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| Plan Name | IDENTITY REHAB 401(K) PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | IDENTITY REHAB CORPORATION |
| Employer identification number (EIN): | 203931142 |
| NAIC Classification: | 812990 |
| NAIC Description: | All Other Personal Services |
Additional information about IDENTITY REHAB CORPORATION
| Jurisdiction of Incorporation: | Colorado Department of State |
| Incorporation Date: | 2005-12-12 |
| Company Identification Number: | 20051460650 |
| Legal Registered Office Address: |
717 17th St Suite 2700 Denver United States of America (USA) 80202 |
More information about IDENTITY REHAB CORPORATION
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2017-01-01 | JAY B. LEWIS | 2018-03-22 | ||
| 001 | 2016-01-01 | JAY B. LEWIS | 2017-07-17 | ||
| 001 | 2015-01-01 | JAY B. LEWIS | 2016-07-19 | ||
| 001 | 2014-01-01 | JAY B. LEWIS | 2015-07-28 | ||
| 001 | 2013-01-01 | JAY B. LEWIS | 2014-07-02 | ||
| 001 | 2012-01-01 | JAY B. LEWIS | 2013-08-26 | ||
| 001 | 2011-01-01 | JAY B. LEWIS | JAY B. LEWIS | 2012-07-31 | |
| 001 | 2009-01-01 | DENNIS PERKINS |
| Measure | Date | Value |
|---|---|---|
| 2011: IDENTITY REHAB 401(K) PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 26 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 9 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 9 |
| Total of all active and inactive participants | 2011-01-01 | 18 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 18 |
| Number of participants with account balances | 2011-01-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 1 |
| 2009: IDENTITY REHAB 401(K) PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 35 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 5 |
| Total of all active and inactive participants | 2009-01-01 | 40 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 40 |
| Number of participants with account balances | 2009-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 5 |
| Measure | Date | Value |
|---|---|---|
| 2011 : IDENTITY REHAB 401(K) PLAN 2011 401k financial data | ||
| Total income from all sources | 2011-12-31 | $53,646 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $110,172 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $101,251 |
| Total plan assets at end of year | 2011-12-31 | $152,274 |
| Total plan assets at beginning of year | 2011-12-31 | $208,800 |
| Value of fidelity bond covering the plan | 2011-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $56,537 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $-16,076 |
| Net income (gross income less expenses) | 2011-12-31 | $-56,526 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $152,274 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $208,800 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $13,185 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $8,921 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $0 |
| 2010 : IDENTITY REHAB 401(K) PLAN 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $95,643 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $47,678 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $38,841 |
| Total plan assets at end of year | 2010-12-31 | $208,800 |
| Total plan assets at beginning of year | 2010-12-31 | $160,835 |
| Value of fidelity bond covering the plan | 2010-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $57,038 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $23,872 |
| Net income (gross income less expenses) | 2010-12-31 | $47,965 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $208,800 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $160,835 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $14,733 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $8,837 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $0 |
| 2011: IDENTITY REHAB 401(K) PLAN 2011 form 5500 responses | ||
|---|---|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: IDENTITY REHAB 401(K) PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) | |
| Policy contract number | 941673 |
| Policy instance | 1 |
| METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) | |
| Policy contract number | 941673 |
| Policy instance | 1 |