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SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 401k Plan overview

Plan NameSAGE HEALTH SERVICES OF INDIANA INC 401K PLAN
Plan identification number 001

SAGE HEALTH SERVICES OF INDIANA INC 401K 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SAGE HEALTH SERVICES OF INDIANA INC has sponsored the creation of one or more 401k plans.

Company Name:SAGE HEALTH SERVICES OF INDIANA INC
Employer identification number (EIN):351811450
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about SAGE HEALTH SERVICES OF INDIANA INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2243551

More information about SAGE HEALTH SERVICES OF INDIANA INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01KENNETH B ROSS2021-03-23
0012019-01-01KENNETH B. ROSS2020-05-18
0012018-01-01KENNETH B. ROSS2019-05-08
0012017-01-01KENNETH B. ROSS2018-05-14
0012016-01-01KENNETH B. ROSS2017-05-11
0012015-01-01KENNETH B. ROSS
0012014-01-01KENNETH B ROSS
0012013-01-01KENNETH B. ROSS KENNETH B. ROSS2014-10-15
0012012-01-01KENNETH B. ROSS
0012011-01-01KENNETH B. ROSS
0012009-01-01KENNETH B ROSS

Plan Statistics for SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN

401k plan membership statisitcs for SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN

Measure Date Value
2015: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01144
Total number of active participants reported on line 7a of the Form 55002015-01-0117
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0112
Total of all active and inactive participants2015-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0129
Number of participants with account balances2015-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01166
Total number of active participants reported on line 7a of the Form 55002014-01-01104
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0110
Total of all active and inactive participants2014-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01114
Number of participants with account balances2014-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01145
Total number of active participants reported on line 7a of the Form 55002013-01-01161
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-01166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01166
Number of participants with account balances2013-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01135
Total number of active participants reported on line 7a of the Form 55002012-01-01141
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-014
Total of all active and inactive participants2012-01-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01145
Number of participants with account balances2012-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01133
Total number of active participants reported on line 7a of the Form 55002011-01-01133
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01135
Number of participants with account balances2011-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01145
Total number of active participants reported on line 7a of the Form 55002009-01-01118
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0110
Total of all active and inactive participants2009-01-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01128
Number of participants with account balances2009-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-014

Financial Data on SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN

Measure Date Value
2015 : SAGE HEALTH SERVICES OF INDIANA INC 401K 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$2,579
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,014
Total income from all sources (including contributions)2015-12-31$111,577
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$701,985
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$688,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$92,643
Value of total assets at end of year2015-12-31$712,053
Value of total assets at beginning of year2015-12-31$1,301,896
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$13,114
Total interest from all sources2015-12-31$68
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$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$85,583
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$36,055
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$2,579
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$2,014
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-590,408
Value of net assets at end of year (total assets less liabilities)2015-12-31$709,474
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,299,882
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
Investment advisory and management fees2015-12-31$13,114
Value of interest in pooled separate accounts at end of year2015-12-31$566,973
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,074,363
Income. Interest from loans (other than to participants)2015-12-31$68
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$145,080
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$191,478
Net investment gain/loss from pooled separate accounts2015-12-31$18,866
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$7,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$688,871
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 name2015-12-31HARDING, SHYMANSKI & CO, PSC
Accountancy firm EIN2015-12-31351346211
2014 : SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,014
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,081
Total income from all sources (including contributions)2014-12-31$193,711
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$124,430
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$113,080
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$143,838
Value of total assets at end of year2014-12-31$1,301,896
Value of total assets at beginning of year2014-12-31$1,232,682
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$11,350
Total interest from all sources2014-12-31$1,954
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
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$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$128,734
Participant contributions at end of year2014-12-31$36,055
Participant contributions at beginning of year2014-12-31$57,444
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$2,014
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$2,081
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$69,281
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,299,882
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,230,601
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
Investment advisory and management fees2014-12-31$11,350
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$1,074,363
Value of interest in pooled separate accounts at beginning of year2014-12-31$1,013,098
Interest on participant loans2014-12-31$1,954
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$191,478
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$162,140
Net investment gain/loss from pooled separate accounts2014-12-31$47,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$15,104
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$113,080
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 name2014-12-31HARDING, SHYMANSKI & CO., PSC
Accountancy firm EIN2014-12-31351346211
2013 : SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,081
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,349
Total income from all sources (including contributions)2013-12-31$303,258
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$27,678
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$16,220
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$138,597
Value of total assets at end of year2013-12-31$1,232,682
Value of total assets at beginning of year2013-12-31$957,370
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$11,458
Total interest from all sources2013-12-31$2,083
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
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$1,000,000
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$123,629
Participant contributions at end of year2013-12-31$57,444
Participant contributions at beginning of year2013-12-31$53,944
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$2,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$2,349
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$275,580
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,230,601
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$955,021
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
Investment advisory and management fees2013-12-31$11,458
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$0
Value of interest in pooled separate accounts at end of year2013-12-31$1,013,098
Value of interest in pooled separate accounts at beginning of year2013-12-31$853,347
Interest on participant loans2013-12-31$2,083
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$162,140
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$50,079
Net investment gain/loss from pooled separate accounts2013-12-31$162,578
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 contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$14,968
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$16,220
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 name2013-12-31HARDING, SHYMANSKI & CO., PSC
Accountancy firm EIN2013-12-31351346211
2012 : SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,349
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,182
Total income from all sources (including contributions)2012-12-31$232,658
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$11,834
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$370
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$124,802
Value of total assets at end of year2012-12-31$957,370
Value of total assets at beginning of year2012-12-31$735,379
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$11,464
Total interest from all sources2012-12-31$758
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
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$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$111,862
Participant contributions at end of year2012-12-31$53,944
Participant contributions at beginning of year2012-12-31$7,973
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$2,349
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$1,182
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$220,824
Value of net assets at end of year (total assets less liabilities)2012-12-31$955,021
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$734,197
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
Investment advisory and management fees2012-12-31$11,464
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in pooled separate accounts at end of year2012-12-31$853,347
Value of interest in pooled separate accounts at beginning of year2012-12-31$690,153
Interest on participant loans2012-12-31$758
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$50,079
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$37,253
Net investment gain/loss from pooled separate accounts2012-12-31$107,098
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 contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$12,940
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$370
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 name2012-12-31HARDING, SHYMANSKI & CO., PSC
Accountancy firm EIN2012-12-31351346211
2011 : SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,182
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,429
Total income from all sources (including contributions)2011-12-31$87,475
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$61,201
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$57,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$107,784
Value of total assets at end of year2011-12-31$735,379
Value of total assets at beginning of year2011-12-31$709,352
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$3,647
Total interest from all sources2011-12-31$105
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
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$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$97,738
Participant contributions at end of year2011-12-31$7,973
Participant contributions at beginning of year2011-12-31$1,463
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$1,182
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,429
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$26,274
Value of net assets at end of year (total assets less liabilities)2011-12-31$734,197
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$707,923
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
Investment advisory and management fees2011-12-31$3,647
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$707,889
Value of interest in pooled separate accounts at end of year2011-12-31$690,153
Interest on participant loans2011-12-31$105
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$37,253
Net investment gain/loss from pooled separate accounts2011-12-31$-20,414
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 contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$10,046
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$57,554
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 name2011-12-31HARDING, SHYMANSKI & CO., P.S.C.
Accountancy firm EIN2011-12-31351346211
2010 : SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,429
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,008
Total income from all sources (including contributions)2010-12-31$192,320
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$37,712
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$25,087
Value of total corrective distributions2010-12-31$2,430
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$118,488
Value of total assets at end of year2010-12-31$709,352
Value of total assets at beginning of year2010-12-31$554,323
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$10,195
Total interest from all sources2010-12-31$142
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$105,026
Participant contributions at end of year2010-12-31$1,463
Participant contributions at beginning of year2010-12-31$1,359
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,429
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,008
Administrative expenses (other) incurred2010-12-31$370
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$154,608
Value of net assets at end of year (total assets less liabilities)2010-12-31$707,923
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$553,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$9,825
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$707,889
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$552,964
Interest on participant loans2010-12-31$142
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$73,690
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$13,462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$25,087
Contract administrator fees2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31ASSURANCE COMPANY OF AMERICA, LLC
Accountancy firm EIN2010-12-31271424170
2009 : SAGE HEALTH SERVICES OF INDIANA INC 401K 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 SAGE HEALTH SERVICES OF INDIANA INC 401K PLAN

2015: SAGE HEALTH SERVICES OF INDIANA INC 401K 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: SAGE HEALTH SERVICES OF INDIANA INC 401K 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: SAGE HEALTH SERVICES OF INDIANA INC 401K 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: SAGE HEALTH SERVICES OF INDIANA INC 401K 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: SAGE HEALTH SERVICES OF INDIANA INC 401K 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: SAGE HEALTH SERVICES OF INDIANA INC 401K 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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number600883-000
Policy instance 1
Insurance contract or identification number600883-000
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,012
Total amount of fees paid to insurance companyUSD $505
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 Administration0
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 $5,012
Insurance broker organization code?3
Amount paid for insurance broker fees505
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker nameHARDING SHYMANSKI AND COMPANY PSC
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number600883-000
Policy instance 1
Insurance contract or identification number600883-000
Number of Individuals Covered31
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,186
Total amount of fees paid to insurance companyUSD $614
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 Administration0
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 $6,186
Insurance broker organization code?3
Amount paid for insurance broker fees614
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker nameHARDING SHYMANSKI AND COMPANY PSC
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number600883-000
Policy instance 1
Insurance contract or identification number600883-000
Number of Individuals Covered31
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,186
Total amount of fees paid to insurance companyUSD $503
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 Administration0
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 $5,186
Insurance broker organization code?3
Amount paid for insurance broker fees503
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker name
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number600883-000
Policy instance 1
Insurance contract or identification number600883-000
Number of Individuals Covered37
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,097
Total amount of fees paid to insurance companyUSD $608
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 Administration0
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 $3,097
Insurance broker organization code?3
Amount paid for insurance broker fees608
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker name
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number600883-000
Policy instance 1
Insurance contract or identification number600883-000
Number of Individuals Covered28
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $8,364
Total amount of fees paid to insurance companyUSD $2,217
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 Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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