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SKAALEN NURSING & REHABILITATION CENTER INC. 401k Plan overview

Plan NameSKAALEN NURSING & REHABILITATION CENTER INC.
Plan identification number 507

SKAALEN NURSING & REHABILITATION CENTER INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

SKAALEN NURSING AND REHABILITATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name:SKAALEN NURSING AND REHABILITATION CENTER, INC.
Employer identification number (EIN):391104331
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SKAALEN NURSING & REHABILITATION CENTER INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072018-07-01
5072017-07-01DEBRA PUNDT DEBRA PUNDT2019-02-18
5072016-07-01DEBRA PUNDT DEBRA PUNDT2018-02-27
5072015-07-01DEBRA PUNDT DEBRA PUNDT2017-03-21
5072014-07-01DEBRA PUNDT DEBRA PUNDT2016-03-30
5072013-07-01DEBRA PUNDT DEBRA PUNDT2015-02-12
5072012-07-01DEBRA PUNDT DEBRA PUNDT2014-03-03
5072011-07-01DEBRA PUNDT DEBRA PUNDT2013-04-10
5072010-07-01DEBRA PUNDT DEBRA PUNDT2012-04-12

Plan Statistics for SKAALEN NURSING & REHABILITATION CENTER INC.

401k plan membership statisitcs for SKAALEN NURSING & REHABILITATION CENTER INC.

Measure Date Value
2018: SKAALEN NURSING & REHABILITATION CENTER INC. 2018 401k membership
Total participants, beginning-of-year2018-07-01148
Total number of active participants reported on line 7a of the Form 55002018-07-010
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-010
2017: SKAALEN NURSING & REHABILITATION CENTER INC. 2017 401k membership
Total participants, beginning-of-year2017-07-01151
Total number of active participants reported on line 7a of the Form 55002017-07-01148
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01148
2016: SKAALEN NURSING & REHABILITATION CENTER INC. 2016 401k membership
Total participants, beginning-of-year2016-07-01155
Total number of active participants reported on line 7a of the Form 55002016-07-01151
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01151
2015: SKAALEN NURSING & REHABILITATION CENTER INC. 2015 401k membership
Total participants, beginning-of-year2015-07-01186
Total number of active participants reported on line 7a of the Form 55002015-07-01155
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01155
2014: SKAALEN NURSING & REHABILITATION CENTER INC. 2014 401k membership
Total participants, beginning-of-year2014-07-01192
Total number of active participants reported on line 7a of the Form 55002014-07-01186
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01186
2013: SKAALEN NURSING & REHABILITATION CENTER INC. 2013 401k membership
Total participants, beginning-of-year2013-07-01193
Total number of active participants reported on line 7a of the Form 55002013-07-01192
Total of all active and inactive participants2013-07-01192
2012: SKAALEN NURSING & REHABILITATION CENTER INC. 2012 401k membership
Total participants, beginning-of-year2012-07-01192
Total number of active participants reported on line 7a of the Form 55002012-07-01193
Total of all active and inactive participants2012-07-01193
2011: SKAALEN NURSING & REHABILITATION CENTER INC. 2011 401k membership
Total participants, beginning-of-year2011-07-01200
Total number of active participants reported on line 7a of the Form 55002011-07-01192
Total of all active and inactive participants2011-07-01192
2010: SKAALEN NURSING & REHABILITATION CENTER INC. 2010 401k membership
Total participants, beginning-of-year2010-07-010
Total number of active participants reported on line 7a of the Form 55002010-07-01200
Total of all active and inactive participants2010-07-01200

Financial Data on SKAALEN NURSING & REHABILITATION CENTER INC.

Measure Date Value
2019 : SKAALEN NURSING & REHABILITATION CENTER INC. 2019 401k financial data
Total income from all sources (including contributions)2019-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Was this plan covered by a fidelity bond2019-06-30No
If this is an individual account plan, was there a blackout period2019-06-30No
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net assets at end of year (total assets less liabilities)2019-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Did the plan have assets held for investment2019-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30Yes
2018 : SKAALEN NURSING & REHABILITATION CENTER INC. 2018 401k financial data
Total income from all sources (including contributions)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Was this plan covered by a fidelity bond2018-06-30No
If this is an individual account plan, was there a blackout period2018-06-30No
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net assets at end of year (total assets less liabilities)2018-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Did the plan have assets held for investment2018-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
2017 : SKAALEN NURSING & REHABILITATION CENTER INC. 2017 401k financial data
Total income from all sources (including contributions)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Was this plan covered by a fidelity bond2017-06-30No
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net assets at end of year (total assets less liabilities)2017-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Did the plan have assets held for investment2017-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
2016 : SKAALEN NURSING & REHABILITATION CENTER INC. 2016 401k financial data
Total income from all sources (including contributions)2016-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Was this plan covered by a fidelity bond2016-06-30No
If this is an individual account plan, was there a blackout period2016-06-30No
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net assets at end of year (total assets less liabilities)2016-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Did the plan have assets held for investment2016-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
2015 : SKAALEN NURSING & REHABILITATION CENTER INC. 2015 401k financial data
Total income from all sources2015-06-30$0
Total plan assets at end of year2015-06-30$0
Total plan assets at beginning of year2015-06-30$0
Net plan assets at end of year (total assets less liabilities)2015-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$0
2014 : SKAALEN NURSING & REHABILITATION CENTER INC. 2014 401k financial data
Total income from all sources2014-06-30$0
Total plan assets at end of year2014-06-30$0
Total plan assets at beginning of year2014-06-30$0
Net plan assets at end of year (total assets less liabilities)2014-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$0
2013 : SKAALEN NURSING & REHABILITATION CENTER INC. 2013 401k financial data
Total income from all sources2013-06-30$0
Total plan assets at end of year2013-06-30$0
Total plan assets at beginning of year2013-06-30$0
Net plan assets at end of year (total assets less liabilities)2013-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$0
2012 : SKAALEN NURSING & REHABILITATION CENTER INC. 2012 401k financial data
Total income from all sources2012-06-30$0
Total plan assets at end of year2012-06-30$0
Total plan assets at beginning of year2012-06-30$0
Net plan assets at end of year (total assets less liabilities)2012-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$0
2011 : SKAALEN NURSING & REHABILITATION CENTER INC. 2011 401k financial data
Total plan assets at end of year2011-06-30$0
Net plan assets at end of year (total assets less liabilities)2011-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$0

Form 5500 Responses for SKAALEN NURSING & REHABILITATION CENTER INC.

2018: SKAALEN NURSING & REHABILITATION CENTER INC. 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01This submission is the final filingYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: SKAALEN NURSING & REHABILITATION CENTER INC. 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: SKAALEN NURSING & REHABILITATION CENTER INC. 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: SKAALEN NURSING & REHABILITATION CENTER INC. 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: SKAALEN NURSING & REHABILITATION CENTER INC. 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: SKAALEN NURSING & REHABILITATION CENTER INC. 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: SKAALEN NURSING & REHABILITATION CENTER INC. 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: SKAALEN NURSING & REHABILITATION CENTER INC. 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: SKAALEN NURSING & REHABILITATION CENTER INC. 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01First time form 5500 has been submittedYes
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05946126
Policy instance 1
Insurance contract or identification numberTS05946126
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05946126
Policy instance 1
Insurance contract or identification numberTS05946126
Number of Individuals Covered148
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $6,101
Total amount of fees paid to insurance companyUSD $2,741
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered155
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $4,425
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,425
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameTRICOR INC.
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered186
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $4,323
Total amount of fees paid to insurance companyUSD $1,422
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,323
Amount paid for insurance broker fees1422
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameTRICOR INC.
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered192
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $4,368
Total amount of fees paid to insurance companyUSD $1,405
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,368
Amount paid for insurance broker fees1405
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameTRICOR INC.
UNITED OF OMAHA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered193
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $4,270
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,270
Insurance broker organization code?3
Insurance broker nameTRICOR INC.
UNITED OF OMAHA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered192
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $4,358
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED OF OMAHA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG 0ADJE
Policy instance 1
Insurance contract or identification numberGUG 0ADJE
Number of Individuals Covered200
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $5,865
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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