401k Plan data: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS plan

SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 401k Plan overview

Plan Name	SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS
Plan identification number	002

SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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(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.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

ARC OF THE SHOALS has sponsored the creation of one or more 401k plans.

Company Name: ARC OF THE SHOALS

Employer identification number (EIN): 630412649

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-01-01 KIM SENNETT 2020-07-24
002 2018-01-01 KIM SENNETT 2019-09-19
002 2017-01-01
002 2016-01-01 KIM SENNETT 2017-07-28
002 2015-01-01 KIM SENNETT 2016-08-01
002 2014-01-01 KIM SENNETT 2015-10-12
002 2013-01-01 KIM SENNETT
002 2012-01-01 DONNA AKINS
002 2011-01-01 DONNA AKINS 2012-10-14
002 2010-01-01 DONNA AKINS 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2019-01-01	KIM SENNETT	2020-07-24
002	2018-01-01	KIM SENNETT	2019-09-19
002	2017-01-01
002	2016-01-01	KIM SENNETT	2017-07-28
002	2015-01-01	KIM SENNETT	2016-08-01
002	2014-01-01	KIM SENNETT	2015-10-12
002	2013-01-01	KIM SENNETT
002	2012-01-01	DONNA AKINS
002	2011-01-01	DONNA AKINS	2012-10-14
002	2010-01-01	DONNA AKINS	2011-10-14

Plan Statistics for SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS

401k plan membership statisitcs for SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS

Measure Date Value
2013: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2013 401k membership
Total participants, beginning-of-year 2013-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 140
Number of retired or separated participants receiving benefits 2013-01-01 5
Number of other retired or separated participants entitled to future benefits 2013-01-01 12
Total of all active and inactive participants 2013-01-01 157
Total participants 2013-01-01 157
Number of participants with account balances 2013-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 3
2012: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2012 401k membership
Total participants, beginning-of-year 2012-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 139
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 11
Total of all active and inactive participants 2012-01-01 152
Total participants 2012-01-01 152
Number of participants with account balances 2012-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 4

Measure	Date	Value
2013: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2013 401k membership
Total participants, beginning-of-year	2013-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	140
Number of retired or separated participants receiving benefits	2013-01-01	5
Number of other retired or separated participants entitled to future benefits	2013-01-01	12
Total of all active and inactive participants	2013-01-01	157
Total participants	2013-01-01	157
Number of participants with account balances	2013-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	3
2012: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2012 401k membership
Total participants, beginning-of-year	2012-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	139
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	11
Total of all active and inactive participants	2012-01-01	152
Total participants	2012-01-01	152
Number of participants with account balances	2012-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	4

Financial Data on SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS

Measure	Date	Value
2013 : SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$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	$161,223
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$43,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$42,234
Expenses. Certain deemed distributions of participant loans	2013-12-31	$1,025
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$78,157
Value of total assets at end of year	2013-12-31	$732,441
Value of total assets at beginning of year	2013-12-31	$614,737
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$260
Total interest from all sources	2013-12-31	$10,997
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$43,159
Participant contributions at end of year	2013-12-31	$17,434
Participant contributions at beginning of year	2013-12-31	$11,696
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$3
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$117,704
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$732,441
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$614,737
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$345,614
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$278,090
Interest earned on other investments	2013-12-31	$10,997
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$369,393
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$324,633
Net investment gain/loss from pooled separate accounts	2013-12-31	$72,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$34,998
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$315
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$42,234
Contract administrator fees	2013-12-31	$260
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HAYNES DOWNARD, LLP
Accountancy firm EIN	2013-12-31	631133963
2012 : SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$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	$125,054
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$12,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$12,029
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$85,936
Value of total assets at end of year	2012-12-31	$614,737
Value of total assets at beginning of year	2012-12-31	$501,902
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$190
Total interest from all sources	2012-12-31	$9,642
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$190
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$50,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$46,577
Participant contributions at end of year	2012-12-31	$11,696
Participant contributions at beginning of year	2012-12-31	$4,263
Participant contributions at end of year	2012-12-31	$3
Participant contributions at beginning of year	2012-12-31	$59
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$112,835
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$614,737
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$501,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$278,090
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$225,326
Interest earned on other investments	2012-12-31	$9,642
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$324,633
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$271,067
Net investment gain/loss from pooled separate accounts	2012-12-31	$29,476
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$39,359
Employer contributions (assets) at end of year	2012-12-31	$315
Employer contributions (assets) at beginning of year	2012-12-31	$1,187
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$12,029
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HAYNES DOWNARD, LLP
Accountancy firm EIN	2012-12-31	631133963

Form 5500 Responses for SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS

2013: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SECTION 403B RETIREMENT PLAN FOR THE ARC OF THE SHOALS 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
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1095444

Policy instance

Insurance contract or identification number	1095444
Number of Individuals Covered	63
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-19
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?	Yes

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1095444

Policy instance

Insurance contract or identification number	1095444
Number of Individuals Covered	60
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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?	Yes

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Company Name:	ARC OF THE SHOALS
Employer identification number (EIN):	630412649
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations