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PINES HEALTHCARE CENTER 401(K) PLAN 401k Plan overview

Plan NamePINES HEALTHCARE CENTER 401(K) PLAN
Plan identification number 001

PINES HEALTHCARE CENTER 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

TALLAHASSEE CARE, INC., DBA ARIA NURSING AND REHAB has sponsored the creation of one or more 401k plans.

Company Name:TALLAHASSEE CARE, INC., DBA ARIA NURSING AND REHAB
Employer identification number (EIN):431620600
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PINES HEALTHCARE CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01YONI KLEIN2019-08-29
0012017-01-01YONI KLEIN2018-09-20
0012016-01-01YONI KLEIN2017-08-14
0012015-01-01RON CORK2016-08-04
0012014-01-01RON CORK2015-07-20
0012013-01-01RON CORK
0012012-01-01RON CORK
0012011-01-01RON CORK2012-07-27
0012010-01-01RON CORK2011-07-26

Plan Statistics for PINES HEALTHCARE CENTER 401(K) PLAN

401k plan membership statisitcs for PINES HEALTHCARE CENTER 401(K) PLAN

Measure Date Value
2022: PINES HEALTHCARE CENTER 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01509
Total number of active participants reported on line 7a of the Form 55002022-01-01520
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0122
Total of all active and inactive participants2022-01-01542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01542
Number of participants with account balances2022-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: PINES HEALTHCARE CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01426
Total number of active participants reported on line 7a of the Form 55002021-01-01491
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0118
Total of all active and inactive participants2021-01-01509
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01509
Number of participants with account balances2021-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-011
2020: PINES HEALTHCARE CENTER 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01393
Total number of active participants reported on line 7a of the Form 55002020-01-01401
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0119
Total of all active and inactive participants2020-01-01420
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01420
Number of participants with account balances2020-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: PINES HEALTHCARE CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01262
Total number of active participants reported on line 7a of the Form 55002019-01-01329
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0119
Total of all active and inactive participants2019-01-01348
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01348
Number of participants with account balances2019-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2013: PINES HEALTHCARE CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01112
Total number of active participants reported on line 7a of the Form 55002013-01-0164
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0120
Total of all active and inactive participants2013-01-0184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0184
Number of participants with account balances2013-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PINES HEALTHCARE CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01130
Total number of active participants reported on line 7a of the Form 55002012-01-01101
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0110
Total of all active and inactive participants2012-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01111
Number of participants with account balances2012-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011

Financial Data on PINES HEALTHCARE CENTER 401(K) PLAN

Measure Date Value
2022 : PINES HEALTHCARE CENTER 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$5,202
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$15,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$5,865
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$93,856
Value of total assets at end of year2022-12-31$497,892
Value of total assets at beginning of year2022-12-31$507,747
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$9,192
Total interest from all sources2022-12-31$0
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$70,000
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$88,991
Participant contributions at end of year2022-12-31$2,703
Participant contributions at beginning of year2022-12-31$2,565
Total non interest bearing cash at end of year2022-12-31$570
Total non interest bearing cash at beginning of year2022-12-31$411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-9,855
Value of net assets at end of year (total assets less liabilities)2022-12-31$497,892
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$507,747
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 pooled separate accounts at end of year2022-12-31$489,754
Value of interest in pooled separate accounts at beginning of year2022-12-31$498,200
Net investment gain/loss from pooled separate accounts2022-12-31$-88,654
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$4,865
Employer contributions (assets) at end of year2022-12-31$4,865
Employer contributions (assets) at beginning of year2022-12-31$6,571
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$5,865
Contract administrator fees2022-12-31$9,192
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 plan2022-12-31Disclaimer
Accountancy firm name2022-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2022-12-31261556810
2021 : PINES HEALTHCARE CENTER 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$179,722
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$23,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$10,082
Value of total corrective distributions2021-12-31$5,009
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$128,944
Value of total assets at end of year2021-12-31$507,747
Value of total assets at beginning of year2021-12-31$351,168
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$8,052
Total interest from all sources2021-12-31$0
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$70,000
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$57,886
Participant contributions at end of year2021-12-31$2,565
Participant contributions at beginning of year2021-12-31$2,637
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$64,487
Total non interest bearing cash at end of year2021-12-31$411
Total non interest bearing cash at beginning of year2021-12-31$411
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$156,579
Value of net assets at end of year (total assets less liabilities)2021-12-31$507,747
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$351,168
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 pooled separate accounts at end of year2021-12-31$498,200
Value of interest in pooled separate accounts at beginning of year2021-12-31$340,139
Net investment gain/loss from pooled separate accounts2021-12-31$50,778
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$6,571
Employer contributions (assets) at end of year2021-12-31$6,571
Employer contributions (assets) at beginning of year2021-12-31$7,981
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$10,082
Contract administrator fees2021-12-31$8,052
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 plan2021-12-31Disclaimer
Accountancy firm name2021-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2021-12-31261556810
2020 : PINES HEALTHCARE CENTER 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$145,772
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$22,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$10,398
Value of total corrective distributions2020-12-31$7,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$110,716
Value of total assets at end of year2020-12-31$351,168
Value of total assets at beginning of year2020-12-31$228,060
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$4,890
Total interest from all sources2020-12-31$0
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$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$42,891
Participant contributions at end of year2020-12-31$2,637
Participant contributions at beginning of year2020-12-31$3,687
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$60,486
Administrative expenses (other) incurred2020-12-31$4,890
Total non interest bearing cash at end of year2020-12-31$411
Total non interest bearing cash at beginning of year2020-12-31$642
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$123,108
Value of net assets at end of year (total assets less liabilities)2020-12-31$351,168
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$228,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$340,139
Value of interest in pooled separate accounts at beginning of year2020-12-31$217,601
Net investment gain/loss from pooled separate accounts2020-12-31$35,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$7,339
Employer contributions (assets) at end of year2020-12-31$7,981
Employer contributions (assets) at beginning of year2020-12-31$6,130
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$10,398
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 plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2020-12-31261556810
2019 : PINES HEALTHCARE CENTER 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$99,706
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$59,329
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$55,191
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$60,515
Value of total assets at end of year2019-12-31$228,060
Value of total assets at beginning of year2019-12-31$187,683
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$4,138
Total interest from all sources2019-12-31$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
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$25,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$54,385
Participant contributions at end of year2019-12-31$3,687
Participant contributions at beginning of year2019-12-31$3,396
Administrative expenses (other) incurred2019-12-31$4,138
Total non interest bearing cash at end of year2019-12-31$642
Total non interest bearing cash at beginning of year2019-12-31$642
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$40,377
Value of net assets at end of year (total assets less liabilities)2019-12-31$228,060
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$187,683
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$217,601
Value of interest in pooled separate accounts at beginning of year2019-12-31$176,667
Net investment gain/loss from pooled separate accounts2019-12-31$39,191
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$6,130
Employer contributions (assets) at end of year2019-12-31$6,130
Employer contributions (assets) at beginning of year2019-12-31$6,978
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$55,191
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2019-12-31261556810
2013 : PINES HEALTHCARE CENTER 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$21,884
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$15,184
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$12,994
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$9,339
Value of total assets at end of year2013-12-31$114,145
Value of total assets at beginning of year2013-12-31$107,445
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,190
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$53
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$53
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$2,000,000
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$6,454
Participant contributions at end of year2013-12-31$242
Participant contributions at beginning of year2013-12-31$703
Administrative expenses (other) incurred2013-12-31$2,190
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$6,700
Value of net assets at end of year (total assets less liabilities)2013-12-31$114,145
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$107,445
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$109,407
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$97,063
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,611
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$1,611
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$1,611
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$12,492
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,885
Employer contributions (assets) at end of year2013-12-31$2,885
Employer contributions (assets) at beginning of year2013-12-31$8,068
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$12,994
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 name2013-12-31PICKET CHANEY & MCMULLEN LLP
Accountancy firm EIN2013-12-31481246310
2012 : PINES HEALTHCARE CENTER 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$26,035
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$17,426
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$15,385
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$19,447
Value of total assets at end of year2012-12-31$107,445
Value of total assets at beginning of year2012-12-31$98,836
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,041
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$6,588
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$6,588
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$2,000,000
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$11,379
Participant contributions at end of year2012-12-31$703
Participant contributions at beginning of year2012-12-31$1,246
Administrative expenses (other) incurred2012-12-31$2,041
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$8,609
Value of net assets at end of year (total assets less liabilities)2012-12-31$107,445
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$98,836
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$97,063
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$86,264
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$1,611
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$1,611
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$1,611
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$8,068
Employer contributions (assets) at end of year2012-12-31$8,068
Employer contributions (assets) at beginning of year2012-12-31$9,715
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$15,385
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 name2012-12-31PICKET CHANEY & MCMULLEN LLP
Accountancy firm EIN2012-12-31481246310

Form 5500 Responses for PINES HEALTHCARE CENTER 401(K) PLAN

2022: PINES HEALTHCARE CENTER 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PINES HEALTHCARE CENTER 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PINES HEALTHCARE CENTER 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PINES HEALTHCARE CENTER 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2013: PINES HEALTHCARE CENTER 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PINES HEALTHCARE CENTER 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number134827
Policy instance 1
Insurance contract or identification number134827
Number of Individuals Covered48
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,363
Total amount of fees paid to insurance companyUSD $237
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 $2,363
Insurance broker organization code?3
Amount paid for insurance broker fees237
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number134827
Policy instance 1
Insurance contract or identification number134827
Number of Individuals Covered44
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,027
Total amount of fees paid to insurance companyUSD $203
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 $2,027
Insurance broker organization code?3
Amount paid for insurance broker fees203
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number134827
Policy instance 1
Insurance contract or identification number134827
Number of Individuals Covered37
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,170
Total amount of fees paid to insurance companyUSD $117
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 $1,170
Insurance broker organization code?3
Amount paid for insurance broker fees117
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number134827
Policy instance 1
Insurance contract or identification number134827
Number of Individuals Covered38
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,002
Total amount of fees paid to insurance companyUSD $357
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 $1,002
Insurance broker organization code?3
Amount paid for insurance broker fees357
Additional information about fees paid to insurance brokerTPA COMPENSATION
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number640851
Policy instance 1
Insurance contract or identification number640851
Number of Individuals Covered17
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $259
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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 $194
Insurance broker organization code?3
Insurance broker nameLARRY GLANZ
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number640851
Policy instance 1
Insurance contract or identification number640851
Number of Individuals Covered15
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $243
Total amount of fees paid to insurance companyUSD $182
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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 $182
Amount paid for insurance broker fees182
Insurance broker organization code?3
Insurance broker nameLARRY GLANZ

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