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SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameSOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 503

SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

SOUTHWESTERN HEALTHCARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:SOUTHWESTERN HEALTHCARE, INC.
Employer identification number (EIN):261503650
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-10-01ANDREA IMES2023-02-28
5032020-10-01ANDREA IMES2022-04-26
5032019-10-01DEBRA BIEBER2021-01-22
5032018-10-01DEBRA BIEBER2020-03-24
5032017-10-01
5032016-10-01
5032015-10-01
5032014-10-01DEBRA BIEBER
5032013-10-01DEBRA BIEBER
5032013-05-01DEBRA BIEBER
5032012-05-01DEBRA BIEBER
5032011-05-01DEBRA BIEBER
5032009-05-01JOHN K. BROWNING

Plan Statistics for SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2021: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01313
Total number of active participants reported on line 7a of the Form 55002021-10-01292
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-012
Total of all active and inactive participants2021-10-01294
2020: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01315
Total number of active participants reported on line 7a of the Form 55002020-10-01313
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-011
Total of all active and inactive participants2020-10-01314
2019: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01301
Total number of active participants reported on line 7a of the Form 55002019-10-01315
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-011
Total of all active and inactive participants2019-10-01316
2018: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01301
Total number of active participants reported on line 7a of the Form 55002018-10-01301
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-011
Total of all active and inactive participants2018-10-01302
2017: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01262
Total number of active participants reported on line 7a of the Form 55002017-10-01279
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01279
2016: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01226
Total number of active participants reported on line 7a of the Form 55002016-10-01262
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01262
2015: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01235
Total number of active participants reported on line 7a of the Form 55002015-10-01226
Total of all active and inactive participants2015-10-01226
2014: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01194
Total number of active participants reported on line 7a of the Form 55002014-10-01233
Number of retired or separated participants receiving benefits2014-10-012
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01235
2013: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01193
Total number of active participants reported on line 7a of the Form 55002013-10-01191
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01191
Total participants, beginning-of-year2013-05-01177
Total number of active participants reported on line 7a of the Form 55002013-05-01191
Number of retired or separated participants receiving benefits2013-05-012
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-01193
2012: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01173
Total number of active participants reported on line 7a of the Form 55002012-05-01174
Number of retired or separated participants receiving benefits2012-05-013
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-01177
2011: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01171
Total number of active participants reported on line 7a of the Form 55002011-05-01171
Number of retired or separated participants receiving benefits2011-05-012
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01173
2009: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01171
Total number of active participants reported on line 7a of the Form 55002009-05-01169
Number of retired or separated participants receiving benefits2009-05-011
Number of other retired or separated participants entitled to future benefits2009-05-010
Total of all active and inactive participants2009-05-01170

Financial Data on SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2014 : SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2014-09-30$0
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total transfer of assets to this plan2014-09-30$0
Total transfer of assets from this plan2014-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Expenses. Interest paid2014-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022014-09-30$0
Total income from all sources (including contributions)2014-09-30$1,960,966
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$2,370,914
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$2,299,011
Expenses. Certain deemed distributions of participant loans2014-09-30$0
Value of total corrective distributions2014-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$1,960,833
Value of total assets at end of year2014-09-30$30,449
Value of total assets at beginning of year2014-09-30$440,397
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$71,903
Total income from rents2014-09-30$0
Total interest from all sources2014-09-30$133
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Assets. Real estate other than employer real property at end of year2014-09-30$0
Assets. Real estate other than employer real property at beginning of year2014-09-30$0
Administrative expenses professional fees incurred2014-09-30$9,096
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-09-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-09-30$0
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$486,445
Participant contributions at end of year2014-09-30$0
Participant contributions at beginning of year2014-09-30$0
Participant contributions at end of year2014-09-30$0
Participant contributions at beginning of year2014-09-30$0
Assets. Other investments not covered elsewhere at end of year2014-09-30$0
Assets. Other investments not covered elsewhere at beginning of year2014-09-30$0
Income. Received or receivable in cash from other sources (including rollovers)2014-09-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-09-30$22,264
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-09-30$0
Assets. Loans (other than to participants) at end of year2014-09-30$0
Assets. Loans (other than to participants) at beginning of year2014-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-09-30$0
Other income not declared elsewhere2014-09-30$0
Administrative expenses (other) incurred2014-09-30$606
Liabilities. Value of operating payables at end of year2014-09-30$0
Liabilities. Value of operating payables at beginning of year2014-09-30$0
Total non interest bearing cash at end of year2014-09-30$0
Total non interest bearing cash at beginning of year2014-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Income. Non cash contributions2014-09-30$0
Value of net income/loss2014-09-30$-409,948
Value of net assets at end of year (total assets less liabilities)2014-09-30$30,449
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$440,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Assets. partnership/joint venture interests at end of year2014-09-30$0
Assets. partnership/joint venture interests at beginning of year2014-09-30$0
Investment advisory and management fees2014-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-09-30$0
Value of interest in pooled separate accounts at end of year2014-09-30$0
Value of interest in pooled separate accounts at beginning of year2014-09-30$0
Interest on participant loans2014-09-30$0
Income. Interest from loans (other than to participants)2014-09-30$0
Interest earned on other investments2014-09-30$0
Income. Interest from US Government securities2014-09-30$0
Income. Interest from corporate debt instruments2014-09-30$0
Value of interest in master investment trust accounts at end of year2014-09-30$0
Value of interest in master investment trust accounts at beginning of year2014-09-30$0
Value of interest in common/collective trusts at end of year2014-09-30$0
Value of interest in common/collective trusts at beginning of year2014-09-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$30,449
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$440,397
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$440,397
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$133
Assets. Value of investments in 103.12 investment entities at end of year2014-09-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2014-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-09-30$509,671
Asset value of US Government securities at end of year2014-09-30$0
Asset value of US Government securities at beginning of year2014-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-09-30$0
Net investment gain/loss from pooled separate accounts2014-09-30$0
Net investment gain or loss from common/collective trusts2014-09-30$0
Net gain/loss from 103.12 investment entities2014-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Assets. Invements in employer securities at end of year2014-09-30$0
Assets. Invements in employer securities at beginning of year2014-09-30$0
Assets. Value of employer real property at end of year2014-09-30$0
Assets. Value of employer real property at beginning of year2014-09-30$0
Contributions received in cash from employer2014-09-30$1,474,388
Employer contributions (assets) at end of year2014-09-30$0
Employer contributions (assets) at beginning of year2014-09-30$0
Income. Dividends from preferred stock2014-09-30$0
Income. Dividends from common stock2014-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$1,767,076
Asset. Corporate debt instrument preferred debt at end of year2014-09-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-09-30$0
Asset. Corporate debt instrument debt (other) at end of year2014-09-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2014-09-30$0
Contract administrator fees2014-09-30$62,201
Assets. Corporate common stocks other than exployer securities at end of year2014-09-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2014-09-30$0
Liabilities. Value of benefit claims payable at end of year2014-09-30$0
Liabilities. Value of benefit claims payable at beginning of year2014-09-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2014-09-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-09-30$0
Did the plan have assets held for investment2014-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Aggregate proceeds on sale of assets2014-09-30$0
Aggregate carrying amount (costs) on sale of assets2014-09-30$0
Liabilities. Value of acquisition indebtedness at end of year2014-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30FALL CREEK ASSOCIATES, LLC
Accountancy firm EIN2014-09-30364785555
2013 : SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-09-30$0
Total unrealized appreciation/depreciation of assets2013-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Expenses. Interest paid2013-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-09-30$0
Total income from all sources (including contributions)2013-09-30$833,103
Total loss/gain on sale of assets2013-09-30$0
Total of all expenses incurred2013-09-30$740,230
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$714,226
Expenses. Certain deemed distributions of participant loans2013-09-30$0
Value of total corrective distributions2013-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$833,011
Value of total assets at end of year2013-09-30$440,397
Value of total assets at beginning of year2013-09-30$347,524
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$26,004
Total income from rents2013-09-30$0
Total interest from all sources2013-09-30$92
Total dividends received (eg from common stock, registered investment company shares)2013-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-09-30$0
Assets. Real estate other than employer real property at end of year2013-09-30$0
Assets. Real estate other than employer real property at beginning of year2013-09-30$0
Administrative expenses professional fees incurred2013-09-30$2,833
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-09-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-09-30$0
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$205,085
Participant contributions at end of year2013-09-30$0
Participant contributions at beginning of year2013-09-30$0
Participant contributions at end of year2013-09-30$0
Participant contributions at beginning of year2013-09-30$0
Assets. Other investments not covered elsewhere at end of year2013-09-30$0
Assets. Other investments not covered elsewhere at beginning of year2013-09-30$0
Income. Received or receivable in cash from other sources (including rollovers)2013-09-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-09-30$8,944
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-09-30$0
Assets. Loans (other than to participants) at end of year2013-09-30$0
Assets. Loans (other than to participants) at beginning of year2013-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-09-30$0
Other income not declared elsewhere2013-09-30$0
Administrative expenses (other) incurred2013-09-30$0
Liabilities. Value of operating payables at end of year2013-09-30$0
Liabilities. Value of operating payables at beginning of year2013-09-30$0
Total non interest bearing cash at end of year2013-09-30$0
Total non interest bearing cash at beginning of year2013-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Income. Non cash contributions2013-09-30$0
Value of net income/loss2013-09-30$92,873
Value of net assets at end of year (total assets less liabilities)2013-09-30$440,397
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$347,524
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Assets. partnership/joint venture interests at end of year2013-09-30$0
Assets. partnership/joint venture interests at beginning of year2013-09-30$0
Investment advisory and management fees2013-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-09-30$0
Value of interest in pooled separate accounts at end of year2013-09-30$0
Value of interest in pooled separate accounts at beginning of year2013-09-30$0
Interest on participant loans2013-09-30$0
Income. Interest from loans (other than to participants)2013-09-30$0
Interest earned on other investments2013-09-30$0
Income. Interest from US Government securities2013-09-30$0
Income. Interest from corporate debt instruments2013-09-30$0
Value of interest in master investment trust accounts at end of year2013-09-30$0
Value of interest in master investment trust accounts at beginning of year2013-09-30$0
Value of interest in common/collective trusts at end of year2013-09-30$0
Value of interest in common/collective trusts at beginning of year2013-09-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-09-30$440,397
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-09-30$347,524
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-09-30$347,524
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-09-30$92
Assets. Value of investments in 103.12 investment entities at end of year2013-09-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-09-30$193,004
Asset value of US Government securities at end of year2013-09-30$0
Asset value of US Government securities at beginning of year2013-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-09-30$0
Net investment gain/loss from pooled separate accounts2013-09-30$0
Net investment gain or loss from common/collective trusts2013-09-30$0
Net gain/loss from 103.12 investment entities2013-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Assets. Invements in employer securities at end of year2013-09-30$0
Assets. Invements in employer securities at beginning of year2013-09-30$0
Assets. Value of employer real property at end of year2013-09-30$0
Assets. Value of employer real property at beginning of year2013-09-30$0
Contributions received in cash from employer2013-09-30$627,926
Employer contributions (assets) at end of year2013-09-30$0
Employer contributions (assets) at beginning of year2013-09-30$0
Income. Dividends from preferred stock2013-09-30$0
Income. Dividends from common stock2013-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$512,278
Asset. Corporate debt instrument preferred debt at end of year2013-09-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-09-30$0
Asset. Corporate debt instrument debt (other) at end of year2013-09-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-09-30$0
Contract administrator fees2013-09-30$23,171
Assets. Corporate common stocks other than exployer securities at end of year2013-09-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-09-30$0
Liabilities. Value of benefit claims payable at end of year2013-09-30$0
Liabilities. Value of benefit claims payable at beginning of year2013-09-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2013-09-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-09-30$0
Did the plan have assets held for investment2013-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Aggregate proceeds on sale of assets2013-09-30$0
Aggregate carrying amount (costs) on sale of assets2013-09-30$0
Liabilities. Value of acquisition indebtedness at end of year2013-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-09-30$0
Unrealized appreciation/depreciation of real estate assets2013-04-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-04-30$0
Total unrealized appreciation/depreciation of assets2013-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-04-30$0
Expenses. Interest paid2013-04-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-04-30$0
Total income from all sources (including contributions)2013-04-30$1,538,222
Total loss/gain on sale of assets2013-04-30$0
Total of all expenses incurred2013-04-30$1,917,903
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-04-30$1,859,813
Expenses. Certain deemed distributions of participant loans2013-04-30$0
Value of total corrective distributions2013-04-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-04-30$1,537,519
Value of total assets at end of year2013-04-30$347,524
Value of total assets at beginning of year2013-04-30$727,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-04-30$58,090
Total income from rents2013-04-30$0
Total interest from all sources2013-04-30$703
Total dividends received (eg from common stock, registered investment company shares)2013-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-04-30$0
Assets. Real estate other than employer real property at end of year2013-04-30$0
Assets. Real estate other than employer real property at beginning of year2013-04-30$0
Administrative expenses professional fees incurred2013-04-30$5,645
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-04-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-04-30$0
Was this plan covered by a fidelity bond2013-04-30Yes
Value of fidelity bond cover2013-04-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-04-30No
Contributions received from participants2013-04-30$1,128,638
Participant contributions at end of year2013-04-30$0
Participant contributions at beginning of year2013-04-30$0
Participant contributions at end of year2013-04-30$0
Participant contributions at beginning of year2013-04-30$0
Assets. Other investments not covered elsewhere at end of year2013-04-30$0
Assets. Other investments not covered elsewhere at beginning of year2013-04-30$0
Income. Received or receivable in cash from other sources (including rollovers)2013-04-30$408,881
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-04-30$16,756
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-04-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-04-30$0
Assets. Loans (other than to participants) at end of year2013-04-30$0
Assets. Loans (other than to participants) at beginning of year2013-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-04-30$0
Other income not declared elsewhere2013-04-30$0
Administrative expenses (other) incurred2013-04-30$0
Liabilities. Value of operating payables at end of year2013-04-30$0
Liabilities. Value of operating payables at beginning of year2013-04-30$0
Total non interest bearing cash at end of year2013-04-30$0
Total non interest bearing cash at beginning of year2013-04-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Income. Non cash contributions2013-04-30$0
Value of net income/loss2013-04-30$-379,681
Value of net assets at end of year (total assets less liabilities)2013-04-30$347,524
Value of net assets at beginning of year (total assets less liabilities)2013-04-30$727,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-04-30No
Were any leases to which the plan was party in default or uncollectible2013-04-30No
Assets. partnership/joint venture interests at end of year2013-04-30$0
Assets. partnership/joint venture interests at beginning of year2013-04-30$0
Investment advisory and management fees2013-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-04-30$0
Value of interest in pooled separate accounts at end of year2013-04-30$0
Value of interest in pooled separate accounts at beginning of year2013-04-30$0
Interest on participant loans2013-04-30$0
Income. Interest from loans (other than to participants)2013-04-30$0
Interest earned on other investments2013-04-30$0
Income. Interest from US Government securities2013-04-30$0
Income. Interest from corporate debt instruments2013-04-30$0
Value of interest in master investment trust accounts at end of year2013-04-30$0
Value of interest in master investment trust accounts at beginning of year2013-04-30$0
Value of interest in common/collective trusts at end of year2013-04-30$0
Value of interest in common/collective trusts at beginning of year2013-04-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-04-30$347,524
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-04-30$727,205
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-04-30$727,205
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-04-30$703
Assets. Value of investments in 103.12 investment entities at end of year2013-04-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-04-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-04-30$328,930
Asset value of US Government securities at end of year2013-04-30$0
Asset value of US Government securities at beginning of year2013-04-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-04-30$0
Net investment gain/loss from pooled separate accounts2013-04-30$0
Net investment gain or loss from common/collective trusts2013-04-30$0
Net gain/loss from 103.12 investment entities2013-04-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-04-30No
Was there a failure to transmit to the plan any participant contributions2013-04-30No
Has the plan failed to provide any benefit when due under the plan2013-04-30No
Assets. Invements in employer securities at end of year2013-04-30$0
Assets. Invements in employer securities at beginning of year2013-04-30$0
Assets. Value of employer real property at end of year2013-04-30$0
Assets. Value of employer real property at beginning of year2013-04-30$0
Employer contributions (assets) at end of year2013-04-30$0
Employer contributions (assets) at beginning of year2013-04-30$0
Income. Dividends from preferred stock2013-04-30$0
Income. Dividends from common stock2013-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-04-30$1,514,127
Asset. Corporate debt instrument preferred debt at end of year2013-04-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-04-30$0
Asset. Corporate debt instrument debt (other) at end of year2013-04-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-04-30$0
Contract administrator fees2013-04-30$52,445
Assets. Corporate common stocks other than exployer securities at end of year2013-04-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-04-30$0
Liabilities. Value of benefit claims payable at end of year2013-04-30$0
Liabilities. Value of benefit claims payable at beginning of year2013-04-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2013-04-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-04-30$0
Did the plan have assets held for investment2013-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-04-30No
Aggregate proceeds on sale of assets2013-04-30$0
Aggregate carrying amount (costs) on sale of assets2013-04-30$0
Liabilities. Value of acquisition indebtedness at end of year2013-04-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-04-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-04-30No
Opinion of an independent qualified public accountant for this plan2013-04-30Unqualified
Accountancy firm name2013-04-30FALL CREEK ASSOCIATES, LLC
Accountancy firm EIN2013-04-30352134560
2012 : SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-04-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-04-30$0
Total unrealized appreciation/depreciation of assets2012-04-30$0
Total transfer of assets to this plan2012-04-30$0
Total transfer of assets from this plan2012-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-04-30$0
Total income from all sources (including contributions)2012-04-30$1,478,135
Total loss/gain on sale of assets2012-04-30$0
Total of all expenses incurred2012-04-30$1,505,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$1,450,516
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$1,476,922
Value of total assets at end of year2012-04-30$727,205
Value of total assets at beginning of year2012-04-30$754,445
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$54,859
Total income from rents2012-04-30$0
Total interest from all sources2012-04-30$1,213
Total dividends received (eg from common stock, registered investment company shares)2012-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-04-30$0
Assets. Real estate other than employer real property at end of year2012-04-30$0
Assets. Real estate other than employer real property at beginning of year2012-04-30$0
Administrative expenses professional fees incurred2012-04-30$5,557
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-04-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-04-30$0
Was this plan covered by a fidelity bond2012-04-30Yes
Value of fidelity bond cover2012-04-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$368,645
Participant contributions at end of year2012-04-30$0
Participant contributions at beginning of year2012-04-30$0
Participant contributions at end of year2012-04-30$0
Participant contributions at beginning of year2012-04-30$0
Assets. Other investments not covered elsewhere at end of year2012-04-30$0
Assets. Other investments not covered elsewhere at beginning of year2012-04-30$0
Income. Received or receivable in cash from other sources (including rollovers)2012-04-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-04-30$15,685
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-04-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-04-30$0
Assets. Loans (other than to participants) at end of year2012-04-30$0
Assets. Loans (other than to participants) at beginning of year2012-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-04-30$0
Other income not declared elsewhere2012-04-30$0
Administrative expenses (other) incurred2012-04-30$0
Liabilities. Value of operating payables at end of year2012-04-30$0
Liabilities. Value of operating payables at beginning of year2012-04-30$0
Total non interest bearing cash at end of year2012-04-30$0
Total non interest bearing cash at beginning of year2012-04-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Income. Non cash contributions2012-04-30$0
Value of net income/loss2012-04-30$-27,240
Value of net assets at end of year (total assets less liabilities)2012-04-30$727,205
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$754,445
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Assets. partnership/joint venture interests at end of year2012-04-30$0
Assets. partnership/joint venture interests at beginning of year2012-04-30$0
Investment advisory and management fees2012-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-04-30$0
Value of interest in pooled separate accounts at end of year2012-04-30$0
Value of interest in pooled separate accounts at beginning of year2012-04-30$0
Interest on participant loans2012-04-30$0
Income. Interest from loans (other than to participants)2012-04-30$0
Interest earned on other investments2012-04-30$0
Income. Interest from US Government securities2012-04-30$0
Income. Interest from corporate debt instruments2012-04-30$0
Value of interest in master investment trust accounts at end of year2012-04-30$0
Value of interest in master investment trust accounts at beginning of year2012-04-30$0
Value of interest in common/collective trusts at end of year2012-04-30$0
Value of interest in common/collective trusts at beginning of year2012-04-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-04-30$727,205
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-04-30$754,445
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-04-30$754,445
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-04-30$1,213
Assets. Value of investments in 103.12 investment entities at end of year2012-04-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-04-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-04-30$265,860
Asset value of US Government securities at end of year2012-04-30$0
Asset value of US Government securities at beginning of year2012-04-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-04-30$0
Net investment gain/loss from pooled separate accounts2012-04-30$0
Net investment gain or loss from common/collective trusts2012-04-30$0
Net gain/loss from 103.12 investment entities2012-04-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30No
Was there a failure to transmit to the plan any participant contributions2012-04-30No
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Assets. Invements in employer securities at end of year2012-04-30$0
Assets. Invements in employer securities at beginning of year2012-04-30$0
Assets. Value of employer real property at end of year2012-04-30$0
Assets. Value of employer real property at beginning of year2012-04-30$0
Contributions received in cash from employer2012-04-30$1,108,277
Employer contributions (assets) at end of year2012-04-30$0
Employer contributions (assets) at beginning of year2012-04-30$0
Income. Dividends from preferred stock2012-04-30$0
Income. Dividends from common stock2012-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$1,168,971
Asset. Corporate debt instrument preferred debt at end of year2012-04-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-04-30$0
Asset. Corporate debt instrument debt (other) at end of year2012-04-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-04-30$0
Contract administrator fees2012-04-30$49,302
Assets. Corporate common stocks other than exployer securities at end of year2012-04-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-04-30$0
Liabilities. Value of benefit claims payable at end of year2012-04-30$0
Liabilities. Value of benefit claims payable at beginning of year2012-04-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2012-04-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-04-30$0
Did the plan have assets held for investment2012-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30No
Aggregate proceeds on sale of assets2012-04-30$0
Aggregate carrying amount (costs) on sale of assets2012-04-30$0
Liabilities. Value of acquisition indebtedness at end of year2012-04-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-04-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30No
Opinion of an independent qualified public accountant for this plan2012-04-30Unqualified
Accountancy firm name2012-04-30FALL CREEK ASSOCIATES, LLC
Accountancy firm EIN2012-04-30352134560
2011 : SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-04-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-04-30$0
Total unrealized appreciation/depreciation of assets2011-04-30$0
Total transfer of assets to this plan2011-04-30$0
Total transfer of assets from this plan2011-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-04-30$0
Expenses. Interest paid2011-04-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022011-04-30$0
Total income from all sources (including contributions)2011-04-30$1,433,457
Total loss/gain on sale of assets2011-04-30$0
Total of all expenses incurred2011-04-30$1,536,569
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-04-30$1,468,838
Expenses. Certain deemed distributions of participant loans2011-04-30$0
Value of total corrective distributions2011-04-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-04-30$1,431,950
Value of total assets at end of year2011-04-30$754,445
Value of total assets at beginning of year2011-04-30$857,557
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-04-30$67,731
Total income from rents2011-04-30$0
Total interest from all sources2011-04-30$1,507
Total dividends received (eg from common stock, registered investment company shares)2011-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-04-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-04-30$0
Assets. Real estate other than employer real property at end of year2011-04-30$0
Assets. Real estate other than employer real property at beginning of year2011-04-30$0
Administrative expenses professional fees incurred2011-04-30$5,568
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-04-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-04-30$0
Was this plan covered by a fidelity bond2011-04-30Yes
Value of fidelity bond cover2011-04-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-04-30No
Contributions received from participants2011-04-30$352,648
Participant contributions at end of year2011-04-30$0
Participant contributions at beginning of year2011-04-30$0
Participant contributions at end of year2011-04-30$0
Participant contributions at beginning of year2011-04-30$0
Assets. Other investments not covered elsewhere at end of year2011-04-30$0
Assets. Other investments not covered elsewhere at beginning of year2011-04-30$0
Income. Received or receivable in cash from other sources (including rollovers)2011-04-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-04-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-04-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-04-30$0
Assets. Loans (other than to participants) at end of year2011-04-30$0
Assets. Loans (other than to participants) at beginning of year2011-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-04-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-04-30$0
Other income not declared elsewhere2011-04-30$0
Administrative expenses (other) incurred2011-04-30$15,734
Liabilities. Value of operating payables at end of year2011-04-30$0
Liabilities. Value of operating payables at beginning of year2011-04-30$0
Total non interest bearing cash at end of year2011-04-30$0
Total non interest bearing cash at beginning of year2011-04-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Income. Non cash contributions2011-04-30$0
Value of net income/loss2011-04-30$-103,112
Value of net assets at end of year (total assets less liabilities)2011-04-30$754,445
Value of net assets at beginning of year (total assets less liabilities)2011-04-30$857,557
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-04-30No
Were any leases to which the plan was party in default or uncollectible2011-04-30No
Assets. partnership/joint venture interests at end of year2011-04-30$0
Assets. partnership/joint venture interests at beginning of year2011-04-30$0
Investment advisory and management fees2011-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-04-30$0
Value of interest in pooled separate accounts at end of year2011-04-30$0
Value of interest in pooled separate accounts at beginning of year2011-04-30$0
Interest on participant loans2011-04-30$0
Income. Interest from loans (other than to participants)2011-04-30$0
Interest earned on other investments2011-04-30$0
Income. Interest from US Government securities2011-04-30$0
Income. Interest from corporate debt instruments2011-04-30$0
Value of interest in master investment trust accounts at end of year2011-04-30$0
Value of interest in master investment trust accounts at beginning of year2011-04-30$0
Value of interest in common/collective trusts at end of year2011-04-30$0
Value of interest in common/collective trusts at beginning of year2011-04-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-04-30$754,445
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-04-30$857,557
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-04-30$857,557
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-04-30$1,507
Assets. Value of investments in 103.12 investment entities at end of year2011-04-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-04-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-04-30$327,594
Asset value of US Government securities at end of year2011-04-30$0
Asset value of US Government securities at beginning of year2011-04-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-04-30$0
Net investment gain/loss from pooled separate accounts2011-04-30$0
Net investment gain or loss from common/collective trusts2011-04-30$0
Net gain/loss from 103.12 investment entities2011-04-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-04-30No
Was there a failure to transmit to the plan any participant contributions2011-04-30No
Has the plan failed to provide any benefit when due under the plan2011-04-30No
Assets. Invements in employer securities at end of year2011-04-30$0
Assets. Invements in employer securities at beginning of year2011-04-30$0
Assets. Value of employer real property at end of year2011-04-30$0
Assets. Value of employer real property at beginning of year2011-04-30$0
Contributions received in cash from employer2011-04-30$1,079,302
Employer contributions (assets) at end of year2011-04-30$0
Employer contributions (assets) at beginning of year2011-04-30$0
Income. Dividends from preferred stock2011-04-30$0
Income. Dividends from common stock2011-04-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-04-30$1,141,244
Asset. Corporate debt instrument preferred debt at end of year2011-04-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2011-04-30$0
Asset. Corporate debt instrument debt (other) at end of year2011-04-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2011-04-30$0
Contract administrator fees2011-04-30$46,429
Assets. Corporate common stocks other than exployer securities at end of year2011-04-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-04-30$0
Liabilities. Value of benefit claims payable at end of year2011-04-30$0
Liabilities. Value of benefit claims payable at beginning of year2011-04-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2011-04-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-04-30$0
Did the plan have assets held for investment2011-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-04-30No
Aggregate proceeds on sale of assets2011-04-30$0
Aggregate carrying amount (costs) on sale of assets2011-04-30$0
Liabilities. Value of acquisition indebtedness at end of year2011-04-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-04-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-04-30No
Opinion of an independent qualified public accountant for this plan2011-04-30Unqualified
Accountancy firm name2011-04-30FALL CREEK ASSOCIATES, LLC
Accountancy firm EIN2011-04-30352134560

Form 5500 Responses for SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN

2021: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2009: SOUTHWESTERN HEALTHCARE, INC. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – TrustYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberCI 961529
Policy instance 7
Insurance contract or identification numberCI 961529
Number of Individuals Covered162
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,059
Total amount of fees paid to insurance companyUSD $1,655
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $13,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,059
Amount paid for insurance broker fees283
Additional information about fees paid to insurance brokerOVERRIDES
Insurance broker organization code?3
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number514
Policy instance 1
Insurance contract or identification number514
Number of Individuals Covered267
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,005
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,005
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI 961606
Policy instance 2
Insurance contract or identification numberAI 961606
Number of Individuals Covered162
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,924
Total amount of fees paid to insurance companyUSD $1,494
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,924
Amount paid for insurance broker fees212
Additional information about fees paid to insurance brokerOVERRIDES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12260799
Policy instance 3
Insurance contract or identification number12260799
Number of Individuals Covered204
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $1,464
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,464
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40049
Policy instance 4
Insurance contract or identification numberHCCLOT40049
Number of Individuals Covered227
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $4,545
Total amount of fees paid to insurance companyUSD $818
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $45,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,545
Amount paid for insurance broker fees818
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969586
Policy instance 5
Insurance contract or identification numberFLX969586
Number of Individuals Covered267
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,863
Total amount of fees paid to insurance companyUSD $3,005
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,901
Insurance broker organization code?3
Amount paid for insurance broker fees3005
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK966341
Policy instance 6
Insurance contract or identification numberLK966341
Number of Individuals Covered292
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,129
Total amount of fees paid to insurance companyUSD $2,738
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,150
Insurance broker organization code?3
Amount paid for insurance broker fees2738
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12260799
Policy instance 3
Insurance contract or identification number12260799
Number of Individuals Covered206
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $1,474
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,474
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40049
Policy instance 4
Insurance contract or identification numberHCCLOT40049
Number of Individuals Covered240
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,668
Total amount of fees paid to insurance companyUSD $840
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $46,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,668
Amount paid for insurance broker fees840
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969586
Policy instance 5
Insurance contract or identification numberFLX969586
Number of Individuals Covered313
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,842
Total amount of fees paid to insurance companyUSD $2,948
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,842
Insurance broker organization code?3
Amount paid for insurance broker fees2948
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK866341
Policy instance 6
Insurance contract or identification numberLK866341
Number of Individuals Covered290
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,746
Total amount of fees paid to insurance companyUSD $2,915
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,746
Insurance broker organization code?3
Amount paid for insurance broker fees2915
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK966341
Policy instance 2
Insurance contract or identification numberOK966341
Number of Individuals Covered313
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $997
Total amount of fees paid to insurance companyUSD $340
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,003
Insurance broker organization code?3
Amount paid for insurance broker fees340
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number514
Policy instance 1
Insurance contract or identification number514
Number of Individuals Covered313
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $5,509
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,509
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460047G
Policy instance 6
Insurance contract or identification number460047G
Number of Individuals Covered53
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,257
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $8,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,257
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460048G
Policy instance 5
Insurance contract or identification number460048G
Number of Individuals Covered51
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,162
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $7,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,162
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12260799
Policy instance 3
Insurance contract or identification number12260799
Number of Individuals Covered192
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,399
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,399
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number874514G
Policy instance 2
Insurance contract or identification number874514G
Number of Individuals Covered315
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $22,923
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $154,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,923
Insurance broker organization code?3
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number514
Policy instance 1
Insurance contract or identification number514
Number of Individuals Covered210
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $6,416
Total amount of fees paid to insurance companyUSD $910
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,416
Amount paid for insurance broker fees910
Additional information about fees paid to insurance brokerNEW BUSINESS BONUS, RETENTION BONUS
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40049
Policy instance 4
Insurance contract or identification numberHCCLOT40049
Number of Individuals Covered237
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,750
Total amount of fees paid to insurance companyUSD $855
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $47,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,750
Amount paid for insurance broker fees855
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460047G
Policy instance 6
Insurance contract or identification number460047G
Number of Individuals Covered29
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $517
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $3,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $503
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460048G
Policy instance 5
Insurance contract or identification number460048G
Number of Individuals Covered27
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $592
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $3,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $573
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40049
Policy instance 4
Insurance contract or identification numberHCCLOT40049
Number of Individuals Covered238
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $5,079
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $43,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,079
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12260799
Policy instance 3
Insurance contract or identification number12260799
Number of Individuals Covered185
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,334
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,334
Insurance broker organization code?3
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0000514
Policy instance 1
Insurance contract or identification number0000514
Number of Individuals Covered215
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $5,582
Total amount of fees paid to insurance companyUSD $811
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,582
Amount paid for insurance broker fees811
Additional information about fees paid to insurance brokerNEW BUSINESS BONUS, RETENTION BONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number874514G
Policy instance 2
Insurance contract or identification number874514G
Number of Individuals Covered301
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $22,289
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $138,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,947
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number874514G
Policy instance 2
Insurance contract or identification number874514G
Number of Individuals Covered279
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $22,063
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $132,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12260799
Policy instance 3
Insurance contract or identification number12260799
Number of Individuals Covered188
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,271
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4124
Policy instance 4
Insurance contract or identification number947-4124
Number of Individuals Covered121
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $5,069
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $42,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460048G
Policy instance 5
Insurance contract or identification number460048G
Number of Individuals Covered18
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $417
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $2,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number460047G
Policy instance 6
Insurance contract or identification number460047G
Number of Individuals Covered18
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $302
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $2,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF INDIANA (National Association of Insurance Commissioners NAIC id number: 52634 )
Policy contract number0000514
Policy instance 1
Insurance contract or identification number0000514
Number of Individuals Covered199
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $5,450
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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