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VAN DYK HEALTH CARE, INC. 401k Plan overview

Plan NameVAN DYK HEALTH CARE, INC.
Plan identification number 502

VAN DYK HEALTH CARE, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

VAN DYK HEALTH CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:VAN DYK HEALTH CARE, INC.
Employer identification number (EIN):222587793
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VAN DYK HEALTH CARE, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-07-01DONNA MELCHIONDA2020-01-31
5022018-07-01DONNA MELCHIONDA2020-11-12
5022017-07-01DONNA MELCHIONDA2019-04-10
5022016-07-01
5022015-07-01DONNA MELCHIONDA
5022014-07-01
5022013-07-01
5022012-07-01ROBERT VAN DYK
5022011-06-01ROBERT VAN DYK
5022009-06-01ROBERT VAN DYK

Plan Statistics for VAN DYK HEALTH CARE, INC.

401k plan membership statisitcs for VAN DYK HEALTH CARE, INC.

Measure Date Value
2018: VAN DYK HEALTH CARE, INC. 2018 401k membership
Total participants, beginning-of-year2018-07-01255
Total number of active participants reported on line 7a of the Form 55002018-07-01185
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01185
Number of employers contributing to the scheme2018-07-010
2017: VAN DYK HEALTH CARE, INC. 2017 401k membership
Total participants, beginning-of-year2017-07-01203
Total number of active participants reported on line 7a of the Form 55002017-07-01545
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01545
Number of employers contributing to the scheme2017-07-010
2016: VAN DYK HEALTH CARE, INC. 2016 401k membership
Total participants, beginning-of-year2016-07-01193
Total number of active participants reported on line 7a of the Form 55002016-07-01203
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01203
2015: VAN DYK HEALTH CARE, INC. 2015 401k membership
Total participants, beginning-of-year2015-07-01278
Total number of active participants reported on line 7a of the Form 55002015-07-01193
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01193
2014: VAN DYK HEALTH CARE, INC. 2014 401k membership
Total participants, beginning-of-year2014-07-01278
Total number of active participants reported on line 7a of the Form 55002014-07-01278
Total of all active and inactive participants2014-07-01278
2013: VAN DYK HEALTH CARE, INC. 2013 401k membership
Total participants, beginning-of-year2013-07-01164
Total number of active participants reported on line 7a of the Form 55002013-07-010
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-010
2012: VAN DYK HEALTH CARE, INC. 2012 401k membership
Total participants, beginning-of-year2012-07-01168
Total number of active participants reported on line 7a of the Form 55002012-07-010
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-010
2011: VAN DYK HEALTH CARE, INC. 2011 401k membership
Total participants, beginning-of-year2011-06-01157
Total number of active participants reported on line 7a of the Form 55002011-06-010
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-010
2009: VAN DYK HEALTH CARE, INC. 2009 401k membership
Total participants, beginning-of-year2009-06-01155
Total number of active participants reported on line 7a of the Form 55002009-06-010
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-010
Total of all active and inactive participants2009-06-010

Financial Data on VAN DYK HEALTH CARE, INC.

Measure Date Value
2015 : VAN DYK HEALTH CARE, INC. 2015 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Was this plan covered by a fidelity bond2015-06-30No
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-06-30No
Did the plan have assets held for investment2015-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
2014 : VAN DYK HEALTH CARE, INC. 2014 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Was this plan covered by a fidelity bond2014-06-30No
If this is an individual account plan, was there a blackout period2014-06-30No
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-06-30No
Did the plan have assets held for investment2014-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
2013 : VAN DYK HEALTH CARE, INC. 2013 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Was this plan covered by a fidelity bond2013-06-30No
If this is an individual account plan, was there a blackout period2013-06-30No
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-06-30No
Did the plan have assets held for investment2013-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
2012 : VAN DYK HEALTH CARE, INC. 2012 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-31No
Was this plan covered by a fidelity bond2012-05-31No
If this is an individual account plan, was there a blackout period2012-05-31No
Were there any nonexempt tranactions with any party-in-interest2012-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-31No
Were any leases to which the plan was party in default or uncollectible2012-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-31No
Was there a failure to transmit to the plan any participant contributions2012-05-31No
Has the plan failed to provide any benefit when due under the plan2012-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-05-31No
Did the plan have assets held for investment2012-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-31No

Form 5500 Responses for VAN DYK HEALTH CARE, INC.

2018: VAN DYK HEALTH CARE, INC. 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: VAN DYK HEALTH CARE, INC. 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: VAN DYK HEALTH CARE, INC. 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: VAN DYK HEALTH CARE, INC. 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: VAN DYK HEALTH CARE, INC. 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: VAN DYK HEALTH CARE, INC. 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: VAN DYK HEALTH CARE, INC. 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: VAN DYK HEALTH CARE, INC. 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2009: VAN DYK HEALTH CARE, INC. 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01This submission is the final filingNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number905507
Policy instance 1
Insurance contract or identification number905507
Number of Individuals Covered185
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $3,419
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $76,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,419
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number905507
Policy instance 1
Insurance contract or identification number905507
Number of Individuals Covered545
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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