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NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NameNORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN
Plan identification number 001

NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN Benefits

401k Plan TypeDefined 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.
  • 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.
  • 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

NORTH SHORE HEALTHCARE LLC has sponsored the creation of one or more 401k plans.

Company Name:NORTH SHORE HEALTHCARE LLC
Employer identification number (EIN):475124382
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01CHRISTINA MATTHEWS2024-10-15
0012022-01-01TROY OESTREICH2023-10-12
0012021-01-01TROY OESTREICH2022-10-07
0012020-01-01HEATHER HACKER2021-10-06
0012019-01-01MADDIE SMITH2020-10-05
0012018-01-01DEANNA DE LA PASQUA2019-10-08
0012017-01-01

Plan Statistics for NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN

Measure Date Value
2023: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-013,061
Total number of active participants reported on line 7a of the Form 55002023-01-013,145
Number of retired or separated participants receiving benefits2023-01-0110
Number of other retired or separated participants entitled to future benefits2023-01-01171
Total of all active and inactive participants2023-01-013,326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-013,326
Number of participants with account balances2023-01-01567
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,904
Total number of active participants reported on line 7a of the Form 55002022-01-012,809
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01175
Total of all active and inactive participants2022-01-012,984
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-012,984
Number of participants with account balances2022-01-01559
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-013,232
Total number of active participants reported on line 7a of the Form 55002021-01-012,718
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01186
Total of all active and inactive participants2021-01-012,904
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-012,904
Number of participants with account balances2021-01-01597
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,658
Total number of active participants reported on line 7a of the Form 55002020-01-013,133
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0199
Total of all active and inactive participants2020-01-013,232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-013,232
Number of participants with account balances2020-01-01563
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,855
Total number of active participants reported on line 7a of the Form 55002019-01-012,475
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01183
Total of all active and inactive participants2019-01-012,658
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-012,658
Number of participants with account balances2019-01-01621
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012,781
Total number of active participants reported on line 7a of the Form 55002018-01-012,714
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01141
Total of all active and inactive participants2018-01-012,855
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-012,855
Number of participants with account balances2018-01-01577
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,261
Total number of active participants reported on line 7a of the Form 55002017-01-012,743
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0138
Total of all active and inactive participants2017-01-012,781
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-012,781
Number of participants with account balances2017-01-01374
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN

Measure Date Value
2023 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$93,447
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$118,593
Total income from all sources (including contributions)2023-12-31$4,469,844
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$2,657,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$2,634,309
Expenses. Certain deemed distributions of participant loans2023-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$2,199,233
Value of total assets at end of year2023-12-31$16,288,574
Value of total assets at beginning of year2023-12-31$14,501,514
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$23,329
Total interest from all sources2023-12-31$7,666
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$2,096,452
Participant contributions at end of year2023-12-31$140,042
Participant contributions at beginning of year2023-12-31$183,435
Participant contributions at end of year2023-12-31$55,537
Participant contributions at beginning of year2023-12-31$27,266
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$102,233
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$93,447
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$118,593
Other income not declared elsewhere2023-12-31$9,915
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$1,812,206
Value of net assets at end of year (total assets less liabilities)2023-12-31$16,195,127
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$14,382,921
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$15,459,281
Value of interest in pooled separate accounts at beginning of year2023-12-31$13,247,115
Interest on participant loans2023-12-31$7,666
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$633,714
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$1,043,698
Net investment gain/loss from pooled separate accounts2023-12-31$2,253,030
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$548
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$2,634,309
Contract administrator fees2023-12-31$23,329
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2023-12-31381357951
2022 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-608,705
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,641,259
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,612,846
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,081,328
Value of total assets at end of year2022-12-31$14,474,248
Value of total assets at beginning of year2022-12-31$16,724,212
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$28,413
Total interest from all sources2022-12-31$18,859
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$28,413
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,051,307
Participant contributions at end of year2022-12-31$183,435
Participant contributions at beginning of year2022-12-31$228,676
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$29,143
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,249,964
Value of net assets at end of year (total assets less liabilities)2022-12-31$14,474,248
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$16,724,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$13,247,115
Value of interest in pooled separate accounts at beginning of year2022-12-31$15,591,586
Interest on participant loans2022-12-31$8,833
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$10,026
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,043,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$903,950
Net investment gain/loss from pooled separate accounts2022-12-31$-2,708,892
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$878
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,612,846
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2022-12-31381357951
2021 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,530,145
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,044,297
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,019,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,707,366
Value of total assets at end of year2021-12-31$16,724,212
Value of total assets at beginning of year2021-12-31$14,238,364
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$24,362
Total interest from all sources2021-12-31$16,849
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$24,362
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,927,463
Participant contributions at end of year2021-12-31$228,676
Participant contributions at beginning of year2021-12-31$205,972
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$779,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,485,848
Value of net assets at end of year (total assets less liabilities)2021-12-31$16,724,212
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$14,238,364
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$15,591,586
Value of interest in pooled separate accounts at beginning of year2021-12-31$13,391,201
Interest on participant loans2021-12-31$10,139
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$6,710
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$903,950
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$641,191
Net investment gain/loss from pooled separate accounts2021-12-31$1,805,930
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,019,935
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2021-12-31381357951
2020 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$4,011,601
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,078,426
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,044,055
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,243,261
Value of total assets at end of year2020-12-31$14,238,364
Value of total assets at beginning of year2020-12-31$11,305,189
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$34,371
Total interest from all sources2020-12-31$17,018
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$34,371
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,805,186
Participant contributions at end of year2020-12-31$205,972
Participant contributions at beginning of year2020-12-31$179,751
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$438,017
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$2,933,175
Value of net assets at end of year (total assets less liabilities)2020-12-31$14,238,364
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$11,305,189
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$13,391,201
Value of interest in pooled separate accounts at beginning of year2020-12-31$10,676,241
Interest on participant loans2020-12-31$10,921
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$6,097
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$641,191
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$449,197
Net investment gain/loss from pooled separate accounts2020-12-31$1,751,322
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$58
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,044,055
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2020-12-31381357951
2019 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$0
Total transfer of assets from this plan2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,781,050
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,230,369
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,209,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,887,346
Value of total assets at end of year2019-12-31$11,305,189
Value of total assets at beginning of year2019-12-31$8,754,508
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$21,078
Total interest from all sources2019-12-31$14,957
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$21,078
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,594,071
Participant contributions at end of year2019-12-31$179,751
Participant contributions at beginning of year2019-12-31$166,458
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$292,004
Other income not declared elsewhere2019-12-31$1,878,747
Administrative expenses (other) incurred2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$2,550,681
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,305,189
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$8,754,508
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$10,676,241
Value of interest in pooled separate accounts at beginning of year2019-12-31$8,264,079
Interest on participant loans2019-12-31$0
Income. Interest from loans (other than to participants)2019-12-31$11,023
Interest earned on other investments2019-12-31$0
Income. Interest from US Government securities2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$3,934
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$449,197
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$323,971
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,271
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,209,291
Contract administrator fees2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2019-12-31381357951
2018 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$3,487,060
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$875,159
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$858,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$4,104,457
Value of total assets at end of year2018-12-31$8,754,508
Value of total assets at beginning of year2018-12-31$6,142,607
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$16,749
Total interest from all sources2018-12-31$10,831
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$16,749
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,404,241
Participant contributions at end of year2018-12-31$166,458
Participant contributions at beginning of year2018-12-31$97,341
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$2,699,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$2,611,901
Value of net assets at end of year (total assets less liabilities)2018-12-31$8,754,508
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$6,142,607
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$8,264,079
Value of interest in pooled separate accounts at beginning of year2018-12-31$5,773,740
Interest on participant loans2018-12-31$7,823
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$3,008
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$323,971
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$271,526
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-628,228
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,166
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$858,410
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2018-12-31381357951
2017 : NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$2,945,168
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$3,476,419
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$278,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$269,411
Expenses. Certain deemed distributions of participant loans2017-12-31$5,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,186,848
Value of total assets at end of year2017-12-31$6,142,607
Value of total assets at beginning of year2017-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,052
Total interest from all sources2017-12-31$3,432
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$4,052
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$579,025
Participant contributions at end of year2017-12-31$97,341
Participant contributions at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$2,607,823
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,197,439
Value of net assets at end of year (total assets less liabilities)2017-12-31$6,142,607
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$5,773,740
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$2,262
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$1,170
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$271,526
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$286,139
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$269,411
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31TURNER, STONE AND CO., LLP
Accountancy firm EIN2017-12-31752608885

Form 5500 Responses for NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN

2023: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NORTH SHORE HEALTHCARE, LLC RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered567
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $37,347
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered560
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $37,015
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,015
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered597
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $38,965
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,965
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered563
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $36,079
Total amount of fees paid to insurance companyUSD $10,217
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,079
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered620
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $35,319
Total amount of fees paid to insurance companyUSD $7,900
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,319
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered573
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $97,799
Total amount of fees paid to insurance companyUSD $18,749
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97,799
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number817812
Policy instance 1
Insurance contract or identification number817812
Number of Individuals Covered374
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $28,753
Total amount of fees paid to insurance companyUSD $614
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,753
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.

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