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BAY AREA COMMUNITY HEALTH 403(B) PLAN 401k Plan overview

Plan NameBAY AREA COMMUNITY HEALTH 403(B) PLAN
Plan identification number 003

BAY AREA COMMUNITY HEALTH 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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) received services of leased employees, as defined in Code section 414(n), during the plan year.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BAY AREA COMMUNITY HEALTH has sponsored the creation of one or more 401k plans.

Company Name:BAY AREA COMMUNITY HEALTH
Employer identification number (EIN):237255735
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAY AREA COMMUNITY HEALTH 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01
0032021-01-01
0032020-01-01
0032019-01-01
0032018-01-01
0032017-01-01JAGAT SHETH
0032016-01-01JAGAT SHETH JAGAT SHETH2017-10-10
0032015-01-01JAGAT SHETH JAGAT SHETH2016-10-07
0032014-01-01JOHN ROBLES JOHN ROBLES2015-10-09

Plan Statistics for BAY AREA COMMUNITY HEALTH 403(B) PLAN

401k plan membership statisitcs for BAY AREA COMMUNITY HEALTH 403(B) PLAN

Measure Date Value
2022: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01820
Total number of active participants reported on line 7a of the Form 55002022-01-01647
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-01125
Total of all active and inactive participants2022-01-01774
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01774
Number of participants with account balances2022-01-01586
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0163
2021: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01818
Total number of active participants reported on line 7a of the Form 55002021-01-01379
Number of retired or separated participants receiving benefits2021-01-016
Number of other retired or separated participants entitled to future benefits2021-01-01402
Total of all active and inactive participants2021-01-01787
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01787
Number of participants with account balances2021-01-01692
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-01121
2020: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01487
Total number of active participants reported on line 7a of the Form 55002020-01-01678
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-01138
Total of all active and inactive participants2020-01-01818
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01818
Number of participants with account balances2020-01-01705
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0152
2019: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01337
Total number of active participants reported on line 7a of the Form 55002019-01-01338
Number of retired or separated participants receiving benefits2019-01-014
Number of other retired or separated participants entitled to future benefits2019-01-01145
Total of all active and inactive participants2019-01-01487
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01487
Number of participants with account balances2019-01-01389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0142
2018: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01297
Total number of active participants reported on line 7a of the Form 55002018-01-01213
Number of retired or separated participants receiving benefits2018-01-0112
Number of other retired or separated participants entitled to future benefits2018-01-01112
Total of all active and inactive participants2018-01-01337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01337
Number of participants with account balances2018-01-01337
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0136
2017: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01321
Total number of active participants reported on line 7a of the Form 55002017-01-01248
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0148
Total of all active and inactive participants2017-01-01296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01296
Number of participants with account balances2017-01-01269
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01194
Total number of active participants reported on line 7a of the Form 55002016-01-01248
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-0169
Total of all active and inactive participants2016-01-01321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01321
Number of participants with account balances2016-01-01228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0118
2015: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01215
Total number of active participants reported on line 7a of the Form 55002015-01-01126
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0166
Total of all active and inactive participants2015-01-01194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01194
Number of participants with account balances2015-01-01210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0122
2014: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01179
Total number of active participants reported on line 7a of the Form 55002014-01-01189
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0126
Total of all active and inactive participants2014-01-01215
Total participants2014-01-01215
Number of participants with account balances2014-01-01162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0114

Financial Data on BAY AREA COMMUNITY HEALTH 403(B) PLAN

Measure Date Value
2022 : BAY AREA COMMUNITY HEALTH 403(B) 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$3,662,980
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,017,781
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$983,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$6,111,254
Value of total assets at end of year2022-12-31$15,500,224
Value of total assets at beginning of year2022-12-31$12,855,025
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$34,368
Total interest from all sources2022-12-31$8,043
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$510,712
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$510,712
Administrative expenses professional fees incurred2022-12-31$1,168
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$300,000
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$2,136,966
Participant contributions at end of year2022-12-31$218,973
Participant contributions at beginning of year2022-12-31$103,856
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$2,743,983
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$2,645,199
Value of net assets at end of year (total assets less liabilities)2022-12-31$15,500,224
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$12,855,025
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 registered invesment companies (eg mutual funds) at end of year2022-12-31$14,632,791
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$12,343,499
Interest on participant loans2022-12-31$8,043
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$648,460
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$407,670
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,967,029
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$1,230,305
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$983,413
Contract administrator fees2022-12-31$33,200
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 plan2022-12-31Unqualified
Accountancy firm name2022-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2022-12-31472718509
2021 : BAY AREA COMMUNITY HEALTH 403(B) 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$5,040,544
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,124,834
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,090,169
Value of total corrective distributions2021-12-31$6,192
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,565,967
Value of total assets at end of year2021-12-31$12,855,025
Value of total assets at beginning of year2021-12-31$8,939,315
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$28,473
Total interest from all sources2021-12-31$5,820
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$309,934
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$309,934
Administrative expenses professional fees incurred2021-12-31$799
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$300,000
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$2,202,977
Participant contributions at end of year2021-12-31$103,856
Participant contributions at beginning of year2021-12-31$122,660
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$40,768
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$3,915,710
Value of net assets at end of year (total assets less liabilities)2021-12-31$12,855,025
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,939,315
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 registered invesment companies (eg mutual funds) at end of year2021-12-31$12,343,499
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$8,534,579
Interest on participant loans2021-12-31$5,820
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$407,670
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$282,076
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,158,823
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$1,322,222
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,090,169
Contract administrator fees2021-12-31$27,674
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 plan2021-12-31Unqualified
Accountancy firm name2021-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2021-12-31472718509
2020 : BAY AREA COMMUNITY HEALTH 403(B) 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$3,535,627
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$900,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$879,172
Value of total corrective distributions2020-12-31$227
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,393,976
Value of total assets at end of year2020-12-31$8,939,315
Value of total assets at beginning of year2020-12-31$6,304,041
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$20,954
Total interest from all sources2020-12-31$5,408
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$225,326
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$225,326
Administrative expenses professional fees incurred2020-12-31$516
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$1,435,411
Participant contributions at end of year2020-12-31$122,660
Participant contributions at beginning of year2020-12-31$94,426
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$147,042
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
Value of net income/loss2020-12-31$2,635,274
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,939,315
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,304,041
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 registered invesment companies (eg mutual funds) at end of year2020-12-31$8,534,579
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$6,209,615
Interest on participant loans2020-12-31$5,408
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$282,076
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$910,917
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$811,523
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$879,172
Contract administrator fees2020-12-31$20,438
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 name2020-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2020-12-31472718509
2019 : BAY AREA COMMUNITY HEALTH 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$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$2,396,140
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$566,882
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$549,857
Value of total corrective distributions2019-12-31$6,107
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,333,850
Value of total assets at end of year2019-12-31$6,304,041
Value of total assets at beginning of year2019-12-31$4,474,783
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$10,918
Total interest from all sources2019-12-31$5,291
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$148,372
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$148,372
Administrative expenses professional fees incurred2019-12-31$800
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$300,000
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$852,939
Participant contributions at end of year2019-12-31$94,426
Participant contributions at beginning of year2019-12-31$106,148
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$20,275
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
Value of net income/loss2019-12-31$1,829,258
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,304,041
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,474,783
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$6,209,615
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,368,635
Interest on participant loans2019-12-31$5,291
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$908,627
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$460,636
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$549,857
Contract administrator fees2019-12-31$10,118
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
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 name2019-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2019-12-31472718509
2018 : BAY AREA COMMUNITY HEALTH 403(B) 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$943,822
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$232,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$222,141
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,257,774
Value of total assets at end of year2018-12-31$4,474,783
Value of total assets at beginning of year2018-12-31$3,763,453
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$10,351
Total interest from all sources2018-12-31$6,824
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$178,704
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$178,704
Administrative expenses professional fees incurred2018-12-31$2,028
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$300,000
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$688,279
Participant contributions at end of year2018-12-31$106,148
Participant contributions at beginning of year2018-12-31$122,338
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$139,864
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$711,330
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,474,783
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,763,453
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
Investment advisory and management fees2018-12-31$4,983
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$4,368,635
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,641,115
Interest on participant loans2018-12-31$6,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-499,480
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$429,631
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$222,141
Contract administrator fees2018-12-31$3,340
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 name2018-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2018-12-31472718509
2017 : BAY AREA COMMUNITY HEALTH 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
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$1,573,896
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$389,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$370,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,075,139
Value of total assets at end of year2017-12-31$3,763,453
Value of total assets at beginning of year2017-12-31$2,579,476
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$19,258
Total interest from all sources2017-12-31$4,567
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$91,886
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$91,886
Administrative expenses professional fees incurred2017-12-31$1,089
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$300,000
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$615,186
Participant contributions at end of year2017-12-31$122,338
Participant contributions at beginning of year2017-12-31$73,530
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$122,635
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$1,183,977
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,763,453
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,579,476
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 registered invesment companies (eg mutual funds) at end of year2017-12-31$3,641,115
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,505,946
Interest on participant loans2017-12-31$4,567
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$402,304
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
Contributions received in cash from employer2017-12-31$337,318
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$370,661
Contract administrator fees2017-12-31$18,169
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 name2017-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2017-12-31472718509
2016 : BAY AREA COMMUNITY HEALTH 403(B) PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$984,388
Total of all expenses incurred2016-12-31$506,198
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$497,598
Value of total corrective distributions2016-12-31$1,803
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$769,454
Value of total assets at end of year2016-12-31$2,579,476
Value of total assets at beginning of year2016-12-31$2,101,286
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$6,797
Total interest from all sources2016-12-31$5,516
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$58,321
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$58,321
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$300,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$456,497
Participant contributions at end of year2016-12-31$73,530
Participant contributions at beginning of year2016-12-31$132,875
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$31,198
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$478,190
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,579,476
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,101,286
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,505,946
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,968,411
Interest on participant loans2016-12-31$5,516
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$151,097
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$281,759
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$497,598
Contract administrator fees2016-12-31$6,797
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2016-12-31472718509
2015 : BAY AREA COMMUNITY HEALTH 403(B) PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$740,521
Total of all expenses incurred2015-12-31$319,732
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$314,432
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$773,919
Value of total assets at end of year2015-12-31$2,101,286
Value of total assets at beginning of year2015-12-31$1,680,497
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$5,300
Total interest from all sources2015-12-31$4,166
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$74,139
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$74,139
Administrative expenses professional fees incurred2015-12-31$5,300
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$300,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$501,562
Participant contributions at end of year2015-12-31$132,875
Participant contributions at beginning of year2015-12-31$43,458
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$420,789
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,101,286
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,680,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,968,411
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,627,966
Interest on participant loans2015-12-31$4,166
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-111,703
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$272,357
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$9,073
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$314,432
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2015-12-31472718509
2014 : BAY AREA COMMUNITY HEALTH 403(B) PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$1,749,601
Total of all expenses incurred2014-12-31$69,104
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$65,754
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,665,577
Value of total assets at end of year2014-12-31$1,680,497
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$3,350
Total interest from all sources2014-12-31$1,865
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$34,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$34,520
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$300,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$429,652
Participant contributions at end of year2014-12-31$43,458
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$950,472
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,680,497
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,680,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,627,966
Interest on participant loans2014-12-31$1,865
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$47,639
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$285,453
Employer contributions (assets) at end of year2014-12-31$9,073
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$65,754
Contract administrator fees2014-12-31$3,350
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31JWT & ASSOCIATES, LLP
Accountancy firm EIN2014-12-31472718509

Form 5500 Responses for BAY AREA COMMUNITY HEALTH 403(B) PLAN

2022: BAY AREA COMMUNITY HEALTH 403(B) 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: BAY AREA COMMUNITY HEALTH 403(B) 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: BAY AREA COMMUNITY HEALTH 403(B) 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: BAY AREA COMMUNITY HEALTH 403(B) 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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: BAY AREA COMMUNITY HEALTH 403(B) 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: BAY AREA COMMUNITY HEALTH 403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 Administration1
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?No
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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered14
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 Administration1
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?No
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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered18
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 Administration1
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?No
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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered11
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 Administration1
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?No
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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 Administration1
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?No
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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number808960A
Policy instance 1
Insurance contract or identification number808960A
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 Administration1
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?No
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

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