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RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameRIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN
Plan identification number 001

RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN Benefits

401k Plan TypeDefined 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
  • 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

RIVER OAKS OF MINNESOTA has sponsored the creation of one or more 401k plans.

Company Name:RIVER OAKS OF MINNESOTA
Employer identification number (EIN):832284893
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01MICHAEL MADSON
0012023-01-01
0012023-01-01MICHAEL MADSON
0012022-01-01
0012022-01-01MICHAEL MADSON
0012021-01-01MICHAEL MADSON2022-10-17
0012020-04-15MICHAEL MADSON2021-09-20

Financial Data on RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN

Measure Date Value
2023 : RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$614,756
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$269,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$244,229
Value of total corrective distributions2023-12-31$9,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$435,377
Value of total assets at end of year2023-12-31$1,192,220
Value of total assets at beginning of year2023-12-31$846,906
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$16,180
Total interest from all sources2023-12-31$1,161
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$100,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$300,246
Participant contributions at end of year2023-12-31$20,550
Participant contributions at beginning of year2023-12-31$8,353
Participant contributions at beginning of year2023-12-31$10,163
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$1,177
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-12-31$576
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$345,314
Value of net assets at end of year (total assets less liabilities)2023-12-31$1,192,220
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$846,906
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$1,171,670
Value of interest in pooled separate accounts at beginning of year2023-12-31$821,051
Interest on participant loans2023-12-31$1,161
Net investment gain/loss from pooled separate accounts2023-12-31$178,218
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$133,954
Employer contributions (assets) at beginning of year2023-12-31$7,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$243,653
Contract administrator fees2023-12-31$16,180
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN2023-12-31411489071
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total income from all sources (including contributions)2023-01-01$614,756
Total loss/gain on sale of assets2023-01-01$0
Total of all expenses incurred2023-01-01$269,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$244,229
Value of total corrective distributions2023-01-01$9,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$435,377
Value of total assets at end of year2023-01-01$1,192,220
Value of total assets at beginning of year2023-01-01$846,906
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$16,180
Total interest from all sources2023-01-01$1,161
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$100,000
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$300,246
Participant contributions at end of year2023-01-01$20,550
Participant contributions at beginning of year2023-01-01$8,353
Participant contributions at beginning of year2023-01-01$10,163
Income. Received or receivable in cash from other sources (including rollovers)2023-01-01$1,177
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-01-01$576
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$345,314
Value of net assets at end of year (total assets less liabilities)2023-01-01$1,192,220
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$846,906
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest in pooled separate accounts at end of year2023-01-01$1,171,670
Value of interest in pooled separate accounts at beginning of year2023-01-01$821,051
Interest on participant loans2023-01-01$1,161
Net investment gain/loss from pooled separate accounts2023-01-01$178,218
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$133,954
Employer contributions (assets) at beginning of year2023-01-01$7,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$243,653
Contract administrator fees2023-01-01$16,180
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN2023-01-01411489071
2022 : RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$331,967
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$199,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$159,747
Value of total corrective distributions2022-12-31$27,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$465,712
Value of total assets at end of year2022-12-31$846,906
Value of total assets at beginning of year2022-12-31$714,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$11,878
Total interest from all sources2022-12-31$370
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$100,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$298,696
Participant contributions at end of year2022-12-31$8,353
Participant contributions at beginning of year2022-12-31$8,147
Participant contributions at end of year2022-12-31$10,163
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$665
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$132,701
Value of net assets at end of year (total assets less liabilities)2022-12-31$846,906
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$714,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$821,051
Value of interest in pooled separate accounts at beginning of year2022-12-31$705,992
Interest on participant loans2022-12-31$369
Interest earned on other investments2022-12-31$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$66
Net investment gain/loss from pooled separate accounts2022-12-31$-134,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$167,016
Employer contributions (assets) at end of year2022-12-31$7,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$159,082
Contract administrator fees2022-12-31$11,878
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31SMITH, SCHAFER, AND ASSOCIATES, LTD
Accountancy firm EIN2022-12-31411489071
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$331,967
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$199,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$159,747
Value of total corrective distributions2022-01-01$27,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$465,712
Value of total assets at end of year2022-01-01$846,906
Value of total assets at beginning of year2022-01-01$714,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$11,878
Total interest from all sources2022-01-01$370
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$100,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$298,696
Participant contributions at end of year2022-01-01$8,353
Participant contributions at beginning of year2022-01-01$8,147
Participant contributions at end of year2022-01-01$10,163
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-01-01$665
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$132,701
Value of net assets at end of year (total assets less liabilities)2022-01-01$846,906
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$714,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$821,051
Value of interest in pooled separate accounts at beginning of year2022-01-01$705,992
Interest on participant loans2022-01-01$369
Interest earned on other investments2022-01-01$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-01$66
Net investment gain/loss from pooled separate accounts2022-01-01$-134,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$167,016
Employer contributions (assets) at end of year2022-01-01$7,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$159,082
Contract administrator fees2022-01-01$11,878
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01SMITH, SCHAFER, AND ASSOCIATES, LTD
Accountancy firm EIN2022-01-01411489071

Form 5500 Responses for RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN

2023: RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: RIVER OAKS OF MINNESOTA 401(K) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered102
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number724435
Policy instance 2
Insurance contract or identification number724435
Number of Individuals Covered102
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,528
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number724435
Policy instance 2

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