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FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 401k Plan overview

Plan NameFRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN
Plan identification number 001

FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • 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.

401k Sponsoring company profile

FRIENDS OF FAMILY HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name:FRIENDS OF FAMILY HEALTH CENTER
Employer identification number (EIN):271316512
NAIC Classification:611000

Additional information about FRIENDS OF FAMILY HEALTH CENTER

Jurisdiction of Incorporation: California Department of State
Incorporation Date: 2009-10-01
Company Identification Number: C3114389
Legal Registered Office Address: 501 S. Idaho Street, #100

La Habra
United States of America (USA)
90631

More information about FRIENDS OF FAMILY HEALTH CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01
0012016-01-01DAWN TA2017-06-16
0012015-01-01DAWN TA2016-07-26
0012014-01-01DAWN TA2015-09-10
0012014-01-01DAWN TA2015-07-28
0012013-10-01DAWN TA2014-07-15

Plan Statistics for FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN

401k plan membership statisitcs for FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN

Measure Date Value
2023: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01195
Total number of active participants reported on line 7a of the Form 55002023-01-01154
Number of retired or separated participants receiving benefits2023-01-0113
Number of other retired or separated participants entitled to future benefits2023-01-0134
Total of all active and inactive participants2023-01-01201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01201
Number of participants with account balances2023-01-01127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01151
Total number of active participants reported on line 7a of the Form 55002022-01-01141
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0154
Total of all active and inactive participants2022-01-01195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01195
Number of participants with account balances2022-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01144
Total number of active participants reported on line 7a of the Form 55002021-01-01105
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0146
Total of all active and inactive participants2021-01-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01151
Number of participants with account balances2021-01-01116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01133
Total number of active participants reported on line 7a of the Form 55002020-01-0198
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0145
Total of all active and inactive participants2020-01-01143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01144
Number of participants with account balances2020-01-01112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-012
2019: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01123
Total number of active participants reported on line 7a of the Form 55002019-01-01100
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0133
Total of all active and inactive participants2019-01-01133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01133
Number of participants with account balances2019-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-015
2018: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01123
Total number of active participants reported on line 7a of the Form 55002018-01-01103
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0120
Total of all active and inactive participants2018-01-01123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01123
Number of participants with account balances2018-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN

Measure Date Value
2023 : FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-12-31$0
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total transfer of assets to this plan2023-12-31$0
Total transfer of assets from this plan2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$59,494
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$4,125
Total income from all sources (including contributions)2023-12-31$2,570,121
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$1,045,963
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$986,312
Expenses. Certain deemed distributions of participant loans2023-12-31$0
Value of total corrective distributions2023-12-31$59,494
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$1,293,222
Value of total assets at end of year2023-12-31$10,210,605
Value of total assets at beginning of year2023-12-31$8,631,078
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$157
Total interest from all sources2023-12-31$18,913
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$0
Assets. Real estate other than employer real property at end of year2023-12-31$0
Assets. Real estate other than employer real property at beginning of year2023-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2023-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2023-12-31$0
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$662,839
Participant contributions at end of year2023-12-31$14,468
Participant contributions at beginning of year2023-12-31$21,691
Participant contributions at end of year2023-12-31$0
Participant contributions at beginning of year2023-12-31$0
Assets. Other investments not covered elsewhere at end of year2023-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2023-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$164,260
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-12-31$24,232
Assets. Loans (other than to participants) at end of year2023-12-31$0
Assets. Loans (other than to participants) at beginning of year2023-12-31$0
Other income not declared elsewhere2023-12-31$0
Administrative expenses (other) incurred2023-12-31$157
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Income. Non cash contributions2023-12-31$0
Value of net income/loss2023-12-31$1,524,158
Value of net assets at end of year (total assets less liabilities)2023-12-31$10,151,111
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$8,626,953
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Assets. partnership/joint venture interests at end of year2023-12-31$0
Assets. partnership/joint venture interests at beginning of year2023-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$8,992,003
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$7,405,024
Value of interest in pooled separate accounts at end of year2023-12-31$0
Value of interest in pooled separate accounts at beginning of year2023-12-31$0
Interest on participant loans2023-12-31$93
Income. Interest from loans (other than to participants)2023-12-31$0
Interest earned on other investments2023-12-31$18,820
Income. Interest from US Government securities2023-12-31$0
Income. Interest from corporate debt instruments2023-12-31$0
Value of interest in master investment trust accounts at end of year2023-12-31$0
Value of interest in master investment trust accounts at beginning of year2023-12-31$0
Value of interest in common/collective trusts at end of year2023-12-31$0
Value of interest in common/collective trusts at beginning of year2023-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2023-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2023-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$1,176,310
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$1,195,736
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$0
Asset value of US Government securities at end of year2023-12-31$0
Asset value of US Government securities at beginning of year2023-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$0
Net investment gain/loss from pooled separate accounts2023-12-31$1,257,986
Net investment gain or loss from common/collective trusts2023-12-31$0
Net gain/loss from 103.12 investment entities2023-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31Yes
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$466,123
Employer contributions (assets) at end of year2023-12-31$27,824
Employer contributions (assets) at beginning of year2023-12-31$8,627
Income. Dividends from preferred stock2023-12-31$0
Income. Dividends from common stock2023-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$962,080
Asset. Corporate debt instrument preferred debt at end of year2023-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2023-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2023-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2023-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2023-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2023-12-31$0
Liabilities. Value of benefit claims payable at end of year2023-12-31$59,494
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$4,125
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Aggregate proceeds on sale of assets2023-12-31$0
Aggregate carrying amount (costs) on sale of assets2023-12-31$0
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31PDM, LLP
Accountancy firm EIN2023-12-31330783700
2022 : FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$4,125
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$36,111
Total income from all sources (including contributions)2022-12-31$-478,427
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$977,367
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$972,911
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Value of total corrective distributions2022-12-31$4,125
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$990,159
Value of total assets at end of year2022-12-31$8,631,078
Value of total assets at beginning of year2022-12-31$10,118,858
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$331
Total interest from all sources2022-12-31$1,766
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
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$0
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
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$544,279
Participant contributions at end of year2022-12-31$21,691
Participant contributions at beginning of year2022-12-31$52,159
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$65,707
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$331
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
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-1,455,794
Value of net assets at end of year (total assets less liabilities)2022-12-31$8,626,953
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$10,082,747
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
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$7,405,024
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$9,498,752
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$0
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$1,766
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,195,736
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$552,815
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-1,470,352
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
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$380,173
Employer contributions (assets) at end of year2022-12-31$8,627
Employer contributions (assets) at beginning of year2022-12-31$15,132
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$972,911
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Liabilities. Value of benefit claims payable at end of year2022-12-31$4,125
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$36,111
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
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PDM, LLP
Accountancy firm EIN2022-12-31330783700
2021 : FRIENDS OF FAMILY HEALTH CENTER 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$36,111
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$15,631
Total income from all sources (including contributions)2021-12-31$2,391,723
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$349,663
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$313,146
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$36,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$961,879
Value of total assets at end of year2021-12-31$10,118,858
Value of total assets at beginning of year2021-12-31$8,056,318
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$406
Total interest from all sources2021-12-31$6,486
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
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$512,768
Participant contributions at end of year2021-12-31$52,159
Participant contributions at beginning of year2021-12-31$77,850
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$39,807
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$406
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$2,042,060
Value of net assets at end of year (total assets less liabilities)2021-12-31$10,082,747
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,040,687
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$9,498,752
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,852,257
Interest on participant loans2021-12-31$0
Interest earned on other investments2021-12-31$6,486
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$552,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,126,211
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$1,423,358
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$409,304
Employer contributions (assets) at end of year2021-12-31$15,132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$313,146
Liabilities. Value of benefit claims payable at end of year2021-12-31$36,111
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$15,631
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 name2021-12-31PDM, LLP
Accountancy firm EIN2021-12-31330783700
2020 : FRIENDS OF FAMILY HEALTH CENTER 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$15,631
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$1,654,156
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$101,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$85,579
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$15,631
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$866,006
Value of total assets at end of year2020-12-31$8,056,318
Value of total assets at beginning of year2020-12-31$6,488,212
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$471
Total interest from all sources2020-12-31$11,692
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
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$507,885
Participant contributions at end of year2020-12-31$77,850
Participant contributions at beginning of year2020-12-31$107,881
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$20,953
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$471
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$1,552,475
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,040,687
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,488,212
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$6,852,257
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,366,516
Interest on participant loans2020-12-31$0
Interest earned on other investments2020-12-31$11,692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,126,211
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,013,815
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from pooled separate accounts2020-12-31$776,458
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$337,168
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$85,579
Liabilities. Value of benefit claims payable at end of year2020-12-31$15,631
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 name2020-12-31PDM, LLP
Accountancy firm EIN2020-12-31330783700
2019 : FRIENDS OF FAMILY HEALTH CENTER 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$2,013,930
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$203,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$172,860
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$30,266
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$958,864
Value of total assets at end of year2019-12-31$6,488,212
Value of total assets at beginning of year2019-12-31$4,677,929
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$521
Total interest from all sources2019-12-31$6,192
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
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$495,122
Participant contributions at end of year2019-12-31$107,881
Participant contributions at beginning of year2019-12-31$184,018
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$89,536
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$521
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$1,810,283
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,488,212
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,677,929
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$5,366,516
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,453,856
Interest on participant loans2019-12-31$0
Interest earned on other investments2019-12-31$6,192
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,013,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$40,055
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$1,048,874
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$374,206
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$172,860
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 name2019-12-31PDM, LLP
Accountancy firm EIN2019-12-31330783700
2018 : FRIENDS OF FAMILY HEALTH CENTER 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$632,056
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$125,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$96,652
Expenses. Certain deemed distributions of participant loans2018-12-31$1,290
Value of total corrective distributions2018-12-31$25,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$807,214
Value of total assets at end of year2018-12-31$4,677,929
Value of total assets at beginning of year2018-12-31$4,171,276
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,073
Total interest from all sources2018-12-31$8,700
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$200,000
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$387,526
Participant contributions at end of year2018-12-31$184,018
Participant contributions at beginning of year2018-12-31$111,196
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$164,463
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$2,073
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$506,653
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,677,929
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$4,171,276
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$4,453,856
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,783,091
Interest on participant loans2018-12-31$5,555
Interest earned on other investments2018-12-31$3,145
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$40,055
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$276,989
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-183,858
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$255,225
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$96,652
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 name2018-12-31PDM, LLP
Accountancy firm EIN2018-12-31330783700

Form 5500 Responses for FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN

2023: FRIENDS OF FAMILY HEALTH CENTER 403(B) PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: FRIENDS OF FAMILY HEALTH CENTER 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 benefit arrangement – InsuranceYes
2021: FRIENDS OF FAMILY HEALTH CENTER 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 benefit arrangement – InsuranceYes
2020: FRIENDS OF FAMILY HEALTH CENTER 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 benefit arrangement – InsuranceYes
2019: FRIENDS OF FAMILY HEALTH CENTER 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 – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: FRIENDS OF FAMILY HEALTH CENTER 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 – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number61669
Policy instance 1
Insurance contract or identification number61669
Number of Individuals Covered201
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,170
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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061669
Policy instance 1
Insurance contract or identification number061669
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,676
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
Amount paid for insurance broker fees3676
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061669B
Policy instance 1
Insurance contract or identification number061669B
Number of Individuals Covered118
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,656
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3656
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061669B
Policy instance 1
Insurance contract or identification number061669B
Number of Individuals Covered115
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,656
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3656
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061669B
Policy instance 1
Insurance contract or identification number061669B
Number of Individuals Covered116
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $27,103
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees27103
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061669B
Policy instance 1
Insurance contract or identification number061669B
Number of Individuals Covered107
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

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