401k Plan data: COMMUNITY CARE AGENCY 401K PLAN AND TRUST plan

COMMUNITY CARE AGENCY 401K PLAN AND TRUST 401k Plan overview

Plan Name	COMMUNITY CARE AGENCY 401K PLAN AND TRUST
Plan identification number	001

COMMUNITY CARE AGENCY 401K PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

COMMUNITY CARE AGENCY LLC has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY CARE AGENCY LLC

Employer identification number (EIN): 202463922

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about COMMUNITY CARE AGENCY LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 1064361

More information about COMMUNITY CARE AGENCY LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY CARE AGENCY 401K PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 HUNG NGUYEN 2024-07-19
001 2022-01-01 HUNG NGUYEN 2023-09-19
001 2021-01-01 HUNG NGUYEN 2022-09-16
001 2020-01-01 HUNG NGUYEN 2021-07-12
001 2019-01-01 HUNG NGUYEN 2020-07-08
001 2018-01-01 HUNG NGUYEN 2019-06-18
001 2017-01-01 HUNG NGUYEN 2018-07-06
001 2016-01-01 HUNG NGUYEN 2017-07-17
001 2015-01-01 HUNG NGUYEN 2016-08-05
001 2014-01-01 HUNG NGUYEN 2015-07-20
001 2013-01-01 HUNG NGUYEN
001 2012-01-01 HUNG NGUYEN
001 2011-01-01 HUNG NGUYEN
001 2010-01-01 HUNG NGUYEN 2011-10-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01	HUNG NGUYEN	2024-07-19
001	2022-01-01	HUNG NGUYEN	2023-09-19
001	2021-01-01	HUNG NGUYEN	2022-09-16
001	2020-01-01	HUNG NGUYEN	2021-07-12
001	2019-01-01	HUNG NGUYEN	2020-07-08
001	2018-01-01	HUNG NGUYEN	2019-06-18
001	2017-01-01	HUNG NGUYEN	2018-07-06
001	2016-01-01	HUNG NGUYEN	2017-07-17
001	2015-01-01	HUNG NGUYEN	2016-08-05
001	2014-01-01	HUNG NGUYEN	2015-07-20
001	2013-01-01	HUNG NGUYEN
001	2012-01-01	HUNG NGUYEN
001	2011-01-01	HUNG NGUYEN
001	2010-01-01	HUNG NGUYEN	2011-10-07

Plan Statistics for COMMUNITY CARE AGENCY 401K PLAN AND TRUST

401k plan membership statisitcs for COMMUNITY CARE AGENCY 401K PLAN AND TRUST

Measure Date Value
2013: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 73
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 13
Total of all active and inactive participants 2013-01-01 86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 86
Number of participants with account balances 2013-01-01 55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 115
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 115
Number of participants with account balances 2012-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 162
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 163
Number of participants with account balances 2011-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2013: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	73
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	13
Total of all active and inactive participants	2013-01-01	86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	86
Number of participants with account balances	2013-01-01	55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	115
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	115
Number of participants with account balances	2012-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	162
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	163
Number of participants with account balances	2011-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on COMMUNITY CARE AGENCY 401K PLAN AND TRUST

Measure	Date	Value
2013 : COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$21,281
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$27,580
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$26,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$13,370
Value of total assets at end of year	2013-12-31	$57,119
Value of total assets at beginning of year	2013-12-31	$63,418
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$966
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,737
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,737
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$7,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$13,370
Administrative expenses (other) incurred	2013-12-31	$966
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-6,299
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$57,119
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$63,418
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$57,119
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$63,418
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$6,174
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$26,614
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	THOMAS M. DITULLIO
Accountancy firm EIN	2013-12-31	222331049
2012 : COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$21,327
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$945
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$895
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$15,464
Value of total assets at end of year	2012-12-31	$63,418
Value of total assets at beginning of year	2012-12-31	$43,036
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$50
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$2,084
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$2,084
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$15,464
Administrative expenses (other) incurred	2012-12-31	$50
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$20,382
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$63,418
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$43,036
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$63,418
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$43,036
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$3,779
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$895
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	THOMAS M. DITULLIO
Accountancy firm EIN	2012-12-31	222331049
2011 : COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$22,111
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$21,945
Value of total assets at end of year	2011-12-31	$43,036
Value of total assets at beginning of year	2011-12-31	$20,925
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$841
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$841
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$3,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$21,945
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$22,111
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$43,036
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$20,925
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$43,036
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$20,925
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	RICHARD D SANTORO
Accountancy firm EIN	2011-12-31	222305609
2010 : COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$21,269
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$294
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$19,911
Value of total assets at end of year	2010-12-31	$20,925
Value of total assets at beginning of year	2010-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$50
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$556
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$556
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$19,911
Administrative expenses (other) incurred	2010-12-31	$50
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$20,925
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$20,925
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$20,925
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$802
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$294
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	RICHARD D SANTORO
Accountancy firm EIN	2010-12-31	222305609

Form 5500 Responses for COMMUNITY CARE AGENCY 401K PLAN AND TRUST

2013: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COMMUNITY CARE AGENCY 401K PLAN AND TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	COMMUNITY CARE AGENCY LLC
Employer identification number (EIN):	202463922
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	1064361