whose funds are investmentoptions in your Plan. The disclosures herein are intended to satisfy the EIC requirements for Form 5500Schedule C purposes, as applicable.
Other Investment-Related Fees:The investment funds offered by your Plan may have fees that are retained by the fund company or otherinvestment provider as payment for ongoing management of the fund and other services. The fee amounts willvary from fund to fund and are generally charged as a percentage of the fund’s value.
Please refer to the latest investment materials such as prospectuses and other regulatory disclosures foreach of the funds held by your Plan (as provided by your Plan’s investment advisor or directly from the fundcompanies or investment firms) for details regarding services and fees.
The latest prospectus and other regulatory documents for each of the funds held by the plan can be foundwithin the Investment section of the Plan Service Center.
This list of investment fees is intended to give the plan a list of the most important fees being charged tothe plan or its participants. It is intended to provide information regarding all material fees, but may not becomprehensive and may not include information on fees such as Self Directed Brokerage Accounts, LifeInsurance, Employer Stock, etc. For other fee information, please refer to all other plan documents includingservice agreement and/or prospectus, including information that may be needed to comply with ParticipantDisclosure obligations. As your Recordkeeper, we make no representation as to the completeness or accuracyof materials, such as prospectuses, created and/or provided by a third-party investment provider.
Affiliates and Subcontractors
We are required to disclose certain fees paid between Great-West Financial ("Great-West") and its relatedparties (affiliates/subsidiaries and subcontractors). This includes compensation paid in connection with theservices Great-West or its affiliates/subsidiaries have agreed to provide to the plan, if the compensation is set
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on a transaction/incentive basis (such as commissions, soft dollars, or finder’s fees) or if the compensation ischarged directly against a plan investment and reflected in the investment’s net value.
The fees disclosed are not in addition to previously disclosed fees; rather, this information is intended toincrease transparency about how Great-West Financial uses the fees it receives.
Affiliates:The following entities are affiliates of the Recordkeeper, in that they directly or indirectly control, are controlledby, or are under common control with the Recordkeeper. These affiliates may receive fees from the plan, orfrom the Recordkeeper or another affiliate for performing certain services for the plan.
Refer to the Itemized Services and Cost section for details regarding affiliate payments.
GWFS Equities, Inc. is an affiliate that receives payments from the Investment Provider. Payments are firstpaid to GWFS Equities, Inc. which in turn pays the Recordkeeper.
Great-West Capital Management, LLC is an affiliate that receives payments from the Investment Provider.
Great-West Funds, Inc. is an affiliate that receives payments from the Investment Provider.
Affiliates: The following are affiliates or subsidiaries of Great-West Retirement Services ("GWRS"), but not allGWRS affiliates or subsidiaries may pertain to your Plan.
n Advised Assets Group, LLCn GWFS Equities, Inc.n EMJAY Corporationn FASCore, LLCn Great-West Capital Management, LLCn Great-West Funds, Inc.n Putnam Investment Companyn Great-West Trust Company, LLCn Great-West Life & Annuity Insurance Company of New York
Subcontractors:A subcontractor is any person or entity that is not an affiliate of the Recordkeeper and that is expected toreceive $1,000 or more in compensation for performing one or more services for your Plan under a contract orarrangement with the Recordkeeper. All such subcontractors, if any, are listed in the table below, along with theservice they provide and the fee they receive.
Please refer to the Itemized Services and Costs section for details regarding subcontractor payments.
COMPANY SUBCONTRACTOR PROVIDED SERVICE
None
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E. Itemized Services and CostsThis section details how each service expense is calculated. Totals here are presented in the Summary of Feeand Expense Estimates section. Estimates presented are based on expenditures and activity in the 12 monthperiod ending November 30, 2015 and on the following:
Total Assets $5,416,608
Unallocated Plan Assets $1,659Participant Assets $5,372,496Loan Balances $42,453
Number of Participants 87
The annual estimates displayed in this document will not match actual financial reports such as the AnnualPlan Summary.
Payments to Investment Providers (IP)SERVICE CODE 1.1
ESTIMATEDGROSS
PAYMENTSTO IP
ESTIMATEDPAYMENTS
FROM IP
ESTIMATEDNET
PAYMENTSINVESTMENT
BASIS FORESTIMATE
GROSS/NET
EXPENSERATIO [estimate X net
expense ratio]
12B-1 ADMIN[(12b1 X
estimate)+(Admin Xestimate)]
[gross pmts-pmts from IP]
American Century InvestmentsAmerican Century OneChoice In Ret Inv
$0 Assets infund
0.79%/0.79%
$0 ($0) $0
Total for AmericanCentury Investments
$0 $0 ($0) $0
American FundsAmerican FundsAmerican Balanced R3
$119,580Assets in fund
0.94%/0.94%
$1,124 0.50% 0.15% ($777) $347
American Funds CapitalWorld G/I R3
$270,212Assets in fund
1.09%/1.09%
$2,945 0.50% 0.15% ($1,756) $1,189
American FundsEuroPacific Gr R3
$157,181Assets in fund
1.14%/1.14%
$1,792 0.50% 0.15% ($1,022) $770
American Funds GrowthFund of Amer R3
$1,110,763Assets in fund
0.98%/0.98%
$10,885 0.50% 0.15% ($7,220) $3,665
American Funds NewWorld Fund - R3
$88,490 Assetsin fund
1.34%/1.34%
$1,186 0.50% 0.15% ($575) $611
Total for AmericanFunds
$1,746,226 $17,932 ($11,350) $6,582
ArtisanArtisan Mid Cap ValueInvestor
$262,570Assets in fund
1.19%/1.19%
$3,125 0.35% ($919) $2,206
Total for Artisan $262,570 $3,125 ($919) $2,206BlackRock
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ESTIMATEDGROSS
PAYMENTSTO IP
ESTIMATEDPAYMENTS
FROM IP
ESTIMATEDNET
PAYMENTSINVESTMENT
BASIS FORESTIMATE
GROSS/NET
EXPENSERATIO [estimate X net
expense ratio]
12B-1 ADMIN[(12b1 X
estimate)+(Admin Xestimate)]
[gross pmts-pmts from IP]
BlackRock GlobalAllocation Inv A
$16,776 Assetsin fund
1.13%/1.13%
$190 0.25% 0.25% ($84) $106
BlackRock High YieldBond R
$227,851Assets in fund
1.27%/1.24%
$2,825 0.50% 0.15% ($1,481) $1,344
Total for BlackRock $244,627 $3,015 ($1,565) $1,450Dodge & CoxDodge & Cox Stock $219,596
Assets in fund0.52%/0.52%
$1,142 0.10% ($220) $922
Total for Dodge & Cox $219,596 $1,142 ($220) $922FederatedFederated US Govt Sec:1-3 Years SS
$18,442 Assetsin fund
0.98%/0.80%
$148 0.40% ($74) $74
Total for Federated $18,442 $148 ($74) $74Fidelity InvestmentsFidelity Advisor NewInsights A
$22,856 Assetsin fund
0.92%/0.92%
$210 0.25% 0.25% ($114) $96
Total for FidelityInvestments
$22,856 $210 ($114) $96
Franklin Templeton InvestmentsFranklin Small Cap ValueFund A
$7,381 Assetsin fund
1.14%/1.14%
$84 0.25% 0.25% ($36) $48
Templeton Global BondAdv
$42,285 Assetsin fund
0.66%/0.65%
$275 0.25% ($106) $169
Total for FranklinTempleton Investments
$49,666 $359 ($142) $217
Great-West FundsGreat-West Lifetime 2015Fund II T1
$137 Assets infund
0.99%/0.97%
$1 0.10% 0.35% ($0) $1
Great-West Lifetime 2025Fund II T1
$15,450 Assetsin fund
1.02%/1.01%
$156 0.10% 0.35% ($69) $87
Great-West Lifetime 2035Fund II T1
$1,952 Assetsin fund
1.07%/1.07%
$21 0.10% 0.35% ($9) $12
Great-West Lifetime 2045Fund II T1
$19,086 Assetsin fund
1.07%/1.06%
$202 0.10% 0.35% ($86) $116
Great-West Lifetime 2055Fund II T1
$4,233 Assetsin fund
1.08%/1.07%
$45 0.10% 0.35% ($19) $26
Total for Great-WestFunds
$40,858 $425 ($183) $242
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ESTIMATEDGROSS
PAYMENTSTO IP
ESTIMATEDPAYMENTS
FROM IP
ESTIMATEDNET
PAYMENTSINVESTMENT
BASIS FORESTIMATE
GROSS/NET
EXPENSERATIO [estimate X net
expense ratio]
12B-1 ADMIN[(12b1 X
estimate)+(Admin Xestimate)]
[gross pmts-pmts from IP]
JPMorganJPMorgan Equity IncomeA
$385,407Assets in fund
1.09%/1.04%
$4,008 0.25% 0.25% ($1,928) $2,080
JPMorgan Small CapGrowth Select
$6,890 Assetsin fund
1.27%/1.08%
$74 0.25% ($17) $57
Total for JPMorgan $392,297 $4,082 ($1,945) $2,137LazardLazard Emerging MarketsOpen
$86,478 Assetsin fund
1.37%/1.37%
$1,185 0.25% 0.10% ($302) $883
Total for Lazard $86,478 $1,185 ($302) $883Metropolitan West FundsMetropolitan West TotalRe Bd Admin Cl
$82,897 Assetsin fund
0.80%/0.80%
$663 0.21% 0.29% ($414) $249
Total for MetropolitanWest Funds
$82,897 $663 ($414) $249
Neuberger BermanNeuberger BermanGenesis Adv
$255,605Assets in fund
1.37%/1.37%
$3,502 0.25% 0.35% ($1,534) $1,968
Total for NeubergerBerman
$255,605 $3,502 ($1,534) $1,968
Prudential InvestmentsPrudential Jennison MidCap Growth A
$185,826Assets in fund
1.05%/1.05%
$1,951 0.25% 0.25% ($930) $1,021
Total for PrudentialInvestments
$185,826 $1,951 ($930) $1,021
ThornburgThornburg InternationalValue R3
$82,188 Assetsin fund
1.61%/1.45%
$1,192 0.50% 0.20% ($575) $617
Total for Thornburg $82,188 $1,192 ($575) $617VanguardVanguard 500 IndexInvestor
$791,280Assets in fund
0.17%/0.17%
$1,345 ($0) $1,345
Vanguard FTSE SocialIndex Inv
$4,672 Assetsin fund
0.27%/0.27%
$13 ($0) $13
Vanguard InternationalValue Portfolio
$48,953 Assetsin fund
0.44%/0.44%
$215 ($0) $215
Vanguard Small CapIndex Fund
$239,441Assets in fund
0.23%/0.23%
$551 ($0) $551
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ESTIMATEDGROSS
PAYMENTSTO IP
ESTIMATEDPAYMENTS
FROM IP
ESTIMATEDNET
PAYMENTSINVESTMENT
BASIS FORESTIMATE
GROSS/NET
EXPENSERATIO [estimate X net
expense ratio]
12B-1 ADMIN[(12b1 X
estimate)+(Admin Xestimate)]
[gross pmts-pmts from IP]
Vanguard Total BondMarket Index
$218,917Assets in fund
0.20%/0.20%
$438 ($0) $438
Total for Vanguard $1,303,263 $2,562 ($0) $2,562
Blank fields in the table above can be assumed to be not applicable or zero.
Not all 12b-1 and/or Admin fees may flow through the Recordkeeper. A third party may be receiving the 12b-1and/or Admin fees directly. Due to this, the amount shown in the Estimated Net Payments column may beoverstated.
SERVICE CODE 1.1
ESTIMATEDGROSS
PAYMENTSTO IP
ESTIMATEDPAYMENTS
TO RKESTIMATED
NET EXPENSEINVESTMENTBASIS FORESTIMATE
FEEESTIMATE
[basis X feeestimate]
ALLOCATIONTO RK
[basis Xallocation to RK]
[payments fromIP - allocation to RK]
Great-West General AccountKey Guaranteed PortfolioFund
$380,762 Assetsin fund
0.35% $1,333 0.25% ($952) $381
Total for Great-WestGeneral Account
$380,762 $1,333 ($952) $381
For an explanation of the Fee Estimate and the Allocation to Recordkeeper, please see the "General AccountFund and General Provisions" disclosure in the Disclosure Section of this document.
Total Annual Payment Estimate to Investment Providers (IP) (Q)$21,607
Payments to Recordkeeper (RK)Plan Services Fees
SERVICECODE
FEE TYPE PAID BY ANNUAL FEEBASIS FORESTIMATE
GROSSPAYMENTS
2.1 Asset Based Charge Deducted fromParticipant
0.28% $4,991,734Assets in Plan*
$13,977
Total Annual Payment Estimate for Plan Services (Y)$13,977
Participant Services FeesSERVICE
CODEFEE TYPE PAID BY FEE
GROSSPAYMENTS
2.2 AAG Online Investment Advice Deducted fromParticipant
$25 $0
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SERVICECODE
FEE TYPE PAID BY FEEGROSS
PAYMENTS
AAG Online Managed Accounts Deducted fromParticipant
Up to $100K = 0.650000%Next $150K = 0.550000%Next $150K = 0.450000%Over $400K = 0.350000%
$333
Loan Maintenance Fee Deducted fromParticipant
$50 $563
Periodic Payment MaintenanceFee
Deducted fromParticipant
$25 $0
Benefit Disbursement Fee‡ Netted fromDistribution
$50 Per Distribution** $400
Loan Origination Fee Deducted from Loan $75 Per Loan** $750
Periodic Payment Origination Fee‡ Deducted from InitialPayment
$50 Per PPAY Set Up $0
Total Annual Actual Payments for Participant Services (W)$2,046
Participant Service Fees displayed above are the actual assessed fees to date based on a rolling twelve monthperiod.
Listing of Available Additional Services and FeesSERVICE
CODESERVICE PAID BY FEES
2.3 Qualified Domestic Relations Order ProcessingServices
Billed to Plan Sponsor $75 per request
Representation During IRS/DOL Audit Billed to Plan Sponsor Quoted upon request
Consultation Related to Plan Mergers Billed to Plan Sponsor Quoted upon request
Data Entry Services Billed to Plan Sponsor $75 per hour
Reconciliation of Loan Data Billed to Plan Sponsor $75 per hour
Special Consulting Services Billed to Plan Sponsor $75 per hour
Additional Services Available to Plans Utilizing Empower Retirement Compliance Services2.3 Additional Compliance Testing for 401(a)(4)
Non-discriminationBilled to Plan Sponsor $1,000 per plan year
Additional Compliance Testing for 401(k)/(m) Billed to Plan Sponsor $75 per hour
Additional Compliance Testing for 410(b) Billed to Plan Sponsor $75 per hour
Plan Document Amendments to Change PlanYear
Billed to Plan Sponsor $1,600 Per request
Conversion to Internal Compliance Billed to Plan Sponsor $1,000 Per request
Employer Discretionary Contributions Billed to Plan Sponsor $75 per hour
IRS Filing of Letter of Determination Billed to Plan Sponsor $75 per hour
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SERVICECODE
SERVICE PAID BY FEES
Other Compliance Testing and/or CorrectiveCalculations
Billed to Plan Sponsor $75 per hour
Plan Disaggregation Billed to Plan Sponsor $1,600 per plan year
Creation/Amendment - Prototype PlanDocument
Billed to Plan Sponsor $325 Per request
Plan Termination Services Billed to Plan Sponsor $2,000 Per request
Rights and Features Test Billed to Plan Sponsor $75 per hour
Creation/Amendment - Volume Submitter PlanDocument
Billed to Plan Sponsor $575 Per request
Plan level additional services listed may be requested by the Plan Sponsor in writing. The applicable fee willapply to any services performed based on that request.
Additional ServicesCurrently your plan has no Actual Additional Services payments.
Total Annual Actual Payment for Additional Services $0
Contract Termination Fee:Contract Termination Fees may apply. For more information, refer to your annuity contract and/or fee schedule.
Payments to OthersSERVICE
CODESERVICE
PROVIDERSERVICE
DESCRIPTIONFEES
BASIS FORESTIMATE
GROSSPAYMENTS
Financial Professional Services3.1 TRIAD ADVISORS
INCFinancialProfessional
0.45% $5,467,407Assets as ofCommissionDate
$24,603
Total $24,603Trustee and Custodial Services3.2 Great-West Trust,LLC Trustee Services $750 Flat Fee $750
Total $750Participant Advice3.3 Advised Assets Group,
LLC.Online InvestmentAdvice
$25 Actual Expenses $0
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SERVICECODE
SERVICEPROVIDER
SERVICEDESCRIPTION
FEESBASIS FORESTIMATE
GROSSPAYMENTS
Advised Assets Group,LLC.
Managed Accounts Up to $100K = 0.650000%Next $150K = 0.550000%Next $150K = 0.450000%Over $400K = 0.350000%
Actual Expenses $333
Total $333
Total Annual Payment Estimate for Others (Z)$25,686
Superscript letters in parentheses (x) denote the flow of fee totals throughout this document.* The Basis for Estimate may not be calculated on all plan assets or money types.
** Participant loan set up and distribution fees may not reflect additional fees charged by a third party. Thirdparties should be disclosing the amounts they receive in a separate document.
‡ Distribution Charge for Participants may vary by the reason the distribution is taken and by fund. See yourcontract for details.
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: White Plains, NY; and theirsubsidiaries and affiliates. All trademarks, logos, service marks, and design elements used are owned by their respective owners and are used by permission.