401k Plan data: LAKE PINES HOSPITAL 401(K) PLAN plan

LAKE PINES HOSPITAL 401(K) PLAN 401k Plan overview

Plan Name	LAKE PINES HOSPITAL 401(K) PLAN
Plan identification number	001

LAKE PINES HOSPITAL 401(K) PLAN Benefits

401k Plan Type

Defined 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.

401k Sponsoring company profile

LAKE PINES HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: LAKE PINES HOSPITAL

Employer identification number (EIN): 475441649

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKE PINES HOSPITAL 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01
001 2019-01-01
001 2018-01-01 GEORGE DUNAWAY 2019-06-04
001 2017-01-01 ALVIN MERLIN MD 2018-07-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2020-01-01
001	2019-01-01
001	2018-01-01	GEORGE DUNAWAY	2019-06-04
001	2017-01-01	ALVIN MERLIN MD	2018-07-24

Plan Statistics for LAKE PINES HOSPITAL 401(K) PLAN

401k plan membership statisitcs for LAKE PINES HOSPITAL 401(K) PLAN

Measure Date Value
2020: LAKE PINES HOSPITAL 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Number of participants with account balances 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: LAKE PINES HOSPITAL 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 108
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 61
Total of all active and inactive participants 2019-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 169
Number of participants with account balances 2019-01-01 141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 25

Measure	Date	Value
2020: LAKE PINES HOSPITAL 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Number of participants with account balances	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: LAKE PINES HOSPITAL 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	108
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	61
Total of all active and inactive participants	2019-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	169
Number of participants with account balances	2019-01-01	141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	25

Financial Data on LAKE PINES HOSPITAL 401(K) PLAN

Measure	Date	Value
2020 : LAKE PINES HOSPITAL 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-01-08	$0
Total transfer of assets from this plan	2020-01-08	$316,030
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-01-08	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-01-08	$0
Total income from all sources (including contributions)	2020-01-08	$399
Total loss/gain on sale of assets	2020-01-08	$0
Total of all expenses incurred	2020-01-08	$1,409
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-01-08	$0
Expenses. Certain deemed distributions of participant loans	2020-01-08	$1,409
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-01-08	$0
Value of total assets at end of year	2020-01-08	$0
Value of total assets at beginning of year	2020-01-08	$317,040
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-01-08	$0
Total interest from all sources	2020-01-08	$399
Total dividends received (eg from common stock, registered investment company shares)	2020-01-08	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-01-08	No
Was this plan covered by a fidelity bond	2020-01-08	No
If this is an individual account plan, was there a blackout period	2020-01-08	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-01-08	$0
Were there any nonexempt tranactions with any party-in-interest	2020-01-08	No
Contributions received from participants	2020-01-08	$0
Participant contributions at end of year	2020-01-08	$0
Participant contributions at beginning of year	2020-01-08	$1,411
Income. Received or receivable in cash from other sources (including rollovers)	2020-01-08	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-01-08	No
Value of net income/loss	2020-01-08	$-1,010
Value of net assets at end of year (total assets less liabilities)	2020-01-08	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-01-08	$317,040
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-01-08	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-01-08	No
Were any leases to which the plan was party in default or uncollectible	2020-01-08	No
Value of interest in pooled separate accounts at end of year	2020-01-08	$0
Value of interest in pooled separate accounts at beginning of year	2020-01-08	$301,535
Interest earned on other investments	2020-01-08	$399
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-01-08	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-01-08	$14,094
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-01-08	No
Was there a failure to transmit to the plan any participant contributions	2020-01-08	No
Has the plan failed to provide any benefit when due under the plan	2020-01-08	No
Contributions received in cash from employer	2020-01-08	$0
Did the plan have assets held for investment	2020-01-08	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-01-08	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-01-08	Yes
Opinion of an independent qualified public accountant for this plan	2020-01-08	Unqualified
Accountancy firm name	2020-01-08	SKIBBIE CPA, INC.
Accountancy firm EIN	2020-01-08	270851321
2019 : LAKE PINES HOSPITAL 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$202,373
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$37,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$29,336
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$160,997
Value of total assets at end of year	2019-12-31	$317,040
Value of total assets at beginning of year	2019-12-31	$152,043
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,910
Total interest from all sources	2019-12-31	$41,376
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 year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$1,000
Was this plan covered by a fidelity bond	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$79,970
Participant contributions at end of year	2019-12-31	$1,411
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$5,005
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$164,997
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$317,040
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$152,043
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$47
Value of interest in pooled separate accounts at end of year	2019-12-31	$301,535
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$145,439
Interest earned on other investments	2019-12-31	$41,376
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$14,094
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$6,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$76,022
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$29,336
Contract administrator fees	2019-12-31	$4,863
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SKIBBLE CPA, INC
Accountancy firm EIN	2019-12-31	270851321

Form 5500 Responses for LAKE PINES HOSPITAL 401(K) PLAN

2020: LAKE PINES HOSPITAL 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: LAKE PINES HOSPITAL 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807885

Policy instance

Insurance contract or identification number	807885
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-01-08
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $0
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807885

Policy instance

Insurance contract or identification number	807885
Number of Individuals Covered	169
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,043
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	925
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	LAKE PINES HOSPITAL
Employer identification number (EIN):	475441649
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)