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EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 401k Plan overview

Plan NameEVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN
Plan identification number 001

EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

EVERGREEN RETIREMENT COMMUNITY, INC. has sponsored the creation of one or more 401k plans.

Company Name:EVERGREEN RETIREMENT COMMUNITY, INC.
Employer identification number (EIN):391081800
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01ERIN SANDERS
0012016-01-01ERIN SANDERS
0012015-01-01ERIN SANDERS
0012014-01-01ERIN SANDERS
0012013-01-01ERIN SANDERS
0012012-01-01ERIN SANDERS
0012011-01-01ERIN SANDERS ERIN SANDERS2012-10-15
0012010-01-01JOHN KRUEGER JOHN KRUEGER2011-10-14
0012009-01-01JOHN KRUEGER JOHN KRUEGER2010-10-14
0012008-01-01

Plan Statistics for EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN

401k plan membership statisitcs for EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN

Measure Date Value
2022: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01341
Total number of active participants reported on line 7a of the Form 55002022-01-01384
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0164
Total of all active and inactive participants2022-01-01449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01449
Number of participants with account balances2022-01-01227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01378
Total number of active participants reported on line 7a of the Form 55002021-01-01274
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0164
Total of all active and inactive participants2021-01-01339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01339
Number of participants with account balances2021-01-01202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0114
2020: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01372
Total number of active participants reported on line 7a of the Form 55002020-01-01310
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-0164
Total of all active and inactive participants2020-01-01377
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01377
Number of participants with account balances2020-01-01209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0114
2019: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01357
Total number of active participants reported on line 7a of the Form 55002019-01-01305
Number of retired or separated participants receiving benefits2019-01-014
Number of other retired or separated participants entitled to future benefits2019-01-0154
Total of all active and inactive participants2019-01-01363
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01363
Number of participants with account balances2019-01-01198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0110
2018: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01340
Total number of active participants reported on line 7a of the Form 55002018-01-01294
Number of retired or separated participants receiving benefits2018-01-014
Number of other retired or separated participants entitled to future benefits2018-01-0150
Total of all active and inactive participants2018-01-01348
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01348
Number of participants with account balances2018-01-01204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0124
2017: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01381
Total number of active participants reported on line 7a of the Form 55002017-01-01351
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0129
Total of all active and inactive participants2017-01-01380
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01380
Number of participants with account balances2017-01-01238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0110
2016: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01299
Total number of active participants reported on line 7a of the Form 55002016-01-01375
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-01381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01381
Number of participants with account balances2016-01-01255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01318
Total number of active participants reported on line 7a of the Form 55002015-01-01299
Number of retired or separated participants receiving benefits2015-01-014
Number of other retired or separated participants entitled to future benefits2015-01-0122
Total of all active and inactive participants2015-01-01325
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01325
Number of participants with account balances2015-01-01185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0111
2014: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01311
Total number of active participants reported on line 7a of the Form 55002014-01-01300
Number of retired or separated participants receiving benefits2014-01-014
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-01318
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01318
Number of participants with account balances2014-01-01190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-018
2013: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01300
Total number of active participants reported on line 7a of the Form 55002013-01-01252
Number of retired or separated participants receiving benefits2013-01-0114
Number of other retired or separated participants entitled to future benefits2013-01-0143
Total of all active and inactive participants2013-01-01309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01309
Number of participants with account balances2013-01-01231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0133
2012: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01267
Total number of active participants reported on line 7a of the Form 55002012-01-01255
Number of retired or separated participants receiving benefits2012-01-014
Number of other retired or separated participants entitled to future benefits2012-01-0138
Total of all active and inactive participants2012-01-01297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01297
Number of participants with account balances2012-01-01180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0112
2011: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01364
Total number of active participants reported on line 7a of the Form 55002011-01-01255
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-0111
Total of all active and inactive participants2011-01-01267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01267
Number of participants with account balances2011-01-01161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-017
2010: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01320
Total number of active participants reported on line 7a of the Form 55002010-01-01291
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0173
Total of all active and inactive participants2010-01-01364
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01364
Number of participants with account balances2010-01-01245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01317
Total number of active participants reported on line 7a of the Form 55002009-01-01295
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0125
Total of all active and inactive participants2009-01-01320
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01320
Number of participants with account balances2009-01-01248
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-016

Financial Data on EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN

Measure Date Value
2022 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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$0
Total income from all sources (including contributions)2022-12-31$-1,040,540
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,028,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$937,992
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$809,035
Value of total assets at end of year2022-12-31$11,582,568
Value of total assets at beginning of year2022-12-31$13,651,925
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$90,825
Total interest from all sources2022-12-31$701
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
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$414,925
Participant contributions at end of year2022-12-31$55,701
Participant contributions at beginning of year2022-12-31$82,042
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$14,528
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$50,631
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Liabilities. Value of operating payables at end of year2022-12-31$0
Liabilities. Value of operating payables at beginning of year2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$11,933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,069,357
Value of net assets at end of year (total assets less liabilities)2022-12-31$11,582,568
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$13,651,925
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$11,174,864
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$11,144,659
Interest on participant loans2022-12-31$701
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$106
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$106
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$2,065,543
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,850,276
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 contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$343,479
Employer contributions (assets) at end of year2022-12-31$352,003
Employer contributions (assets) at beginning of year2022-12-31$333,114
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$937,992
Contract administrator fees2022-12-31$90,825
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 name2022-12-31WEGNER CPAS LLP
Accountancy firm EIN2022-12-31390974031
2021 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$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$2,649,280
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,780,509
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,681,973
Value of total corrective distributions2021-12-31$315
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$939,317
Value of total assets at end of year2021-12-31$13,651,925
Value of total assets at beginning of year2021-12-31$13,783,154
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$98,221
Total interest from all sources2021-12-31$4,246
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
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$352,068
Participant contributions at end of year2021-12-31$82,042
Participant contributions at beginning of year2021-12-31$72,061
Participant contributions at end of year2021-12-31$14,528
Participant contributions at beginning of year2021-12-31$11,380
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$254,082
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Other income not declared elsewhere2021-12-31$34,471
Liabilities. Value of operating payables at end of year2021-12-31$0
Liabilities. Value of operating payables at beginning of year2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$11,933
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-131,229
Value of net assets at end of year (total assets less liabilities)2021-12-31$13,651,925
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$13,783,154
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$11,144,659
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$10,934,628
Interest on participant loans2021-12-31$4,246
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$106
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$2,065,543
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$2,424,121
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,671,246
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 contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$333,167
Employer contributions (assets) at end of year2021-12-31$333,114
Employer contributions (assets) at beginning of year2021-12-31$340,963
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,681,973
Contract administrator fees2021-12-31$98,221
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 name2021-12-31WEGNER CPAS LLP
Accountancy firm EIN2021-12-31390974031
2020 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$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$2,591,226
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$686,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$599,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$665,846
Value of total assets at end of year2020-12-31$13,783,154
Value of total assets at beginning of year2020-12-31$11,877,958
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$86,477
Total interest from all sources2020-12-31$5,518
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
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$323,292
Participant contributions at end of year2020-12-31$72,061
Participant contributions at beginning of year2020-12-31$98,723
Participant contributions at end of year2020-12-31$11,380
Participant contributions at beginning of year2020-12-31$0
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$1,591
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$35,330
Liabilities. Value of operating payables at end of year2020-12-31$0
Liabilities. Value of operating payables at beginning of year2020-12-31$0
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
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$1,905,196
Value of net assets at end of year (total assets less liabilities)2020-12-31$13,783,154
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$11,877,958
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
Investment advisory and management fees2020-12-31$86,477
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$10,934,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$9,398,811
Interest on participant loans2020-12-31$5,518
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$501
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$501
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$2,424,121
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,061,867
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,884,532
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$340,963
Employer contributions (assets) at end of year2020-12-31$340,963
Employer contributions (assets) at beginning of year2020-12-31$318,056
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$599,553
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 name2020-12-31WEGNER CPAS LLP
Accountancy firm EIN2020-12-31390974031
2019 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at 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 liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$2,668,265
Total income from all sources (including contributions)2019-12-31$2,668,265
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$716,980
Total of all expenses incurred2019-12-31$716,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$652,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$652,373
Expenses. Certain deemed distributions of participant loans2019-12-31$3,370
Expenses. Certain deemed distributions of participant loans2019-12-31$3,370
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$607,501
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$607,501
Value of total assets at end of year2019-12-31$11,877,958
Value of total assets at end of year2019-12-31$11,877,958
Value of total assets at beginning of year2019-12-31$9,926,673
Value of total assets at beginning of year2019-12-31$9,926,673
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$61,237
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$61,237
Total interest from all sources2019-12-31$17,819
Total interest from all sources2019-12-31$17,819
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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
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
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$286,157
Contributions received from participants2019-12-31$286,157
Participant contributions at end of year2019-12-31$98,723
Participant contributions at beginning of year2019-12-31$89,138
Participant contributions at beginning of year2019-12-31$89,138
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$19
Participant contributions at beginning of year2019-12-31$19
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,288
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,288
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
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
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,951,285
Value of net income/loss2019-12-31$1,951,285
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,877,958
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,877,958
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,926,673
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,926,673
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$61,237
Investment advisory and management fees2019-12-31$61,237
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$9,398,811
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$9,398,811
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$7,727,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$7,727,333
Interest on participant loans2019-12-31$5,986
Interest on participant loans2019-12-31$5,986
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$501
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$501
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$11,833
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$11,833
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,061,867
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,061,867
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,793,595
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,793,595
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,042,945
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,042,945
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
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 contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$318,056
Contributions received in cash from employer2019-12-31$318,056
Employer contributions (assets) at end of year2019-12-31$318,056
Employer contributions (assets) at end of year2019-12-31$318,056
Employer contributions (assets) at beginning of year2019-12-31$316,588
Employer contributions (assets) at beginning of year2019-12-31$316,588
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$652,373
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$652,373
Did the plan have assets held for investment2019-12-31Yes
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
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
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
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WEGNER CPAS LLP
Accountancy firm name2019-12-31WEGNER CPAS LLP
Accountancy firm EIN2019-12-31390974031
Accountancy firm EIN2019-12-31390974031
2018 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$5,094
Total income from all sources (including contributions)2018-12-31$157,917
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$264,534
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$207,302
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$598,178
Value of total assets at end of year2018-12-31$9,926,673
Value of total assets at beginning of year2018-12-31$10,038,384
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$57,232
Total interest from all sources2018-12-31$5,936
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$281,590
Participant contributions at end of year2018-12-31$89,138
Participant contributions at beginning of year2018-12-31$122,787
Participant contributions at end of year2018-12-31$19
Participant contributions at beginning of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$5,094
Other income not declared elsewhere2018-12-31$1,098
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-106,617
Value of net assets at end of year (total assets less liabilities)2018-12-31$9,926,673
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$10,033,290
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
Investment advisory and management fees2018-12-31$57,232
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$7,727,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$7,999,396
Interest on participant loans2018-12-31$5,936
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,793,595
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,626,360
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-447,295
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 contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$316,588
Employer contributions (assets) at end of year2018-12-31$316,588
Employer contributions (assets) at beginning of year2018-12-31$289,841
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$207,302
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
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 name2018-12-31WEGNER CPAS LLP
Accountancy firm EIN2018-12-31390974031
2017 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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$5,094
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$2,046,629
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$549,968
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$496,820
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$625,415
Value of total assets at end of year2017-12-31$10,038,384
Value of total assets at beginning of year2017-12-31$8,536,629
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$53,148
Total interest from all sources2017-12-31$36,738
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$277,353
Participant contributions at end of year2017-12-31$122,787
Participant contributions at beginning of year2017-12-31$116,829
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$68,463
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$5,094
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Liabilities. Value of operating payables at end of year2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$0
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$1,496,661
Value of net assets at end of year (total assets less liabilities)2017-12-31$10,033,290
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$8,536,629
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$7,999,396
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$6,628,685
Interest on participant loans2017-12-31$9,380
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,123,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,123,086
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$27,358
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,626,360
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$386,122
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,384,476
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$279,599
Employer contributions (assets) at end of year2017-12-31$289,841
Employer contributions (assets) at beginning of year2017-12-31$281,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$496,820
Contract administrator fees2017-12-31$53,148
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
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 name2017-12-31WEGNER CPAS LLP
Accountancy firm EIN2017-12-31390974031
2016 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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$7,241
Total income from all sources (including contributions)2016-12-31$1,214,144
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,161,328
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,123,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$552,325
Value of total assets at end of year2016-12-31$8,536,629
Value of total assets at beginning of year2016-12-31$8,491,054
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$37,693
Total interest from all sources2016-12-31$16,043
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$148,382
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$148,382
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
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$249,813
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$20,604
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$219
Assets. Loans (other than to participants) at end of year2016-12-31$116,829
Assets. Loans (other than to participants) at beginning of year2016-12-31$21,643
Liabilities. Value of operating payables at end of year2016-12-31$0
Liabilities. Value of operating payables at beginning of year2016-12-31$7,241
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$52,816
Value of net assets at end of year (total assets less liabilities)2016-12-31$8,536,629
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$8,483,813
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$6,628,685
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$5,996,483
Interest on participant loans2016-12-31$3,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,123,086
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$244,763
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$244,763
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$12,668
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$386,122
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,962,474
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$497,394
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$281,908
Employer contributions (assets) at end of year2016-12-31$281,907
Employer contributions (assets) at beginning of year2016-12-31$265,472
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,123,635
Contract administrator fees2016-12-31$37,693
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
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 name2016-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2016-12-31410746749
2015 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$7,241
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$8,063
Total income from all sources (including contributions)2015-12-31$731,518
Total of all expenses incurred2015-12-31$886,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$853,351
Expenses. Certain deemed distributions of participant loans2015-12-31$728
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$666,754
Value of total assets at end of year2015-12-31$8,491,054
Value of total assets at beginning of year2015-12-31$8,647,178
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$32,741
Total interest from all sources2015-12-31$2,040
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$65,734
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$65,734
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$247,190
Participant contributions at end of year2015-12-31$21,643
Participant contributions at beginning of year2015-12-31$218,797
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$154,092
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$219
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$141
Other income not declared elsewhere2015-12-31$68,419
Administrative expenses (other) incurred2015-12-31$2,475
Liabilities. Value of operating payables at end of year2015-12-31$7,241
Liabilities. Value of operating payables at beginning of year2015-12-31$8,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-155,302
Value of net assets at end of year (total assets less liabilities)2015-12-31$8,483,813
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,639,115
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$30,266
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$5,996,483
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$6,092,741
Interest on participant loans2015-12-31$1,908
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$244,763
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$230,498
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$230,498
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$132
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,962,474
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,829,480
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-71,429
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$265,472
Employer contributions (assets) at end of year2015-12-31$265,472
Employer contributions (assets) at beginning of year2015-12-31$275,521
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$853,351
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 name2015-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2015-12-31410746749
2014 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$8,063
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$7,961
Total income from all sources (including contributions)2014-12-31$1,102,369
Total of all expenses incurred2014-12-31$524,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$488,465
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$585,529
Value of total assets at end of year2014-12-31$8,647,178
Value of total assets at beginning of year2014-12-31$8,069,050
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$35,878
Total interest from all sources2014-12-31$1,872
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$55,015
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$55,015
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$238,228
Participant contributions at end of year2014-12-31$218,797
Participant contributions at beginning of year2014-12-31$21,643
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$71,780
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$141
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$134
Other income not declared elsewhere2014-12-31$73,668
Administrative expenses (other) incurred2014-12-31$3,606
Liabilities. Value of operating payables at end of year2014-12-31$8,063
Liabilities. Value of operating payables at beginning of year2014-12-31$7,961
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$578,026
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,639,115
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,061,089
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$32,272
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$6,092,741
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$5,523,449
Interest on participant loans2014-12-31$1,872
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$230,498
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$241,102
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$241,102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,829,480
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$2,269,855
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$386,285
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$275,521
Employer contributions (assets) at end of year2014-12-31$275,521
Employer contributions (assets) at beginning of year2014-12-31$12,867
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$488,465
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 name2014-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2014-12-31410746749
2013 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$7,961
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,388
Total income from all sources (including contributions)2013-12-31$1,724,758
Total of all expenses incurred2013-12-31$667,674
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$633,297
Expenses. Certain deemed distributions of participant loans2013-12-31$3,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$529,206
Value of total assets at end of year2013-12-31$8,069,050
Value of total assets at beginning of year2013-12-31$7,010,393
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$31,290
Total interest from all sources2013-12-31$1,591
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$44,675
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$44,675
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$233,481
Participant contributions at end of year2013-12-31$21,643
Participant contributions at beginning of year2013-12-31$19,301
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$134
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$140
Other income not declared elsewhere2013-12-31$81,619
Administrative expenses (other) incurred2013-12-31$3,028
Liabilities. Value of operating payables at end of year2013-12-31$7,961
Liabilities. Value of operating payables at beginning of year2013-12-31$6,388
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$1,057,084
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,061,089
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,004,005
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$28,262
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$5,523,449
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$4,278,259
Interest on participant loans2013-12-31$1,591
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$241,102
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$237,098
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$237,098
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$2,269,855
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$2,422,552
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$1,067,667
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$295,725
Employer contributions (assets) at end of year2013-12-31$12,867
Employer contributions (assets) at beginning of year2013-12-31$53,043
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$633,297
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 name2013-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2013-12-31410746749
2012 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,388
Total income from all sources (including contributions)2012-12-31$1,181,688
Total of all expenses incurred2012-12-31$656,458
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$610,738
Expenses. Certain deemed distributions of participant loans2012-12-31$10,669
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$565,248
Value of total assets at end of year2012-12-31$7,010,393
Value of total assets at beginning of year2012-12-31$6,478,775
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$35,051
Total interest from all sources2012-12-31$1,517
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$41,273
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$41,273
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$220,995
Participant contributions at end of year2012-12-31$19,301
Participant contributions at beginning of year2012-12-31$15,512
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$29,406
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$140
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$163
Other income not declared elsewhere2012-12-31$84,338
Administrative expenses (other) incurred2012-12-31$2,156
Liabilities. Value of operating payables at end of year2012-12-31$6,388
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$525,230
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,004,005
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$6,478,775
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$32,895
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$4,278,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,739,408
Interest on participant loans2012-12-31$1,236
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$237,098
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$242,138
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$242,138
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$281
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$2,422,552
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$2,481,554
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$489,312
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$314,847
Employer contributions (assets) at end of year2012-12-31$53,043
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$610,738
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 name2012-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2012-12-31410746749
2011 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
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$612,030
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$432,078
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$415,868
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$554,851
Value of total assets at end of year2011-12-31$6,478,775
Value of total assets at beginning of year2011-12-31$6,298,823
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$16,210
Total interest from all sources2011-12-31$98,352
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$27,314
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$27,314
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 period2011-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$234,308
Participant contributions at end of year2011-12-31$15,512
Participant contributions at beginning of year2011-12-31$8,567
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$21,124
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$163
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$8,315
Administrative expenses (other) incurred2011-12-31$1,149
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$179,952
Value of net assets at end of year (total assets less liabilities)2011-12-31$6,478,775
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$6,298,823
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$15,061
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,739,408
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,113,380
Interest on participant loans2011-12-31$257
Interest earned on other investments2011-12-31$98,095
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$242,138
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$2,481,554
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$3,164,957
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-68,487
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$299,419
Employer contributions (assets) at beginning of year2011-12-31$3,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$415,868
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31Yes
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 name2011-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2011-12-31410746749
2010 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,072,772
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$376,720
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$375,961
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$578,501
Value of total assets at end of year2010-12-31$6,298,823
Value of total assets at beginning of year2010-12-31$5,602,771
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$759
Total interest from all sources2010-12-31$119,921
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$226,465
Participant contributions at end of year2010-12-31$8,567
Participant contributions at beginning of year2010-12-31$8,488
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$42,337
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$8,315
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$8,233
Administrative expenses (other) incurred2010-12-31$708
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$696,052
Value of net assets at end of year (total assets less liabilities)2010-12-31$6,298,823
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$5,602,771
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,113,380
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,559,722
Interest earned on other investments2010-12-31$119,921
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$3,164,957
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$3,023,060
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$374,350
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$309,699
Employer contributions (assets) at end of year2010-12-31$3,604
Employer contributions (assets) at beginning of year2010-12-31$3,268
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$375,961
Contract administrator fees2010-12-31$51
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 name2010-12-31BDO USA, LLP
Accountancy firm EIN2010-12-31135381590
2009 : EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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 EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN

2022: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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
2010: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) 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 benefit arrangement – InsuranceYes
2008: EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MASS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number780969-01
Policy instance 4
Insurance contract or identification number780969-01
Number of Individuals Covered171
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberEX20130
Policy instance 3
Insurance contract or identification numberEX20130
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,295
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 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?Yes
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 $1,295
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR20130
Policy instance 1
Insurance contract or identification numberCR20130
Number of Individuals Covered12
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $302
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 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?Yes
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 $302
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSION
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberEX20130
Policy instance 3
Insurance contract or identification numberEX20130
Number of Individuals Covered14
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,194
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 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?Yes
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 $1,194
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered202
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number20130
Policy instance 1
Insurance contract or identification number20130
Number of Individuals Covered12
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $245
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 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?Yes
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 $245
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSION
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberEX20130
Policy instance 3
Insurance contract or identification numberEX20130
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,395
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 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?Yes
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 $1,395
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered209
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number20130
Policy instance 1
Insurance contract or identification number20130
Number of Individuals Covered12
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $330
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 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?Yes
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 $330
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSION
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberEX20130
Policy instance 3
Insurance contract or identification numberEX20130
Number of Individuals Covered15
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,391
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 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 $1,391
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADVISORY FEES
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered323
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number20130
Policy instance 1
Insurance contract or identification number20130
Number of Individuals Covered14
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,818
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?Yes
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
Other information about contractGROUP VARIABLE ANNUITY W/GUAR FUND
Commission paid to Insurance BrokerUSD $1,391
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSION
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberEX20130
Policy instance 3
Insurance contract or identification numberEX20130
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,419
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 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 $1,419
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered351
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number20130
Policy instance 1
Insurance contract or identification number20130
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $442
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?Yes
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
Other information about contractGROUP VARIABLE ANNUITY W/GUAR FUND
Commission paid to Insurance BrokerUSD $442
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADVISOR
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62248-1
Policy instance 2
Insurance contract or identification numberMR 62248-1
Number of Individuals Covered318
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number20130
Policy instance 1
Insurance contract or identification number20130
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,896
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?Yes
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
Other information about contractGROUP VARIABLE ANNUITY W/GUAR FUND
Commission paid to Insurance BrokerUSD $1,896
Insurance broker organization code?4
Insurance broker nameLINCOLN FINANCIAL ADVISORS

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