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THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 401k Plan overview

Plan NameTHE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN
Plan identification number 001

THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.

401k Sponsoring company profile

THE CONCORD NURSING HOME, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE CONCORD NURSING HOME, INC.
Employer identification number (EIN):112290533
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01REVEREND SAMUEL PHILLIPS2023-10-16
0012021-01-01REVEREND SAMUEL PHILLIPS2022-10-17
0012020-01-01REVEREND SAMUEL PHILLIPS2021-10-14
0012019-01-01REVEREND SAMUEL PHILLIPS2020-10-15
0012018-01-01JOSEPHINE CUENCO2019-10-10
0012017-01-01JOSEPHINE CUENCO2018-10-03
0012016-01-01JOSEPHINE CUENCO2017-09-26
0012015-01-01ALFONSO RICHARDSON2016-10-13
0012014-01-01LILLIE BRYANT HOBBS2015-10-13
0012013-01-01LILLIE BRYANT HOBBS
0012012-01-01LILLIE BRYANT HOBBS
0012011-01-01LILLIE BRYANT HOBBS
0012010-01-01LILLIE BRYANT HOBBS
0012009-01-01LILLIE BRYANT HOBBS

Plan Statistics for THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN

401k plan membership statisitcs for THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN

Measure Date Value
2013: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0166
Total number of active participants reported on line 7a of the Form 55002013-01-0125
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0142
Total of all active and inactive participants2013-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0167
Number of participants with account balances2013-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0170
Total number of active participants reported on line 7a of the Form 55002012-01-0125
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0140
Total of all active and inactive participants2012-01-0165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0165
Number of participants with account balances2012-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0169
Total number of active participants reported on line 7a of the Form 55002011-01-0130
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0140
Total of all active and inactive participants2011-01-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0170
Number of participants with account balances2011-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0168
Total number of active participants reported on line 7a of the Form 55002010-01-0132
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0137
Total of all active and inactive participants2010-01-0169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0169
Number of participants with account balances2010-01-0169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-011
2009: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0161
Total number of active participants reported on line 7a of the Form 55002009-01-0127
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0137
Total of all active and inactive participants2009-01-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0164
Number of participants with account balances2009-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN

Measure Date Value
2013 : THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$53,923
Expenses. Total of all expenses incurred2013-12-31$51,705
Benefits paid (including direct rollovers)2013-12-31$45,855
Total plan assets at end of year2013-12-31$591,088
Total plan assets at beginning of year2013-12-31$588,870
Value of fidelity bond covering the plan2013-12-31$60,000
Total contributions received or receivable from participants2013-12-31$0
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$23,923
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$2,218
Net plan assets at end of year (total assets less liabilities)2013-12-31$591,088
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$588,870
Total contributions received or receivable from employer(s)2013-12-31$30,000
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,850
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$62,976
Expenses. Total of all expenses incurred2012-12-31$72,925
Benefits paid (including direct rollovers)2012-12-31$67,194
Total plan assets at end of year2012-12-31$588,870
Total plan assets at beginning of year2012-12-31$598,819
Value of fidelity bond covering the plan2012-12-31$50,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$22,976
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$-9,949
Net plan assets at end of year (total assets less liabilities)2012-12-31$588,870
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$598,819
Total contributions received or receivable from employer(s)2012-12-31$40,000
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$5,731
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$55,600
Expenses. Total of all expenses incurred2011-12-31$15,069
Benefits paid (including direct rollovers)2011-12-31$15,069
Total plan assets at end of year2011-12-31$598,819
Total plan assets at beginning of year2011-12-31$558,288
Value of fidelity bond covering the plan2011-12-31$50,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$15,600
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$40,531
Net plan assets at end of year (total assets less liabilities)2011-12-31$598,819
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$558,288
Total contributions received or receivable from employer(s)2011-12-31$40,000
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$56,052
Expenses. Total of all expenses incurred2010-12-31$26,513
Benefits paid (including direct rollovers)2010-12-31$26,513
Total plan assets at end of year2010-12-31$558,288
Total plan assets at beginning of year2010-12-31$528,749
Value of fidelity bond covering the plan2010-12-31$50,000
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$16,052
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$29,539
Net plan assets at end of year (total assets less liabilities)2010-12-31$558,288
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$528,749
Total contributions received or receivable from employer(s)2010-12-31$40,000
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN

2013: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: THE CONCORD NURSING HOME, INC., PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberA3548
Policy instance 1
Insurance contract or identification numberA3548
Number of Individuals Covered66
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $750
Are there contracts with allocated funds for individual policies?No
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 $0
Amount paid for insurance broker fees750
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameJAMES KIDD
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberA3548
Policy instance 1
Insurance contract or identification numberA3548
Number of Individuals Covered65
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,000
Are there contracts with allocated funds for individual policies?No
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 $0
Amount paid for insurance broker fees1000
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameJAMES KIDD
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberA3548
Policy instance 1
Insurance contract or identification numberA3548
Number of Individuals Covered70
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,000
Are there contracts with allocated funds for individual policies?No
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
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberA3548
Policy instance 1
Insurance contract or identification numberA3548
Number of Individuals Covered69
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $0
Insurance broker organization code?3
Insurance broker nameJAMES KIDD

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