401k Plan data: ELITE HOME HEALTH SERVICES 401(K) PLAN plan

ELITE HOME HEALTH SERVICES 401(K) PLAN 401k Plan overview

Plan Name	ELITE HOME HEALTH SERVICES 401(K) PLAN
Plan identification number	001

ELITE HOME HEALTH SERVICES 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

ELITE HOME HEALTH SERVICES, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: ELITE HOME HEALTH SERVICES, L.L.C.

Employer identification number (EIN): 451837464

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELITE HOME HEALTH SERVICES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01 ANGELA OKEKE 2019-07-25 ANGELA OKEKE 2019-07-25
001 2017-01-01 ANGELA OKEKE ANGELA OKEKE 2018-10-01
001 2016-01-01 ANGELA OKEKE ANGELA OKEKE 2017-10-13
001 2015-01-01 BARBARA JACKSON 2016-09-26 BARBARA JACKSON 2016-09-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01	ANGELA OKEKE	2019-07-25	ANGELA OKEKE	2019-07-25
001	2017-01-01	ANGELA OKEKE		ANGELA OKEKE	2018-10-01
001	2016-01-01	ANGELA OKEKE		ANGELA OKEKE	2017-10-13
001	2015-01-01	BARBARA JACKSON	2016-09-26	BARBARA JACKSON	2016-09-26

Plan Statistics for ELITE HOME HEALTH SERVICES 401(K) PLAN

401k plan membership statisitcs for ELITE HOME HEALTH SERVICES 401(K) PLAN

Measure Date Value
2017: ELITE HOME HEALTH SERVICES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 39
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 15
Total of all active and inactive participants 2017-01-01 54
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 54
Number of participants with account balances 2017-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ELITE HOME HEALTH SERVICES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 50
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 58
Total of all active and inactive participants 2016-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 108
Number of participants with account balances 2016-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4

Measure	Date	Value
2017: ELITE HOME HEALTH SERVICES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	39
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	15
Total of all active and inactive participants	2017-01-01	54
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	54
Number of participants with account balances	2017-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ELITE HOME HEALTH SERVICES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	50
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	58
Total of all active and inactive participants	2016-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	108
Number of participants with account balances	2016-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4

Financial Data on ELITE HOME HEALTH SERVICES 401(K) PLAN

Measure	Date	Value
2017 : ELITE HOME HEALTH SERVICES 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$394,610
Total of all expenses incurred	2017-12-31	$475,700
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$457,107
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$111,179
Value of total assets at end of year	2017-12-31	$1,946,298
Value of total assets at beginning of year	2017-12-31	$2,027,388
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$18,593
Total interest from all sources	2017-12-31	$435
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$5,962
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$5,962
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$300,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$104,740
Participant contributions at end of year	2017-12-31	$12,999
Participant contributions at beginning of year	2017-12-31	$11,373
Participant contributions at end of year	2017-12-31	$32,010
Participant contributions at beginning of year	2017-12-31	$24,864
Total non interest bearing cash at end of year	2017-12-31	$13,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-81,090
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,946,298
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,027,388
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$15,093
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,885,825
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,874,835
Interest on participant loans	2017-12-31	$435
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$69,778
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$277,034
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$6,439
Employer contributions (assets) at end of year	2017-12-31	$2,455
Employer contributions (assets) at beginning of year	2017-12-31	$46,538
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$457,107
Contract administrator fees	2017-12-31	$3,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	KIMBERLIN COMPANY, PLLC
Accountancy firm EIN	2017-12-31	455497718
2016 : ELITE HOME HEALTH SERVICES 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$598,616
Total of all expenses incurred	2016-12-31	$648,411
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$644,496
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$342,130
Value of total assets at end of year	2016-12-31	$2,027,388
Value of total assets at beginning of year	2016-12-31	$2,077,183
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,915
Total interest from all sources	2016-12-31	$692
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$74,679
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$74,679
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$220,046
Participant contributions at end of year	2016-12-31	$11,373
Participant contributions at beginning of year	2016-12-31	$26,531
Participant contributions at end of year	2016-12-31	$24,864
Other income not declared elsewhere	2016-12-31	$1,236
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-49,795
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,027,388
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,077,183
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,874,835
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,973,540
Interest on participant loans	2016-12-31	$692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$69,778
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$77,112
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$179,879
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$122,084
Employer contributions (assets) at end of year	2016-12-31	$46,538
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$644,496
Contract administrator fees	2016-12-31	$3,915
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	KIMBERLIN COMPANY, PLLC
Accountancy firm EIN	2016-12-31	455497718

Form 5500 Responses for ELITE HOME HEALTH SERVICES 401(K) PLAN

2017: ELITE HOME HEALTH SERVICES 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ELITE HOME HEALTH SERVICES 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

128700

Policy instance

Insurance contract or identification number	128700
Number of Individuals Covered	33
Insurance policy start date	2017-04-04
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $17,301
Total amount of fees paid to insurance company	USD $5,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,759
Amount paid for insurance broker fees	43
Insurance broker organization code?	3
Insurance broker name	AMERIPRISE FINANCIAL SERVICES, INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831915

Policy instance

Insurance contract or identification number	GA-831915
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-04-30
Total amount of commissions paid to insurance broker	USD $2,925
Total amount of fees paid to insurance company	USD $488
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,925
Insurance broker organization code?	3
Amount paid for insurance broker fees	488
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	SUNWEST PENSIONS

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Company Name:	ELITE HOME HEALTH SERVICES, L.L.C.
Employer identification number (EIN):	451837464
NAIC Classification:	621610
NAIC Description:	Home Health Care Services