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LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN 401k Plan overview

Plan NameLIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN
Plan identification number 001

LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

LIFECARE INC. D/B/A FRIENDSHIP VILLAGE has sponsored the creation of one or more 401k plans.

Company Name:LIFECARE INC. D/B/A FRIENDSHIP VILLAGE
Employer identification number (EIN):382067110
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-10-01

Plan Statistics for LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN

401k plan membership statisitcs for LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN

Measure Date Value
2021: LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01281
Total number of active participants reported on line 7a of the Form 55002021-10-01189
Number of retired or separated participants receiving benefits2021-10-0118
Number of other retired or separated participants entitled to future benefits2021-10-0191
Total of all active and inactive participants2021-10-01298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-10-010
Total participants2021-10-01298
Number of participants with account balances2021-10-01179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-10-018

Financial Data on LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN

Measure Date Value
2022 : LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total income from all sources (including contributions)2022-09-30$-325,705
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$184,601
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$178,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$296,921
Value of total assets at end of year2022-09-30$3,408,650
Value of total assets at beginning of year2022-09-30$3,918,956
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$5,758
Total interest from all sources2022-09-30$20,858
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30No
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$200,641
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-510,306
Value of net assets at end of year (total assets less liabilities)2022-09-30$3,408,650
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$3,918,956
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-09-30$2,571,364
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-09-30$3,111,104
Interest earned on other investments2022-09-30$20,858
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-09-30$837,286
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-09-30$807,852
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-643,484
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30Yes
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$96,280
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$178,843
Contract administrator fees2022-09-30$5,758
Did the plan have assets held for investment2022-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30PLANTE & MORAN, PLLC
Accountancy firm EIN2022-09-30381357951

Form 5500 Responses for LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN

2021: LIFECARE, INC. DBA FRIENDSHIP VILLAGE 403(B) EMPLOYER RETIREMENT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number52208
Policy instance 1
Insurance contract or identification number52208
Number of Individuals Covered179
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $6,875
Total amount of fees paid to insurance companyUSD $0
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 $4,611
Insurance broker organization code?3

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