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COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 401k Plan overview

Plan NameCOLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST
Plan identification number 501

COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

COLONIAL NURSING HOME, INC. has sponsored the creation of one or more 401k plans.

Company Name:COLONIAL NURSING HOME, INC.
Employer identification number (EIN):720770498
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01
5012016-01-01SUE ANN DESHOTEL
5012015-01-01SUE ANN DESHOTEL
5012014-02-01MARILYN BLALOCK
5012013-03-01MARILYN BLALOCK

Plan Statistics for COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST

401k plan membership statisitcs for COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST

Measure Date Value
2018: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-0198
Total number of active participants reported on line 7a of the Form 55002018-01-01213
Total of all active and inactive participants2018-01-01213
2016: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-0168
Total number of active participants reported on line 7a of the Form 55002016-01-0198
Total of all active and inactive participants2016-01-0198
2015: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0163
Total number of active participants reported on line 7a of the Form 55002015-01-0168
Total of all active and inactive participants2015-01-0168
2014: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-02-0176
Total number of active participants reported on line 7a of the Form 55002014-02-0163
Total of all active and inactive participants2014-02-0163
2013: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-03-0171
Total number of active participants reported on line 7a of the Form 55002013-03-0175
Total of all active and inactive participants2013-03-0175

Financial Data on COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST

Measure Date Value
2016 : COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2016 401k financial data
Total income from all sources2016-12-31$0
Expenses. Total of all expenses incurred2016-12-31$11,122
Benefits paid (including direct rollovers)2016-12-31$4,832
Total plan assets at end of year2016-12-31$12,957
Total plan assets at beginning of year2016-12-31$24,079
Expenses. Other expenses not covered elsewhere2016-12-31$6,290
Net income (gross income less expenses)2016-12-31$-11,122
Net plan assets at end of year (total assets less liabilities)2016-12-31$12,957
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$24,079
Total contributions received or receivable from employer(s)2016-12-31$0
2015 : COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2015 401k financial data
Total income from all sources2015-12-31$676,403
Expenses. Total of all expenses incurred2015-12-31$718,166
Benefits paid (including direct rollovers)2015-12-31$673,099
Total plan assets at end of year2015-12-31$24,079
Total plan assets at beginning of year2015-12-31$65,842
Expenses. Other expenses not covered elsewhere2015-12-31$45,067
Net income (gross income less expenses)2015-12-31$-41,763
Net plan assets at end of year (total assets less liabilities)2015-12-31$24,079
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$65,842
Total contributions received or receivable from employer(s)2015-12-31$676,403
2014 : COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$518,785
Expenses. Total of all expenses incurred2014-12-31$495,346
Benefits paid (including direct rollovers)2014-12-31$454,712
Total plan assets at end of year2014-12-31$65,842
Total plan assets at beginning of year2014-12-31$42,403
Expenses. Other expenses not covered elsewhere2014-12-31$40,634
Net income (gross income less expenses)2014-12-31$23,439
Net plan assets at end of year (total assets less liabilities)2014-12-31$65,842
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$42,403
Total contributions received or receivable from employer(s)2014-12-31$518,785
Total income from all sources2014-01-31$505,548
Expenses. Total of all expenses incurred2014-01-31$463,145
Benefits paid (including direct rollovers)2014-01-31$422,089
Total plan assets at end of year2014-01-31$42,403
Total plan assets at beginning of year2014-01-31$0
Expenses. Other expenses not covered elsewhere2014-01-31$41,056
Net income (gross income less expenses)2014-01-31$42,403
Net plan assets at end of year (total assets less liabilities)2014-01-31$42,403
Net plan assets at beginning of year (total assets less liabilities)2014-01-31$0
Total contributions received or receivable from employer(s)2014-01-31$505,548

Form 5500 Responses for COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST

2018: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – TrustYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement - TrustYes
2013: COLONIAL NURSING HOME, INC. SECONDARY EMPLOYEE BENEFIT PLAN & TRUST 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01First time form 5500 has been submittedYes
2013-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan funding arrangement – TrustYes
2013-03-01Plan benefit arrangement – InsuranceYes
2013-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05933838
Policy instance 1
Insurance contract or identification numberKM05933838
Number of Individuals Covered213
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,353
Total amount of fees paid to insurance companyUSD $806
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $59,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,353
Amount paid for insurance broker fees806
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered68
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $42,268
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedCOMPLIANCE
Welfare Benefit Premiums Paid to CarrierUSD $614,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees38158
Additional information about fees paid to insurance brokerTHIRD PARTY FEES
Insurance broker organization code?5
Insurance broker nameEARL LEMOINE & ASSOC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered63
Insurance policy start date2014-02-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $38,385
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedCOMPLIANCE
Welfare Benefit Premiums Paid to CarrierUSD $454,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees34585
Additional information about fees paid to insurance brokerTHIRD PARTY ADMIN FEES
Insurance broker organization code?5
Insurance broker nameEARL LEMOINE & ASSOC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered75
Insurance policy start date2013-03-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $39,091
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedCOMPLIANCE
Welfare Benefit Premiums Paid to CarrierUSD $413,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees35201
Additional information about fees paid to insurance brokerTHIRD PARTY ADMIN FEES
Insurance broker organization code?5
Insurance broker nameEARL LEMOINE

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