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HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN 401k Plan overview

Plan NameHEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN
Plan identification number 001

HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

HEARTLAND HEALTHCARE PROVIDERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HEARTLAND HEALTHCARE PROVIDERS, INC.
Employer identification number (EIN):473209859
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01JEFF STONER
0012023-01-01
0012023-01-01JEFF STONER
0012022-01-01
0012021-01-01
0012021-01-01
0012021-01-01TYLER BENSON
0012020-01-01
0012019-01-01
0012018-01-01

Financial Data on HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN

Measure Date Value
2023 : HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$8,110
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$6,623
Total income from all sources (including contributions)2023-12-31$1,249,855
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$791,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$743,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$667,630
Value of total assets at end of year2023-12-31$3,345,567
Value of total assets at beginning of year2023-12-31$2,885,598
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$48,298
Total interest from all sources2023-12-31$970
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$482,077
Participant contributions at end of year2023-12-31$14,728
Participant contributions at beginning of year2023-12-31$536
Participant contributions at end of year2023-12-31$33,795
Participant contributions at beginning of year2023-12-31$4,537
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$74,029
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$8,110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$6,623
Administrative expenses (other) incurred2023-12-31$48,298
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$458,482
Value of net assets at end of year (total assets less liabilities)2023-12-31$3,337,457
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$2,878,975
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$246,763
Value of interest in pooled separate accounts at beginning of year2023-12-31$206,913
Interest on participant loans2023-12-31$970
Value of interest in common/collective trusts at end of year2023-12-31$3,022,950
Value of interest in common/collective trusts at beginning of year2023-12-31$2,402,729
Net investment gain or loss from common/collective trusts2023-12-31$581,255
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31Yes
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$111,524
Employer contributions (assets) at end of year2023-12-31$27,331
Employer contributions (assets) at beginning of year2023-12-31$270,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$743,075
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2023-12-31431947695
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$8,110
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$6,623
Total income from all sources (including contributions)2023-01-01$1,249,855
Total loss/gain on sale of assets2023-01-01$0
Total of all expenses incurred2023-01-01$791,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$743,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$667,630
Value of total assets at end of year2023-01-01$3,345,567
Value of total assets at beginning of year2023-01-01$2,885,598
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$48,298
Total interest from all sources2023-01-01$970
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$500,000
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$482,077
Participant contributions at end of year2023-01-01$14,728
Participant contributions at beginning of year2023-01-01$536
Participant contributions at end of year2023-01-01$33,795
Participant contributions at beginning of year2023-01-01$4,537
Income. Received or receivable in cash from other sources (including rollovers)2023-01-01$74,029
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-01$8,110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-01$6,623
Administrative expenses (other) incurred2023-01-01$48,298
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$458,482
Value of net assets at end of year (total assets less liabilities)2023-01-01$3,337,457
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$2,878,975
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest in pooled separate accounts at end of year2023-01-01$246,763
Value of interest in pooled separate accounts at beginning of year2023-01-01$206,913
Interest on participant loans2023-01-01$970
Value of interest in common/collective trusts at end of year2023-01-01$3,022,950
Value of interest in common/collective trusts at beginning of year2023-01-01$2,402,729
Net investment gain or loss from common/collective trusts2023-01-01$581,255
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01Yes
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$111,524
Employer contributions (assets) at end of year2023-01-01$27,331
Employer contributions (assets) at beginning of year2023-01-01$270,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$743,075
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2023-01-01431947695
2022 : HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS 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$6,623
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$1,197,823
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$475,289
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$447,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,636,339
Value of total assets at end of year2022-12-31$2,885,598
Value of total assets at beginning of year2022-12-31$2,156,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$28,216
Total interest from all sources2022-12-31$1,265
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$1,124,988
Participant contributions at end of year2022-12-31$536
Participant contributions at beginning of year2022-12-31$55,377
Participant contributions at end of year2022-12-31$4,537
Participant contributions at beginning of year2022-12-31$16,721
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$76,790
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$6,623
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$722,534
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,878,975
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,156,441
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$206,913
Value of interest in pooled separate accounts at beginning of year2022-12-31$132,446
Interest on participant loans2022-12-31$1,265
Value of interest in common/collective trusts at end of year2022-12-31$2,402,729
Value of interest in common/collective trusts at beginning of year2022-12-31$1,672,259
Net investment gain or loss from common/collective trusts2022-12-31$-439,781
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$434,561
Employer contributions (assets) at end of year2022-12-31$270,883
Employer contributions (assets) at beginning of year2022-12-31$279,638
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$447,073
Contract administrator fees2022-12-31$28,216
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 name2022-12-31MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2022-12-31431947695
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$6,623
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$1,197,823
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$475,289
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$447,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$1,636,339
Value of total assets at end of year2022-01-01$2,885,598
Value of total assets at beginning of year2022-01-01$2,156,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$28,216
Total interest from all sources2022-01-01$1,265
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$500,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$1,124,988
Participant contributions at end of year2022-01-01$536
Participant contributions at beginning of year2022-01-01$55,377
Participant contributions at end of year2022-01-01$4,537
Participant contributions at beginning of year2022-01-01$16,721
Income. Received or receivable in cash from other sources (including rollovers)2022-01-01$76,790
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-01$6,623
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-01$0
Other income not declared elsewhere2022-01-01$25,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$722,534
Value of net assets at end of year (total assets less liabilities)2022-01-01$2,878,975
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$2,156,441
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$206,913
Value of interest in pooled separate accounts at beginning of year2022-01-01$132,446
Interest on participant loans2022-01-01$1,265
Value of interest in common/collective trusts at end of year2022-01-01$2,402,729
Value of interest in common/collective trusts at beginning of year2022-01-01$1,672,259
Net investment gain/loss from pooled separate accounts2022-01-01$-35,169
Net investment gain or loss from common/collective trusts2022-01-01$-439,781
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01Yes
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$434,561
Employer contributions (assets) at end of year2022-01-01$270,883
Employer contributions (assets) at beginning of year2022-01-01$279,638
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$447,073
Contract administrator fees2022-01-01$28,216
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2022-01-01431947695
2021 : HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS 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$1,318,543
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$198,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$189,465
Expenses. Certain deemed distributions of participant loans2021-12-31$171
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,114,154
Value of total assets at end of year2021-12-31$1,888,712
Value of total assets at beginning of year2021-12-31$768,946
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$9,312
Total interest from all sources2021-12-31$416
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$170,000
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$600,305
Participant contributions at end of year2021-12-31$55,311
Participant contributions at beginning of year2021-12-31$786
Participant contributions at end of year2021-12-31$13,551
Participant contributions at beginning of year2021-12-31$14,516
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$219,916
Other income not declared elsewhere2021-12-31$23,354
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$1,119,766
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,888,712
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$768,946
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$132,446
Value of interest in pooled separate accounts at beginning of year2021-12-31$733,399
Interest on participant loans2021-12-31$416
Value of interest in common/collective trusts at end of year2021-12-31$1,672,259
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$203,973
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$293,933
Employer contributions (assets) at end of year2021-12-31$15,145
Employer contributions (assets) at beginning of year2021-12-31$20,245
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$189,465
Contract administrator fees2021-12-31$9,312
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 name2021-12-31MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2021-12-31431947695

Form 5500 Responses for HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN

2023: HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS 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: HEARTLAND HEALTHCARE PROVIDERS 401(K) SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625761
Policy instance 1
Insurance contract or identification number625761
Number of Individuals Covered324
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $116
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625761
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625761
Policy instance 1

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