401k Plan data: FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN plan

FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN 401k Plan overview

Plan Name	FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN
Plan identification number	001

FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
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).
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.

401k Sponsoring company profile

FAMILY SERVICE UPPER OHIO VALLEY has sponsored the creation of one or more 401k plans.

Company Name: FAMILY SERVICE UPPER OHIO VALLEY

Employer identification number (EIN): 550357074

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JILL WILLEY 2023-10-16
001 2021-01-01 JILL WILLEY 2022-10-14
001 2020-01-01 JILL WILLEY 2021-09-09
001 2019-01-01 JILL WILLEY 2020-10-08
001 2018-01-01 JILL WILLEY 2019-10-04
001 2017-01-01 JILL WILLEY 2018-10-01
001 2016-01-01 JILL WILLEY 2017-09-29
001 2015-01-01 JILL WILLEY 2016-12-28
001 2014-01-01 JILL WILLEY 2016-12-28
001 2013-01-01 JILL WILLEY 2016-12-28
001 2012-01-01 GLEN BURTON GLEN BURTON 2013-08-01
001 2011-01-01 GLEN BURTON 2012-07-31
001 2010-01-01 GLEN BURTON 2011-07-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	JILL WILLEY	2023-10-16
001	2021-01-01	JILL WILLEY	2022-10-14
001	2020-01-01	JILL WILLEY	2021-09-09
001	2019-01-01	JILL WILLEY	2020-10-08
001	2018-01-01	JILL WILLEY	2019-10-04
001	2017-01-01	JILL WILLEY	2018-10-01
001	2016-01-01	JILL WILLEY	2017-09-29
001	2015-01-01	JILL WILLEY	2016-12-28
001	2014-01-01	JILL WILLEY	2016-12-28
001	2013-01-01	JILL WILLEY	2016-12-28
001	2012-01-01	GLEN BURTON		GLEN BURTON	2013-08-01
001	2011-01-01	GLEN BURTON	2012-07-31
001	2010-01-01	GLEN BURTON	2011-07-27

Plan Statistics for FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN

401k plan membership statisitcs for FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN

Measure Date Value
2012: FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 46
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 44
Number of retired or separated participants receiving benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 46

Measure	Date	Value
2012: FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	46
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	44
Number of retired or separated participants receiving benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	46

Form 5500 Responses for FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT PLAN

2012: FAMILY SERVICE UPPER OHIO VALLEY RETIREMENT 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

070536

Policy instance

Insurance contract or identification number	070536
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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	N/A
Insurance broker organization code?	3
Insurance broker name	JOHN WILSON

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Company Name:	FAMILY SERVICE UPPER OHIO VALLEY
Employer identification number (EIN):	550357074
NAIC Classification:	624100
NAIC Description:	Individual and Family Services