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ADULT & CHILD HEALTH 401(K) PLAN 401k Plan overview

Plan NameADULT & CHILD HEALTH 401(K) PLAN
Plan identification number 003

ADULT & CHILD HEALTH 401(K) PLAN Benefits

401k Plan TypeDefined 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

ADULT AND CHILD MENTAL HEALTH CTR. has sponsored the creation of one or more 401k plans.

Company Name:ADULT AND CHILD MENTAL HEALTH CTR.
Employer identification number (EIN):351534713
NAIC Classification:621330
NAIC Description:Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADULT & CHILD HEALTH 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032023-01-01
0032022-01-01
0032021-01-01
0032020-01-01
0032019-01-01
0032018-01-01
0032017-01-01JOSEPH F. BREYER
0032016-01-01JOSEPH F. BREYER
0032015-01-01JOSEPH F. BREYER
0032014-01-01JOSEPH BREYER JOSEPH BREYER2015-10-10
0032013-01-01JOSEPH BREYER JOSEPH BREYER2014-10-09
0032012-01-01JOSEPH BREYER JOSEPH BREYER2013-10-11
0032011-01-01JOSEPH BREYER JOSEPH BREYER2012-10-12
0032009-01-01JOSEPH BREYER JOSEPH BREYER2010-10-14
0032009-01-01JOSEPH BREYER JOSEPH BREYER2010-10-14

Plan Statistics for ADULT & CHILD HEALTH 401(K) PLAN

401k plan membership statisitcs for ADULT & CHILD HEALTH 401(K) PLAN

Measure Date Value
2023: ADULT & CHILD HEALTH 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01834
Total number of active participants reported on line 7a of the Form 55002023-01-01531
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-01271
Total of all active and inactive participants2023-01-01802
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01802
Number of participants with account balances2023-01-01783
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: ADULT & CHILD HEALTH 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01868
Total number of active participants reported on line 7a of the Form 55002022-01-01516
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01301
Total of all active and inactive participants2022-01-01817
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01817
Number of participants with account balances2022-01-01799
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ADULT & CHILD HEALTH 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,014
Total number of active participants reported on line 7a of the Form 55002021-01-01508
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01333
Total of all active and inactive participants2021-01-01841
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01841
Number of participants with account balances2021-01-01821
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: ADULT & CHILD HEALTH 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,026
Total number of active participants reported on line 7a of the Form 55002020-01-01488
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01498
Total of all active and inactive participants2020-01-01986
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01987
Number of participants with account balances2020-01-01952
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ADULT & CHILD HEALTH 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01951
Total number of active participants reported on line 7a of the Form 55002019-01-01542
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01481
Total of all active and inactive participants2019-01-011,023
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-011,023
Number of participants with account balances2019-01-011,017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: ADULT & CHILD HEALTH 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01952
Total number of active participants reported on line 7a of the Form 55002018-01-01526
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01424
Total of all active and inactive participants2018-01-01950
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01951
Number of participants with account balances2018-01-01932
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: ADULT & CHILD HEALTH 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01837
Total number of active participants reported on line 7a of the Form 55002017-01-01599
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01353
Total of all active and inactive participants2017-01-01952
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01952
Number of participants with account balances2017-01-01915
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ADULT & CHILD HEALTH 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01582
Total number of active participants reported on line 7a of the Form 55002016-01-01594
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-01243
Total of all active and inactive participants2016-01-01837
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01837
Number of participants with account balances2016-01-01818
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-01149
2015: ADULT & CHILD HEALTH 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01521
Total number of active participants reported on line 7a of the Form 55002015-01-01390
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-01192
Total of all active and inactive participants2015-01-01582
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01582
Number of participants with account balances2015-01-01582
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0184
2014: ADULT & CHILD HEALTH 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01470
Total number of active participants reported on line 7a of the Form 55002014-01-01359
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-01162
Total of all active and inactive participants2014-01-01521
Total participants2014-01-01521
Number of participants with account balances2014-01-01521
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0158
2013: ADULT & CHILD HEALTH 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01440
Total number of active participants reported on line 7a of the Form 55002013-01-01346
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-01124
Total of all active and inactive participants2013-01-01470
Total participants2013-01-01470
Number of participants with account balances2013-01-01470
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0132
2012: ADULT & CHILD HEALTH 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01410
Total number of active participants reported on line 7a of the Form 55002012-01-01331
Number of other retired or separated participants entitled to future benefits2012-01-01109
Total of all active and inactive participants2012-01-01440
Total participants2012-01-01440
Number of participants with account balances2012-01-01440
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0117
2011: ADULT & CHILD HEALTH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01399
Total number of active participants reported on line 7a of the Form 55002011-01-01300
Number of other retired or separated participants entitled to future benefits2011-01-01110
Total of all active and inactive participants2011-01-01410
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-01411
Number of participants with account balances2011-01-01410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0129
2009: ADULT & CHILD HEALTH 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01319
Total number of active participants reported on line 7a of the Form 55002009-01-01333
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-0186
Total of all active and inactive participants2009-01-01420
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01421
Number of participants with account balances2009-01-01421
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0150

Financial Data on ADULT & CHILD HEALTH 401(K) PLAN

Measure Date Value
2023 : ADULT & CHILD HEALTH 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$6,091,985
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$2,401,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$2,324,385
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$2,631,450
Value of total assets at end of year2023-12-31$22,137,170
Value of total assets at beginning of year2023-12-31$18,446,189
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$76,619
Total interest from all sources2023-12-31$15,386
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$458,671
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$458,671
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$1,559,035
Participant contributions at end of year2023-12-31$286,119
Participant contributions at beginning of year2023-12-31$294,559
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$134,520
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
Value of net income/loss2023-12-31$3,690,981
Value of net assets at end of year (total assets less liabilities)2023-12-31$22,137,170
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$18,446,189
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$21,692,942
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$17,991,988
Interest on participant loans2023-12-31$15,386
Income. Interest from loans (other than to participants)2023-12-31$0
Value of interest in common/collective trusts at end of year2023-12-31$158,084
Value of interest in common/collective trusts at beginning of year2023-12-31$159,642
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$2,982,448
Net investment gain or loss from common/collective trusts2023-12-31$4,030
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 contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$937,895
Employer contributions (assets) at end of year2023-12-31$25
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$2,324,385
Contract administrator fees2023-12-31$76,619
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
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31BLUE & CO LLC
Accountancy firm EIN2023-12-31351178661
2022 : ADULT & CHILD HEALTH 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,267,733
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,915,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,841,370
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,667,051
Value of total assets at end of year2022-12-31$18,446,189
Value of total assets at beginning of year2022-12-31$22,628,953
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$73,661
Total interest from all sources2022-12-31$12,381
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$348,677
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$348,677
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$1,530,373
Participant contributions at end of year2022-12-31$294,559
Participant contributions at beginning of year2022-12-31$251,025
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$237,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,182,764
Value of net assets at end of year (total assets less liabilities)2022-12-31$18,446,189
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$22,628,953
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$-7,989
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$17,991,988
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$22,331,400
Interest on participant loans2022-12-31$12,381
Income. Interest from loans (other than to participants)2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$159,642
Value of interest in common/collective trusts at beginning of year2022-12-31$46,528
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,297,863
Net investment gain or loss from common/collective trusts2022-12-31$2,021
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$899,494
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,841,370
Contract administrator fees2022-12-31$81,650
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BLUE & CO LLC
Accountancy firm EIN2022-12-31351178661
2021 : ADULT & CHILD HEALTH 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$5,408,374
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,394,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,340,755
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,450,124
Value of total assets at end of year2021-12-31$22,628,953
Value of total assets at beginning of year2021-12-31$19,615,186
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$53,852
Total interest from all sources2021-12-31$12,056
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$340,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$340,664
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$1,401,378
Participant contributions at end of year2021-12-31$251,025
Participant contributions at beginning of year2021-12-31$250,280
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$231,532
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,013,767
Value of net assets at end of year (total assets less liabilities)2021-12-31$22,628,953
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$19,615,186
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$22,331,400
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$19,247,041
Interest on participant loans2021-12-31$12,056
Income. Interest from loans (other than to participants)2021-12-31$0
Value of interest in common/collective trusts at end of year2021-12-31$46,528
Value of interest in common/collective trusts at beginning of year2021-12-31$117,439
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$2,603,948
Net investment gain or loss from common/collective trusts2021-12-31$1,582
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$817,214
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$426
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,340,755
Contract administrator fees2021-12-31$53,852
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 name2021-12-31BLUE & CO LLC
Accountancy firm EIN2021-12-31351178661
2020 : ADULT & CHILD HEALTH 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$4,978,230
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$6,241,178
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$6,234,630
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,134,406
Value of total assets at end of year2020-12-31$19,615,186
Value of total assets at beginning of year2020-12-31$20,878,134
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,548
Total interest from all sources2020-12-31$2,288
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$277,386
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$277,386
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,181,565
Participant contributions at end of year2020-12-31$250,280
Participant contributions at beginning of year2020-12-31$341,990
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$47,930
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$214,627
Administrative expenses (other) incurred2020-12-31$3,488
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-1,262,948
Value of net assets at end of year (total assets less liabilities)2020-12-31$19,615,186
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$20,878,134
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$19,247,041
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$17,729,625
Interest on participant loans2020-12-31$2,288
Income. Interest from loans (other than to participants)2020-12-31$0
Value of interest in common/collective trusts at end of year2020-12-31$117,439
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,727,591
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,563,854
Net investment gain or loss from common/collective trusts2020-12-31$296
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$738,214
Employer contributions (assets) at end of year2020-12-31$426
Employer contributions (assets) at beginning of year2020-12-31$30,998
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$6,234,630
Contract administrator fees2020-12-31$3,060
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31BLUE & CO LLC
Accountancy firm EIN2020-12-31351178661
2019 : ADULT & CHILD HEALTH 401(K) 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$6,013,843
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,373,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,373,727
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,460,967
Value of total assets at end of year2019-12-31$20,878,134
Value of total assets at beginning of year2019-12-31$16,238,018
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$0
Total interest from all sources2019-12-31$60,391
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$1,279,862
Participant contributions at end of year2019-12-31$341,990
Participant contributions at beginning of year2019-12-31$345,789
Participant contributions at end of year2019-12-31$47,930
Participant contributions at beginning of year2019-12-31$46,763
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$380,120
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$4,640,116
Value of net assets at end of year (total assets less liabilities)2019-12-31$20,878,134
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$16,238,018
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$17,729,625
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$13,547,352
Interest on participant loans2019-12-31$16,154
Interest earned on other investments2019-12-31$44,237
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,727,591
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,268,255
Net investment gain/loss from pooled separate accounts2019-12-31$3,492,485
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$800,985
Employer contributions (assets) at end of year2019-12-31$30,998
Employer contributions (assets) at beginning of year2019-12-31$29,859
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,373,727
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 name2019-12-31BLUE & CO LLC
Accountancy firm EIN2019-12-31351178661
2018 : ADULT & CHILD HEALTH 401(K) 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$1,278,013
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,267,328
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,267,328
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,414,708
Value of total assets at end of year2018-12-31$16,238,018
Value of total assets at beginning of year2018-12-31$16,227,333
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$0
Total interest from all sources2018-12-31$35,464
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$500,000
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$1,213,856
Participant contributions at end of year2018-12-31$345,789
Participant contributions at beginning of year2018-12-31$317,499
Participant contributions at end of year2018-12-31$46,763
Participant contributions at beginning of year2018-12-31$46,549
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$409,334
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$10,685
Value of net assets at end of year (total assets less liabilities)2018-12-31$16,238,018
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$16,227,333
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$13,547,352
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$13,660,781
Interest on participant loans2018-12-31$13,642
Interest earned on other investments2018-12-31$21,822
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$2,268,255
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$2,171,521
Net investment gain/loss from pooled separate accounts2018-12-31$-1,172,159
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$791,518
Employer contributions (assets) at end of year2018-12-31$29,859
Employer contributions (assets) at beginning of year2018-12-31$30,983
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,267,328
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 name2018-12-31BLUE & CO LLC
Accountancy firm EIN2018-12-31351178661
2017 : ADULT & CHILD HEALTH 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$4,602,775
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,133,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,133,507
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,546,990
Value of total assets at end of year2017-12-31$16,227,333
Value of total assets at beginning of year2017-12-31$12,758,065
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$0
Total interest from all sources2017-12-31$36,054
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,244,346
Participant contributions at end of year2017-12-31$317,499
Participant contributions at beginning of year2017-12-31$321,511
Participant contributions at end of year2017-12-31$46,549
Participant contributions at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$495,056
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,469,268
Value of net assets at end of year (total assets less liabilities)2017-12-31$16,227,333
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$12,758,065
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$13,660,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$10,570,395
Interest on participant loans2017-12-31$11,888
Interest earned on other investments2017-12-31$24,166
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$2,171,521
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$1,785,224
Net investment gain/loss from pooled separate accounts2017-12-31$2,019,731
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$807,588
Employer contributions (assets) at end of year2017-12-31$30,983
Employer contributions (assets) at beginning of year2017-12-31$80,935
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,133,507
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31BLUE & CO LLC
Accountancy firm EIN2017-12-31351178661
2016 : ADULT & CHILD HEALTH 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$3,175,077
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$2,323,626
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,279,990
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,135,359
Value of total assets at end of year2016-12-31$12,758,065
Value of total assets at beginning of year2016-12-31$11,906,614
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$43,636
Total interest from all sources2016-12-31$33,040
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,176,865
Participant contributions at end of year2016-12-31$321,511
Participant contributions at beginning of year2016-12-31$254,519
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$468,884
Administrative expenses (other) incurred2016-12-31$43,636
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$851,451
Value of net assets at end of year (total assets less liabilities)2016-12-31$12,758,065
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$11,906,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$10,570,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$9,815,741
Interest on participant loans2016-12-31$10,268
Interest earned on other investments2016-12-31$22,772
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$1,785,224
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,836,354
Net investment gain/loss from pooled separate accounts2016-12-31$1,006,678
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$489,610
Employer contributions (assets) at end of year2016-12-31$80,935
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,279,990
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BLUE & CO LLC
Accountancy firm EIN2016-12-31351178661
2015 : ADULT & CHILD HEALTH 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,383,925
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,682,890
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,648,051
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,409,160
Value of total assets at end of year2015-12-31$11,906,614
Value of total assets at beginning of year2015-12-31$13,205,579
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$34,839
Total interest from all sources2015-12-31$30,733
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$784,856
Participant contributions at end of year2015-12-31$254,519
Participant contributions at beginning of year2015-12-31$268,121
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$324,861
Administrative expenses (other) incurred2015-12-31$34,839
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-1,298,965
Value of net assets at end of year (total assets less liabilities)2015-12-31$11,906,614
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$13,205,579
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$9,815,741
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$9,805,656
Interest on participant loans2015-12-31$10,110
Interest earned on other investments2015-12-31$20,623
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,836,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$3,131,802
Net investment gain/loss from pooled separate accounts2015-12-31$-55,968
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$299,443
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,648,051
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BLUE & CO LLC
Accountancy firm EIN2015-12-31351178661
2014 : ADULT & CHILD HEALTH 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$1,949,739
Total of all expenses incurred2014-12-31$1,419,987
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,417,741
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,172,476
Value of total assets at end of year2014-12-31$13,205,579
Value of total assets at beginning of year2014-12-31$12,675,827
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,246
Total interest from all sources2014-12-31$34,876
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$731,873
Participant contributions at end of year2014-12-31$268,122
Participant contributions at beginning of year2014-12-31$235,458
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$165,790
Other income not declared elsewhere2014-12-31$0
Administrative expenses (other) incurred2014-12-31$2,246
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$529,752
Value of net assets at end of year (total assets less liabilities)2014-12-31$13,205,579
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$12,675,827
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$9,805,655
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$10,460,741
Value of interest in pooled separate accounts at beginning of year2014-12-31$0
Interest on participant loans2014-12-31$9,976
Interest earned on other investments2014-12-31$24,900
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$3,131,802
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,979,628
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$742,387
Net investment gain/loss from pooled separate accounts2014-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$274,813
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,417,741
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31BLUE & CO LLC
Accountancy firm EIN2014-12-31351178661
2013 : ADULT & CHILD HEALTH 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$3,150,063
Total of all expenses incurred2013-12-31$599,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$597,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,039,682
Value of total assets at end of year2013-12-31$12,675,827
Value of total assets at beginning of year2013-12-31$10,124,967
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,815
Total interest from all sources2013-12-31$29,044
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$667,621
Participant contributions at end of year2013-12-31$235,458
Participant contributions at beginning of year2013-12-31$250,872
Participant contributions at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$127,749
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$1,815
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$2,550,860
Value of net assets at end of year (total assets less liabilities)2013-12-31$12,675,827
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$10,124,967
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$10,460,741
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$8,124,366
Value of interest in pooled separate accounts at end of year2013-12-31$0
Value of interest in pooled separate accounts at beginning of year2013-12-31$0
Interest on participant loans2013-12-31$8,133
Interest earned on other investments2013-12-31$20,911
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,979,628
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,749,729
Net investment gain/loss from pooled separate accounts2013-12-31$2,081,337
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$244,312
Employer contributions (assets) at beginning of year2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$597,388
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31BLUE & CO LLC
Accountancy firm EIN2013-12-31351178661
2012 : ADULT & CHILD HEALTH 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$2,528,498
Total of all expenses incurred2012-12-31$604,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$603,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,588,002
Value of total assets at end of year2012-12-31$10,124,967
Value of total assets at beginning of year2012-12-31$8,201,040
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,262
Total interest from all sources2012-12-31$35,693
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$626,954
Participant contributions at end of year2012-12-31$250,872
Participant contributions at beginning of year2012-12-31$273,073
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$23,812
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$716,456
Administrative expenses (other) incurred2012-12-31$1,262
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,923,927
Value of net assets at end of year (total assets less liabilities)2012-12-31$10,124,967
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,201,040
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in pooled separate accounts at end of year2012-12-31$8,124,366
Value of interest in pooled separate accounts at beginning of year2012-12-31$6,437,310
Interest on participant loans2012-12-31$10,451
Interest earned on other investments2012-12-31$25,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$1,749,729
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$1,456,934
Net investment gain/loss from pooled separate accounts2012-12-31$904,803
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$244,592
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$9,911
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$603,309
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31BLUE & CO LLC
Accountancy firm EIN2012-12-31351178661
2011 : ADULT & CHILD HEALTH 401(K) PLAN 2011 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$869,930
Total of all expenses incurred2011-12-31$1,461,438
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,460,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$947,449
Value of total assets at end of year2011-12-31$8,201,040
Value of total assets at beginning of year2011-12-31$8,792,548
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,250
Total interest from all sources2011-12-31$36,514
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$597,418
Participant contributions at end of year2011-12-31$273,073
Participant contributions at beginning of year2011-12-31$237,156
Participant contributions at end of year2011-12-31$23,812
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$259,470
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-591,508
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,201,040
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$8,792,548
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$6,437,310
Value of interest in pooled separate accounts at beginning of year2011-12-31$7,259,416
Interest on participant loans2011-12-31$9,156
Interest earned on other investments2011-12-31$27,358
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$1,456,934
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$1,295,976
Net investment gain/loss from pooled separate accounts2011-12-31$-114,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$90,561
Employer contributions (assets) at end of year2011-12-31$9,911
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,460,188
Contract administrator fees2011-12-31$1,250
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31BLUE & CO LLC
Accountancy firm EIN2011-12-31351178661
2009 : ADULT & CHILD HEALTH 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for ADULT & CHILD HEALTH 401(K) PLAN

2023: ADULT & CHILD HEALTH 401(K) 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 – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: ADULT & CHILD HEALTH 401(K) 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 – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ADULT & CHILD HEALTH 401(K) 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ADULT & CHILD HEALTH 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ADULT & CHILD HEALTH 401(K) 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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: ADULT & CHILD HEALTH 401(K) 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 funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: ADULT & CHILD HEALTH 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ADULT & CHILD HEALTH 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ADULT & CHILD HEALTH 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ADULT & CHILD HEALTH 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ADULT & CHILD HEALTH 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: ADULT & CHILD HEALTH 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ADULT & CHILD HEALTH 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: ADULT & CHILD HEALTH 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered0
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 $3,337
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 fees3337
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 number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered1023
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 $3,607
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 fees3607
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 number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered951
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,035
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 fees4035
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 number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered952
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,993
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 fees3993
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered582
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $887
Are there contracts with allocated funds for individual policies?No
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 fees887
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered521
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,225
Contracts With Unallocated Funds Deposit Administration1
Amount paid for insurance broker fees1225
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered470
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,803
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1803
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered440
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,754
Contracts With Unallocated Funds Deposit Administration1
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 fees555
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameRICKIE HALL
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number050862-G
Policy instance 1
Insurance contract or identification number050862-G
Number of Individuals Covered411
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,603
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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