401k Plan data: REHAB AT WORK 401K PS PLAN plan

REHAB AT WORK 401K PS PLAN 401k Plan overview

Plan Name	REHAB AT WORK 401K PS PLAN
Plan identification number	002

REHAB AT WORK 401K PS 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.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

REHAB AT WORK has sponsored the creation of one or more 401k plans.

Company Name: REHAB AT WORK

Employer identification number (EIN): 521865835

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan REHAB AT WORK 401K PS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01 PAUL R DUBYAK 2022-08-18
002 2020-01-01 LINDA LE BARON 2021-10-13 LINDA LE BARON 2021-10-13
002 2019-01-01 LINDA LE BARON 2020-07-31 LINDA LE BARON 2020-07-31
002 2018-01-01 LINDA LE BARON 2019-06-18 LINDA LE BARON 2019-06-18
002 2017-01-01 LINDA LE BARON 2018-06-14
002 2016-01-01 LINDA LE BARON 2017-06-12 PAUL DUBYAK 2017-06-12
002 2015-01-01 LINDA LE BARON 2016-06-10 LINDA LE BARON 2016-06-10
002 2014-01-01 LINDA LE BARON
002 2013-01-01 LINDA LE BARON
002 2012-01-01 LINDA LE BARON
002 2011-01-01 LINDA LE BARON
002 2010-01-01 REHAB AT WORK CORP 2011-04-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01	PAUL R DUBYAK	2022-08-18
002	2020-01-01	LINDA LE BARON	2021-10-13	LINDA LE BARON	2021-10-13
002	2019-01-01	LINDA LE BARON	2020-07-31	LINDA LE BARON	2020-07-31
002	2018-01-01	LINDA LE BARON	2019-06-18	LINDA LE BARON	2019-06-18
002	2017-01-01	LINDA LE BARON	2018-06-14
002	2016-01-01	LINDA LE BARON	2017-06-12	PAUL DUBYAK	2017-06-12
002	2015-01-01	LINDA LE BARON	2016-06-10	LINDA LE BARON	2016-06-10
002	2014-01-01	LINDA LE BARON
002	2013-01-01	LINDA LE BARON
002	2012-01-01	LINDA LE BARON
002	2011-01-01	LINDA LE BARON
002	2010-01-01	REHAB AT WORK CORP	2011-04-27

Plan Statistics for REHAB AT WORK 401K PS PLAN

401k plan membership statisitcs for REHAB AT WORK 401K PS PLAN

Measure Date Value
2014: REHAB AT WORK 401K PS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 57
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 55
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 8
Total of all active and inactive participants 2014-01-01 63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 63
Number of participants with account balances 2014-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: REHAB AT WORK 401K PS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 59
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 56
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 8
Total of all active and inactive participants 2013-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 64
Number of participants with account balances 2013-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: REHAB AT WORK 401K PS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 56
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 48
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 8
Total of all active and inactive participants 2012-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 56
Number of participants with account balances 2012-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 12
2011: REHAB AT WORK 401K PS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 60
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 53
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 53
Number of participants with account balances 2011-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2014: REHAB AT WORK 401K PS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	57
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	55
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	8
Total of all active and inactive participants	2014-01-01	63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	63
Number of participants with account balances	2014-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: REHAB AT WORK 401K PS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	59
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	56
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	8
Total of all active and inactive participants	2013-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	64
Number of participants with account balances	2013-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: REHAB AT WORK 401K PS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	56
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	48
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	8
Total of all active and inactive participants	2012-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	56
Number of participants with account balances	2012-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	12
2011: REHAB AT WORK 401K PS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	60
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	53
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	53
Number of participants with account balances	2011-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on REHAB AT WORK 401K PS PLAN

Measure	Date	Value
2014 : REHAB AT WORK 401K PS PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total income from all sources	2014-12-31	$287,907
Expenses. Total of all expenses incurred	2014-12-31	$2,770
Benefits paid (including direct rollovers)	2014-12-31	$2,580
Total plan assets at end of year	2014-12-31	$2,347,242
Total plan assets at beginning of year	2014-12-31	$2,062,105
Value of fidelity bond covering the plan	2014-12-31	$9,304
Total contributions received or receivable from participants	2014-12-31	$153,546
Expenses. Other expenses not covered elsewhere	2014-12-31	$190
Contributions received from other sources (not participants or employers)	2014-12-31	$21,285
Other income received	2014-12-31	$72,704
Net income (gross income less expenses)	2014-12-31	$285,137
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,347,242
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,062,105
Assets. Value of participant loans	2014-12-31	$101,886
Total contributions received or receivable from employer(s)	2014-12-31	$40,372
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : REHAB AT WORK 401K PS PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total income from all sources	2013-12-31	$489,196
Expenses. Total of all expenses incurred	2013-12-31	$5,895
Benefits paid (including direct rollovers)	2013-12-31	$5,694
Total plan assets at end of year	2013-12-31	$2,062,105
Total plan assets at beginning of year	2013-12-31	$1,578,804
Value of fidelity bond covering the plan	2013-12-31	$9,304
Total contributions received or receivable from participants	2013-12-31	$147,791
Expenses. Other expenses not covered elsewhere	2013-12-31	$147
Contributions received from other sources (not participants or employers)	2013-12-31	$6,221
Other income received	2013-12-31	$296,432
Net income (gross income less expenses)	2013-12-31	$483,301
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,062,105
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,578,804
Assets. Value of participant loans	2013-12-31	$80,161
Total contributions received or receivable from employer(s)	2013-12-31	$38,752
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$54
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : REHAB AT WORK 401K PS PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total income from all sources	2012-12-31	$320,261
Expenses. Total of all expenses incurred	2012-12-31	$6,578
Benefits paid (including direct rollovers)	2012-12-31	$6,454
Total plan assets at end of year	2012-12-31	$1,578,804
Total plan assets at beginning of year	2012-12-31	$1,265,121
Value of fidelity bond covering the plan	2012-12-31	$9,304
Total contributions received or receivable from participants	2012-12-31	$135,740
Expenses. Other expenses not covered elsewhere	2012-12-31	$124
Contributions received from other sources (not participants or employers)	2012-12-31	$5,500
Other income received	2012-12-31	$143,751
Net income (gross income less expenses)	2012-12-31	$313,683
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,578,804
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,265,121
Assets. Value of participant loans	2012-12-31	$73,499
Total contributions received or receivable from employer(s)	2012-12-31	$35,270
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : REHAB AT WORK 401K PS PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$115,829
Expenses. Total of all expenses incurred	2011-12-31	$102,908
Benefits paid (including direct rollovers)	2011-12-31	$102,821
Total plan assets at end of year	2011-12-31	$1,265,121
Total plan assets at beginning of year	2011-12-31	$1,252,200
Value of fidelity bond covering the plan	2011-12-31	$9,304
Total contributions received or receivable from participants	2011-12-31	$140,352
Expenses. Other expenses not covered elsewhere	2011-12-31	$87
Contributions received from other sources (not participants or employers)	2011-12-31	$10,196
Other income received	2011-12-31	$-69,111
Net income (gross income less expenses)	2011-12-31	$12,921
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,265,121
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,252,200
Assets. Value of participant loans	2011-12-31	$88,060
Total contributions received or receivable from employer(s)	2011-12-31	$34,392
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0

Form 5500 Responses for REHAB AT WORK 401K PS PLAN

2014: REHAB AT WORK 401K PS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: REHAB AT WORK 401K PS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: REHAB AT WORK 401K PS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: REHAB AT WORK 401K PS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825113

Policy instance

Insurance contract or identification number	GA-825113
Number of Individuals Covered	47
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $7,549
Total amount of fees paid to insurance company	USD $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 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?	Yes
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 $7,549
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825113

Policy instance

Insurance contract or identification number	GA-825113
Number of Individuals Covered	47
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,993
Total amount of fees paid to insurance company	USD $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 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?	Yes
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 $5,993
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825113

Policy instance

Insurance contract or identification number	GA-825113
Number of Individuals Covered	48
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,217
Total amount of fees paid to insurance company	USD $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 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?	Yes
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 $4,217
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825113

Policy instance

Insurance contract or identification number	GA-825113
Number of Individuals Covered	48
Insurance policy start date	2011-03-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $10,160
Total amount of fees paid to insurance company	USD $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 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?	Yes
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

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Company Name:	REHAB AT WORK
Employer identification number (EIN):	521865835
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists