401k Plan data: CARMEL VALLEY MANOR MEDICAL PLAN plan

CARMEL VALLEY MANOR MEDICAL PLAN 401k Plan overview

Plan Name	CARMEL VALLEY MANOR MEDICAL PLAN
Plan identification number	502

CARMEL VALLEY MANOR MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

CARMEL VALLEY MANOR has sponsored the creation of one or more 401k plans.

Company Name: CARMEL VALLEY MANOR

Employer identification number (EIN): 946050486

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARMEL VALLEY MANOR MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2010-01-01 JANE IPSEN JANE IPSEN 2015-10-14
502 2009-01-01 JANE IPSEN JANE IPSEN 2015-10-14
502 2008-01-01 JANE IPSEN JANE IPSEN 2015-10-14
502 2007-01-01 JANE IPSEN JANE IPSEN 2015-10-14
502 2006-01-01 JANE IPSEN JANE IPSEN 2015-10-14
502 2005-01-01 JANE IPSEN JANE IPSEN 2015-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2010-01-01	JANE IPSEN	JANE IPSEN	2015-10-14
502	2009-01-01	JANE IPSEN	JANE IPSEN	2015-10-14
502	2008-01-01	JANE IPSEN	JANE IPSEN	2015-10-14
502	2007-01-01	JANE IPSEN	JANE IPSEN	2015-10-14
502	2006-01-01	JANE IPSEN	JANE IPSEN	2015-10-14
502	2005-01-01	JANE IPSEN	JANE IPSEN	2015-10-14

Plan Statistics for CARMEL VALLEY MANOR MEDICAL PLAN

401k plan membership statisitcs for CARMEL VALLEY MANOR MEDICAL PLAN

Measure Date Value
2010: CARMEL VALLEY MANOR MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 126
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 126
Total participants 2010-01-01 126
2009: CARMEL VALLEY MANOR MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 127
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 127
Total participants 2009-01-01 127
2008: CARMEL VALLEY MANOR MEDICAL PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 127
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 127
Total participants 2008-01-01 127
2007: CARMEL VALLEY MANOR MEDICAL PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 124
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 124
Total participants 2007-01-01 124
2006: CARMEL VALLEY MANOR MEDICAL PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 117
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 117
Total participants 2006-01-01 117
2005: CARMEL VALLEY MANOR MEDICAL PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 120
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 0
Total of all active and inactive participants 2005-01-01 120
Total participants 2005-01-01 120

Measure	Date	Value
2010: CARMEL VALLEY MANOR MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	126
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	126
Total participants	2010-01-01	126
2009: CARMEL VALLEY MANOR MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	127
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	127
Total participants	2009-01-01	127
2008: CARMEL VALLEY MANOR MEDICAL PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	127
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	127
Total participants	2008-01-01	127
2007: CARMEL VALLEY MANOR MEDICAL PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	124
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	124
Total participants	2007-01-01	124
2006: CARMEL VALLEY MANOR MEDICAL PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	117
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	117
Total participants	2006-01-01	117
2005: CARMEL VALLEY MANOR MEDICAL PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	120
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	120
Total participants	2005-01-01	120

Form 5500 Responses for CARMEL VALLEY MANOR MEDICAL PLAN

2010: CARMEL VALLEY MANOR MEDICAL PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: CARMEL VALLEY MANOR MEDICAL PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: CARMEL VALLEY MANOR MEDICAL PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2008-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2007: CARMEL VALLEY MANOR MEDICAL PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2007-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2006: CARMEL VALLEY MANOR MEDICAL PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2006-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2005: CARMEL VALLEY MANOR MEDICAL PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Submission has been amended	No
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2005-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2005-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	CARMEL VALLEY MANOR
Employer identification number (EIN):	946050486
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities