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403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 401k Plan overview

Plan Name403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE
Plan identification number 002

403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE Benefits

401k Plan TypeDefined 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.
  • 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

COMMUNITY CARE ALLIANCE has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY CARE ALLIANCE
Employer identification number (EIN):050312278
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about COMMUNITY CARE ALLIANCE

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2015-11-03
Company Identification Number: 603557042
Legal Registered Office Address: 2240 214TH PL SW

BRIER
United States of America (USA)
980368913

More information about COMMUNITY CARE ALLIANCE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022018-01-01
0022017-01-01RITA GANDHI RITA GANDHI2018-10-10
0022016-01-01RITA GANDHI RITA GANDHI2017-10-12
0022015-01-01RITA GANDHI RITA GANDHI2015-11-30
0022015-01-01RITA GANDHI RITA GANDHI2016-10-14
0022014-07-01BENEDICT LESSING
0022014-01-01RITA GANDHI
0022013-07-01BENEDICT LESSING
0022012-07-01CHRISTIAN STEPHENS
0022011-07-01CHRISTIAN STEPHENS
0022010-07-01CHRISTIAN STEPHENS
0022009-07-01CHRISTIAN STEPHENS

Plan Statistics for 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE

401k plan membership statisitcs for 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE

Measure Date Value
2018: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2018 401k membership
Total participants, beginning-of-year2018-01-01403
Total number of active participants reported on line 7a of the Form 55002018-01-01302
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01117
Total of all active and inactive participants2018-01-01419
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-012
Total participants2018-01-01421
Number of participants with account balances2018-01-01403
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2017 401k membership
Total participants, beginning-of-year2017-01-01363
Total number of active participants reported on line 7a of the Form 55002017-01-01285
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01116
Total of all active and inactive participants2017-01-01401
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-012
Total participants2017-01-01403
Number of participants with account balances2017-01-01389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01361
Total number of active participants reported on line 7a of the Form 55002016-01-01270
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0193
Total of all active and inactive participants2016-01-01363
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01363
Number of participants with account balances2016-01-01348
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0116
2015: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01389
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2014 401k membership
Total participants, beginning-of-year2014-07-01396
Total number of active participants reported on line 7a of the Form 55002014-07-01326
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0163
Total of all active and inactive participants2014-07-01389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01389
Number of participants with account balances2014-07-01212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
Total participants, beginning-of-year2014-01-01120
Total number of active participants reported on line 7a of the Form 55002014-01-01114
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-019
Total of all active and inactive participants2014-01-01123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01123
Number of participants with account balances2014-01-01123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2013 401k membership
Total participants, beginning-of-year2013-07-01362
Total number of active participants reported on line 7a of the Form 55002013-07-01331
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-0164
Total of all active and inactive participants2013-07-01395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-01395
Number of participants with account balances2013-07-01196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2012 401k membership
Total participants, beginning-of-year2012-07-01342
Total number of active participants reported on line 7a of the Form 55002012-07-01296
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-0165
Total of all active and inactive participants2012-07-01361
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-01361
Number of participants with account balances2012-07-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2011 401k membership
Total participants, beginning-of-year2011-07-01277
Total number of active participants reported on line 7a of the Form 55002011-07-01279
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0161
Total of all active and inactive participants2011-07-01340
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-01340
Number of participants with account balances2011-07-01174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-010
2010: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2010 401k membership
Total participants, beginning-of-year2010-07-01211
Total number of active participants reported on line 7a of the Form 55002010-07-01249
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-0120
Total of all active and inactive participants2010-07-01269
Total participants2010-07-01269
Number of participants with account balances2010-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
2009: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2009 401k membership
Total participants, beginning-of-year2009-07-01184
Total number of active participants reported on line 7a of the Form 55002009-07-01205
Total of all active and inactive participants2009-07-01205
Total participants2009-07-01205
Number of participants with account balances2009-07-01205

Financial Data on 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE

Measure Date Value
2018 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$385,324
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$585,613
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$581,689
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,135,620
Value of total assets at end of year2018-12-31$12,011,047
Value of total assets at beginning of year2018-12-31$12,211,336
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$3,924
Total interest from all sources2018-12-31$8,846
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$654,954
Participant contributions at end of year2018-12-31$23,660
Participant contributions at beginning of year2018-12-31$23,043
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$304,428
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$3,924
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-200,289
Value of net assets at end of year (total assets less liabilities)2018-12-31$12,011,047
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$12,211,336
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$410,220
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$439,883
Value of interest in pooled separate accounts at end of year2018-12-31$10,611,375
Value of interest in pooled separate accounts at beginning of year2018-12-31$10,976,581
Interest on participant loans2018-12-31$0
Interest earned on other investments2018-12-31$8,846
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$958,920
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$765,519
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$2,366
Net investment gain/loss from pooled separate accounts2018-12-31$-761,508
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$176,238
Employer contributions (assets) at end of year2018-12-31$6,872
Employer contributions (assets) at beginning of year2018-12-31$6,310
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$581,689
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31KAHN, LITWIN, RENZA & CO. LTD
Accountancy firm EIN2018-12-31050409384
2017 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,517,951
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$618,548
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$608,803
Expenses. Certain deemed distributions of participant loans2017-12-31$4,976
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,040,168
Value of total assets at end of year2017-12-31$12,211,336
Value of total assets at beginning of year2017-12-31$10,311,933
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,769
Total interest from all sources2017-12-31$8,556
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$615,669
Participant contributions at end of year2017-12-31$23,043
Participant contributions at beginning of year2017-12-31$20,237
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$257,016
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$4,769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$1,899,403
Value of net assets at end of year (total assets less liabilities)2017-12-31$12,211,336
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$10,311,933
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$439,883
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$400,482
Value of interest in pooled separate accounts at end of year2017-12-31$10,976,581
Value of interest in pooled separate accounts at beginning of year2017-12-31$9,172,860
Interest on participant loans2017-12-31$0
Interest earned on other investments2017-12-31$8,556
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$765,519
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$712,337
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from pooled separate accounts2017-12-31$1,469,227
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$167,483
Employer contributions (assets) at end of year2017-12-31$6,310
Employer contributions (assets) at beginning of year2017-12-31$6,017
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$608,803
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2017-12-31050409384
2016 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$1,913,612
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,859,565
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,855,427
Expenses. Certain deemed distributions of participant loans2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,156,736
Value of total assets at end of year2016-12-31$10,311,933
Value of total assets at beginning of year2016-12-31$10,257,886
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,138
Total interest from all sources2016-12-31$4,962
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$649,985
Participant contributions at end of year2016-12-31$20,237
Participant contributions at beginning of year2016-12-31$23,221
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$274,331
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$62,419
Other income not declared elsewhere2016-12-31$0
Administrative expenses (other) incurred2016-12-31$4,138
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$62,419
Value of net income/loss2016-12-31$54,047
Value of net assets at end of year (total assets less liabilities)2016-12-31$10,311,933
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$10,257,886
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$400,482
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$375,367
Value of interest in pooled separate accounts at end of year2016-12-31$9,172,860
Value of interest in pooled separate accounts at beginning of year2016-12-31$8,896,240
Interest on participant loans2016-12-31$0
Interest earned on other investments2016-12-31$4,962
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$712,337
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$956,577
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$751,914
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$170,001
Employer contributions (assets) at end of year2016-12-31$6,017
Employer contributions (assets) at beginning of year2016-12-31$6,481
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,793,008
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2016-12-31050409384
2015 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$6,027,395
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,242,424
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$870,441
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$868,655
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,513,401
Value of total assets at end of year2015-12-31$10,257,886
Value of total assets at beginning of year2015-12-31$3,858,508
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,786
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$15,019
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$15,019
Administrative expenses professional fees incurred2015-12-31$1,786
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$553,033
Participant contributions at end of year2015-12-31$23,221
Participant contributions at beginning of year2015-12-31$3,920
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$689,050
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$132,219
Other income not declared elsewhere2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Income. Non cash contributions2015-12-31$132,219
Value of net income/loss2015-12-31$371,983
Value of net assets at end of year (total assets less liabilities)2015-12-31$10,257,886
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,858,508
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$375,367
Value of interest in pooled separate accounts at end of year2015-12-31$8,896,240
Value of interest in pooled separate accounts at beginning of year2015-12-31$3,317,243
Interest on participant loans2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$956,577
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$535,174
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-26,255
Net investment gain/loss from pooled separate accounts2015-12-31$-259,741
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$139,099
Employer contributions (assets) at end of year2015-12-31$6,481
Employer contributions (assets) at beginning of year2015-12-31$2,171
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$736,436
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2015-12-31050409384
Total unrealized appreciation/depreciation of assets2015-04-30$0
Total transfer of assets to this plan2015-04-30$0
Total transfer of assets from this plan2015-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-04-30$0
Total income from all sources (including contributions)2015-04-30$368,465
Total loss/gain on sale of assets2015-04-30$0
Total of all expenses incurred2015-04-30$6,052,302
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-04-30$6,051,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-04-30$191,614
Value of total assets at end of year2015-04-30$0
Value of total assets at beginning of year2015-04-30$5,683,837
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-04-30$1,060
Total interest from all sources2015-04-30$2,156
Total dividends received (eg from common stock, registered investment company shares)2015-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-04-30Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2015-04-30$0
Was this plan covered by a fidelity bond2015-04-30Yes
Value of fidelity bond cover2015-04-30$500,000
If this is an individual account plan, was there a blackout period2015-04-30No
Were there any nonexempt tranactions with any party-in-interest2015-04-30No
Contributions received from participants2015-04-30$121,998
Participant contributions at end of year2015-04-30$0
Participant contributions at beginning of year2015-04-30$9,233
Income. Received or receivable in cash from other sources (including rollovers)2015-04-30$35,938
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-04-30$6,027,395
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Income. Non cash contributions2015-04-30$0
Value of net income/loss2015-04-30$-5,683,837
Value of net assets at end of year (total assets less liabilities)2015-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2015-04-30$5,683,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-04-30No
Were any leases to which the plan was party in default or uncollectible2015-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-04-30$505,193
Value of interest in pooled separate accounts at end of year2015-04-30$0
Value of interest in pooled separate accounts at beginning of year2015-04-30$4,789,574
Interest earned on other investments2015-04-30$2,156
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-04-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-04-30$375,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-04-30$18,002
Net investment gain/loss from pooled separate accounts2015-04-30$156,693
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-04-30No
Was there a failure to transmit to the plan any participant contributions2015-04-30Yes
Has the plan failed to provide any benefit when due under the plan2015-04-30No
Contributions received in cash from employer2015-04-30$33,678
Employer contributions (assets) at end of year2015-04-30$0
Employer contributions (assets) at beginning of year2015-04-30$4,344
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-04-30$23,847
Contract administrator fees2015-04-30$1,060
Did the plan have assets held for investment2015-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-04-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-04-30Yes
Opinion of an independent qualified public accountant for this plan2015-04-30Disclaimer
Accountancy firm name2015-04-30KAHN, LITWIN,RENZA & CO, LTD
Accountancy firm EIN2015-04-30050409384
2014 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$470,199
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$140,947
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$138,789
Expenses. Certain deemed distributions of participant loans2014-12-31$2,158
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$268,670
Value of total assets at end of year2014-12-31$3,858,508
Value of total assets at beginning of year2014-12-31$3,529,256
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$6,784
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$199,937
Participant contributions at end of year2014-12-31$3,920
Participant contributions at beginning of year2014-12-31$11,187
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$5,809
Other income not declared elsewhere2014-12-31$0
Administrative expenses (other) incurred2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$329,252
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,858,508
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,529,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$505,193
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$509,861
Value of interest in pooled separate accounts at end of year2014-12-31$3,317,243
Value of interest in pooled separate accounts at beginning of year2014-12-31$3,016,691
Interest on participant loans2014-12-31$0
Interest earned on other investments2014-12-31$6,784
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$535,174
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$512,565
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-12,174
Net investment gain/loss from pooled separate accounts2014-12-31$194,745
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$62,924
Employer contributions (assets) at end of year2014-12-31$2,171
Employer contributions (assets) at beginning of year2014-12-31$1,593
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$138,789
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31KAHN, LITWIN, RENZA AND CO., LTD.
Accountancy firm EIN2014-12-31050409384
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total income from all sources (including contributions)2014-06-30$1,390,358
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$377,347
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$375,963
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$635,605
Value of total assets at end of year2014-06-30$5,551,641
Value of total assets at beginning of year2014-06-30$4,538,630
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$1,384
Total interest from all sources2014-06-30$12,207
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$500,000
If this is an individual account plan, was there a blackout period2014-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$396,475
Participant contributions at end of year2014-06-30$11,187
Participant contributions at beginning of year2014-06-30$7,059
Income. Received or receivable in cash from other sources (including rollovers)2014-06-30$182,987
Administrative expenses (other) incurred2014-06-30$1,384
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$1,013,011
Value of net assets at end of year (total assets less liabilities)2014-06-30$5,551,641
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$4,538,630
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$509,861
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$483,535
Value of interest in pooled separate accounts at end of year2014-06-30$4,720,842
Value of interest in pooled separate accounts at beginning of year2014-06-30$3,740,545
Interest earned on other investments2014-06-30$12,207
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-30$308,158
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-30$306,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$690,146
Net investment gain/loss from pooled separate accounts2014-06-30$52,400
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$56,143
Employer contributions (assets) at end of year2014-06-30$1,593
Employer contributions (assets) at beginning of year2014-06-30$998
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$375,963
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30Yes
Opinion of an independent qualified public accountant for this plan2014-06-30Disclaimer
Accountancy firm name2014-06-30KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2014-06-30050409384
2013 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total income from all sources (including contributions)2013-06-30$964,711
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$626,863
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$624,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$469,157
Value of total assets at end of year2013-06-30$4,538,630
Value of total assets at beginning of year2013-06-30$4,200,782
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$2,606
Total interest from all sources2013-06-30$13,363
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$500,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$348,725
Participant contributions at end of year2013-06-30$7,059
Participant contributions at beginning of year2013-06-30$6,062
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$95,152
Administrative expenses (other) incurred2013-06-30$2,606
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$337,848
Value of net assets at end of year (total assets less liabilities)2013-06-30$4,538,630
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$4,200,782
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$483,535
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$493,545
Value of interest in pooled separate accounts at end of year2013-06-30$3,740,545
Value of interest in pooled separate accounts at beginning of year2013-06-30$3,464,392
Interest earned on other investments2013-06-30$13,363
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$306,493
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$236,783
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$60,745
Net investment gain/loss from pooled separate accounts2013-06-30$421,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$25,280
Employer contributions (assets) at end of year2013-06-30$998
Employer contributions (assets) at beginning of year2013-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$624,257
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2013-06-30050409384
2012 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total income from all sources (including contributions)2012-06-30$202,084
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$599,225
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$597,191
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$320,375
Value of total assets at end of year2012-06-30$4,200,782
Value of total assets at beginning of year2012-06-30$4,597,923
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$2,034
Total interest from all sources2012-06-30$17,923
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$500,000
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$314,370
Participant contributions at end of year2012-06-30$6,062
Participant contributions at beginning of year2012-06-30$10,544
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$6,005
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-397,141
Value of net assets at end of year (total assets less liabilities)2012-06-30$4,200,782
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$4,597,923
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Investment advisory and management fees2012-06-30$2,034
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$493,545
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$507,053
Value of interest in pooled separate accounts at end of year2012-06-30$3,464,392
Value of interest in pooled separate accounts at beginning of year2012-06-30$3,673,428
Interest earned on other investments2012-06-30$17,923
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$236,783
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$406,898
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-12,668
Net investment gain/loss from pooled separate accounts2012-06-30$-123,546
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$597,191
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2012-06-30050409384
2011 : 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total income from all sources (including contributions)2011-06-30$1,219,662
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$716,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$714,031
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$349,941
Value of total assets at end of year2011-06-30$4,597,923
Value of total assets at beginning of year2011-06-30$4,094,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$2,329
Total interest from all sources2011-06-30$19,689
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Assets. Real estate other than employer real property at end of year2011-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-06-30$0
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$350,000
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$289,698
Participant contributions at end of year2011-06-30$0
Participant contributions at end of year2011-06-30$10,544
Participant contributions at beginning of year2011-06-30$9,715
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$60,243
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$0
Assets. Loans (other than to participants) at end of year2011-06-30$0
Total non interest bearing cash at end of year2011-06-30$0
Total non interest bearing cash at beginning of year2011-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$503,302
Value of net assets at end of year (total assets less liabilities)2011-06-30$4,597,923
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$4,094,621
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Assets. partnership/joint venture interests at end of year2011-06-30$0
Investment advisory and management fees2011-06-30$2,329
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$507,053
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$428,709
Value of interest in pooled separate accounts at end of year2011-06-30$3,673,428
Value of interest in pooled separate accounts at beginning of year2011-06-30$3,221,172
Value of interest in common/collective trusts at end of year2011-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$19,689
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$406,898
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$435,025
Asset value of US Government securities at end of year2011-06-30$0
Net investment gain/loss from pooled separate accounts2011-06-30$850,032
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$0
Employer contributions (assets) at end of year2011-06-30$0
Employer contributions (assets) at beginning of year2011-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$714,031
Asset. Corporate debt instrument preferred debt at end of year2011-06-30$0
Asset. Corporate debt instrument debt (other) at end of year2011-06-30$0
Assets. Corporate common stocks other than exployer securities at end of year2011-06-30$0
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30KAHN, LITWIN, RENZA & CO, LTD
Accountancy firm EIN2011-06-30050409384

Form 5500 Responses for 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE

2018: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2010: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: 403(B) THRIFT PLAN OF COMMUNITY CARE ALLIANCE 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number001016I
Policy instance 1
Insurance contract or identification number001016I
Number of Individuals Covered421
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,139
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees4139
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number001016I
Policy instance 1
Insurance contract or identification number001016I
Number of Individuals Covered403
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,450
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees2450
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameBOSTON REGIONAL OFFICE
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered55
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 $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number001016I
Policy instance 1
Insurance contract or identification number001016I
Number of Individuals Covered361
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 $1,129
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1129
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameBOSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D
Policy instance 3
Insurance contract or identification number056845D
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number058288
Policy instance 1
Insurance contract or identification number058288
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered55
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number05828H
Policy instance 1
Insurance contract or identification number05828H
Number of Individuals Covered123
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,075
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1075
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameWESTBOROUGH OFFICE PARK
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D
Policy instance 3
Insurance contract or identification number056845D
Number of Individuals Covered123
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number001016I
Policy instance 1
Insurance contract or identification number001016I
Number of Individuals Covered123
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,075
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1075
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameBOSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D
Policy instance 3
Insurance contract or identification number056845D
Number of Individuals Covered5
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered54
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $193
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $193
Insurance broker organization code?3
Insurance broker nameSECURITIES AMERICA
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number05828H
Policy instance 1
Insurance contract or identification number05828H
Number of Individuals Covered143
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,111
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Amount paid for insurance broker fees2111
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameWESTBOROUGH OFFICE PARK
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered67
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $130
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $130
Insurance broker organization code?3
Insurance broker nameSECURITIES AMERICA
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D
Policy instance 3
Insurance contract or identification number056845D
Number of Individuals Covered7
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number05828H
Policy instance 1
Insurance contract or identification number05828H
Number of Individuals Covered126
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,716
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Amount paid for insurance broker fees462
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker namePETER J. ROMANO
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number05828H
Policy instance 1
Insurance contract or identification number05828H
Number of Individuals Covered111
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,705
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered67
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $130
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D
Policy instance 3
Insurance contract or identification number056845D
Number of Individuals Covered9
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056845D 05828H
Policy instance 1
Insurance contract or identification number056845D 05828H
Number of Individuals Covered107
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $47
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number0000NORT00RI00R
Policy instance 2
Insurance contract or identification number0000NORT00RI00R
Number of Individuals Covered129
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $3,509
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No

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