401k Plan data: PROVIDENCE CARE, LLC 401K PLAN plan

PROVIDENCE CARE, LLC 401K PLAN 401k Plan overview

Plan Name	PROVIDENCE CARE, LLC 401K PLAN
Plan identification number	001

PROVIDENCE CARE, LLC 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
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.
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

PROVIDENCE CARE, LLC has sponsored the creation of one or more 401k plans.

Company Name: PROVIDENCE CARE, LLC

Employer identification number (EIN): 273713863

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENCE CARE, LLC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2020-01-01

Plan Statistics for PROVIDENCE CARE, LLC 401K PLAN

401k plan membership statisitcs for PROVIDENCE CARE, LLC 401K PLAN

Measure Date Value
2022: PROVIDENCE CARE, LLC 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 182
Number of retired or separated participants receiving benefits 2022-01-01 3
Number of other retired or separated participants entitled to future benefits 2022-01-01 22
Total of all active and inactive participants 2022-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 207
Number of participants with account balances 2022-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 18
2021: PROVIDENCE CARE, LLC 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 165
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 13
Total of all active and inactive participants 2021-01-01 181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 181
Number of participants with account balances 2021-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: PROVIDENCE CARE, LLC 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 171
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 2
Total of all active and inactive participants 2020-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 174
Number of participants with account balances 2020-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 4

Measure	Date	Value
2022: PROVIDENCE CARE, LLC 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	182
Number of retired or separated participants receiving benefits	2022-01-01	3
Number of other retired or separated participants entitled to future benefits	2022-01-01	22
Total of all active and inactive participants	2022-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	207
Number of participants with account balances	2022-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	18
2021: PROVIDENCE CARE, LLC 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	165
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	13
Total of all active and inactive participants	2021-01-01	181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	181
Number of participants with account balances	2021-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: PROVIDENCE CARE, LLC 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	171
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	2
Total of all active and inactive participants	2020-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	174
Number of participants with account balances	2020-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	4

Financial Data on PROVIDENCE CARE, LLC 401K PLAN

Measure	Date	Value
2022 : PROVIDENCE CARE, LLC 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$129,418
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$54,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$51,587
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$211,187
Value of total assets at end of year	2022-12-31	$535,538
Value of total assets at beginning of year	2022-12-31	$460,362
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,655
Total interest from all sources	2022-12-31	$142
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$15,000
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$15,000
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$171,051
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$174
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$13,664
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$1,272
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$75,176
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$535,538
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$460,362
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$1,383
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$521,974
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$455,595
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$13,564
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$4,593
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$4,593
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$142
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-96,911
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$26,472
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$51,587
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	APRIO, LLP
Accountancy firm EIN	2022-12-31	571157523
2021 : PROVIDENCE CARE, LLC 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$232,034
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$14,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$12,646
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$188,243
Value of total assets at end of year	2021-12-31	$460,362
Value of total assets at beginning of year	2021-12-31	$242,488
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$1,514
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$48,809
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$48,809
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$50,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$166,597
Participant contributions at end of year	2021-12-31	$174
Participant contributions at beginning of year	2021-12-31	$14,360
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$288
Administrative expenses (other) incurred	2021-12-31	$599
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$217,874
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$460,362
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$242,488
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$915
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$455,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$222,967
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$4,593
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$3,142
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$3,142
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$-5,018
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$21,646
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$1,731
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$12,646
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	APRIO, LLP
Accountancy firm EIN	2021-12-31	571157523
2020 : PROVIDENCE CARE, LLC 401K PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$229,360
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,963
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,472
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$190,946
Value of total assets at end of year	2020-12-31	$226,397
Value of total assets at beginning of year	2020-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$491
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$6,049
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$6,049
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$50,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$157,840
Participant contributions at end of year	2020-12-31	$14,360
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$16,483
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$288
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$235
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$226,397
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$226,397
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$256
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$222,967
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$3,142
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$32,365
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$16,623
Employer contributions (assets) at end of year	2020-12-31	$1,731
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$2,472
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	APRIO, LLP
Accountancy firm EIN	2020-12-31	571157523

Form 5500 Responses for PROVIDENCE CARE, LLC 401K PLAN

2022: PROVIDENCE CARE, LLC 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PROVIDENCE CARE, LLC 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PROVIDENCE CARE, LLC 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PROVIDENCE CARE, LLC
Employer identification number (EIN):	273713863
NAIC Classification:	621610
NAIC Description:	Home Health Care Services