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WEST VIEW NURSING HOME, INC. 401(K) PLAN 401k Plan overview

Plan NameWEST VIEW NURSING HOME, INC. 401(K) PLAN
Plan identification number 001

WEST VIEW NURSING HOME, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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

Company Name:WEST VIEW NURSING HOME, INC.
Employer identification number (EIN):050377584
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WEST VIEW NURSING HOME, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01
0012016-01-01
0012015-01-01
0012015-01-01
0012014-01-01HUGH HALL
0012013-01-01HUGH HALL
0012012-01-01THOMAS GUERRA
0012011-01-01THOMAS GUERRA
0012009-01-01THOMAS GUERRA

Plan Statistics for WEST VIEW NURSING HOME, INC. 401(K) PLAN

401k plan membership statisitcs for WEST VIEW NURSING HOME, INC. 401(K) PLAN

Measure Date Value
2017: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01173
Total number of active participants reported on line 7a of the Form 55002017-01-01155
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0119
Total of all active and inactive participants2017-01-01174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-011
Total participants2017-01-01175
Number of participants with account balances2017-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01160
Total number of active participants reported on line 7a of the Form 55002016-01-01157
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0116
Total of all active and inactive participants2016-01-01173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01173
Number of participants with account balances2016-01-0192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-017
2015: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01159
Total number of active participants reported on line 7a of the Form 55002015-01-01143
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0116
Total of all active and inactive participants2015-01-01160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01160
Number of participants with account balances2015-01-0183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01162
Total number of active participants reported on line 7a of the Form 55002014-01-01136
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0113
Total of all active and inactive participants2014-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01149
Number of participants with account balances2014-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01129
Total number of active participants reported on line 7a of the Form 55002013-01-01138
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0119
Total of all active and inactive participants2013-01-01157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01157
Number of participants with account balances2013-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01108
Total number of active participants reported on line 7a of the Form 55002012-01-01105
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0112
Total of all active and inactive participants2012-01-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01117
Number of participants with account balances2012-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01114
Total number of active participants reported on line 7a of the Form 55002011-01-0195
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0113
Total of all active and inactive participants2011-01-01108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01108
Number of participants with account balances2011-01-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01121
Total number of active participants reported on line 7a of the Form 55002009-01-0196
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0111
Total of all active and inactive participants2009-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01107
Number of participants with account balances2009-01-0150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on WEST VIEW NURSING HOME, INC. 401(K) PLAN

Measure Date Value
2017 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 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$905,438
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$249,901
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$249,167
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$461,434
Value of total assets at end of year2017-12-31$4,260,064
Value of total assets at beginning of year2017-12-31$3,604,527
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$734
Total interest from all sources2017-12-31$622
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
Administrative expenses professional fees incurred2017-12-31$734
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$269,868
Participant contributions at end of year2017-12-31$11,939
Participant contributions at beginning of year2017-12-31$15,628
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$16,612
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
Value of net income/loss2017-12-31$655,537
Value of net assets at end of year (total assets less liabilities)2017-12-31$4,260,064
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,604,527
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$1,204,168
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$968,174
Interest on participant loans2017-12-31$622
Value of interest in common/collective trusts at end of year2017-12-31$2,316,768
Value of interest in common/collective trusts at beginning of year2017-12-31$1,963,174
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$727,189
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$657,551
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$443,382
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$174,954
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$249,167
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
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 name2017-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2017-12-31061009205
2016 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 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$637,076
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$453,838
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$450,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$382,257
Value of total assets at end of year2016-12-31$3,604,527
Value of total assets at beginning of year2016-12-31$3,421,289
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$3,297
Total interest from all sources2016-12-31$586
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
Administrative expenses professional fees incurred2016-12-31$3,297
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$275,255
Participant contributions at end of year2016-12-31$15,628
Participant contributions at beginning of year2016-12-31$3,822
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$183,238
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,604,527
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,421,289
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$968,174
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,773,850
Value of interest in pooled separate accounts at end of year2016-12-31$0
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Interest on participant loans2016-12-31$586
Value of interest in common/collective trusts at end of year2016-12-31$1,963,174
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$657,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$643,617
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$254,233
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$107,002
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$450,541
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
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 name2016-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2016-12-31061009205
2015 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
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$470,021
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$74,417
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$47,254
Expenses. Certain deemed distributions of participant loans2015-12-31$26,358
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$505,062
Value of total assets at end of year2015-12-31$3,421,289
Value of total assets at beginning of year2015-12-31$3,025,685
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$805
Total interest from all sources2015-12-31$1,141
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$805
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$223,023
Participant contributions at end of year2015-12-31$3,822
Participant contributions at beginning of year2015-12-31$34,460
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$152,223
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$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
Value of net income/loss2015-12-31$395,604
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,421,289
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,025,685
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$2,773,850
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,399,831
Value of interest in pooled separate accounts at end of year2015-12-31$0
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$1,141
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$643,617
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$591,394
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-36,182
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 contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$129,816
Employer contributions (assets) at end of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$47,254
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
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 name2015-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2015-12-31061009205
2014 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 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$488,066
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$228,963
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$228,473
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$358,925
Value of total assets at end of year2014-12-31$3,025,685
Value of total assets at beginning of year2014-12-31$2,766,582
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$490
Total interest from all sources2014-12-31$1,366
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 period2014-12-31Yes
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$228,991
Participant contributions at end of year2014-12-31$34,460
Participant contributions at beginning of year2014-12-31$36,733
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$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$259,103
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,025,685
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,766,582
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$2,399,831
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,171,451
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$0
Interest on participant loans2014-12-31$1,366
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$591,394
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$558,398
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$127,775
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 contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$129,934
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$228,473
Contract administrator fees2014-12-31$490
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
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 name2014-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2014-12-31061009205
2013 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$594,004
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$39,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$39,685
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$383,799
Value of total assets at end of year2013-12-31$2,766,582
Value of total assets at beginning of year2013-12-31$2,212,573
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$310
Total interest from all sources2013-12-31$1,482
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$203,864
Participant contributions at end of year2013-12-31$36,733
Participant contributions at beginning of year2013-12-31$35,903
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$62,428
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$554,009
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,766,582
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,212,573
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,171,451
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,668,157
Value of interest in pooled separate accounts at end of year2013-12-31$0
Value of interest in pooled separate accounts at beginning of year2013-12-31$0
Interest on participant loans2013-12-31$1,482
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$558,398
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$508,513
Net investment gain/loss from pooled separate accounts2013-12-31$208,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$117,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$39,685
Contract administrator fees2013-12-31$310
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31Yes
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2013-12-31061009205
2012 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$475,899
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$142,168
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$140,992
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$309,942
Value of total assets at end of year2012-12-31$2,212,573
Value of total assets at beginning of year2012-12-31$1,878,842
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,176
Total interest from all sources2012-12-31$1,029
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$192,293
Participant contributions at end of year2012-12-31$35,903
Participant contributions at beginning of year2012-12-31$15,813
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$12,388
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$2,411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$333,731
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,212,573
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,878,842
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,668,157
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in pooled separate accounts at end of year2012-12-31$0
Value of interest in pooled separate accounts at beginning of year2012-12-31$1,832,590
Interest on participant loans2012-12-31$1,029
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$508,513
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$28,028
Net investment gain/loss from pooled separate accounts2012-12-31$164,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$105,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$140,992
Contract administrator fees2012-12-31$1,176
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31BLUM, SHAPIRO & COMPANY, P.C.
Accountancy firm EIN2012-12-31061009205
2011 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$202,320
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$35,179
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$20,916
Expenses. Certain deemed distributions of participant loans2011-12-31$1,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$222,502
Value of total assets at end of year2011-12-31$1,878,842
Value of total assets at beginning of year2011-12-31$1,711,701
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$12,649
Total interest from all sources2011-12-31$896
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$250,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$141,978
Participant contributions at end of year2011-12-31$15,813
Participant contributions at beginning of year2011-12-31$3,119
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$28,540
Total non interest bearing cash at end of year2011-12-31$2,411
Total non interest bearing cash at beginning of year2011-12-31$2,192
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$167,141
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,878,842
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,711,701
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$1,832,590
Value of interest in pooled separate accounts at beginning of year2011-12-31$1,651,165
Interest on participant loans2011-12-31$232
Interest earned on other investments2011-12-31$664
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$28,028
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$26,685
Net investment gain/loss from pooled separate accounts2011-12-31$-21,078
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$80,524
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$20,916
Contract administrator fees2011-12-31$12,649
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31SULLIVAN & COMPANY CPAS LLP
Accountancy firm EIN2011-12-31061470257
2010 : WEST VIEW NURSING HOME, INC. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$424,996
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$430,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$418,623
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$230,048
Value of total assets at end of year2010-12-31$1,711,701
Value of total assets at beginning of year2010-12-31$1,717,172
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$11,844
Total interest from all sources2010-12-31$1,802
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$250,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$129,124
Participant contributions at end of year2010-12-31$3,119
Participant contributions at beginning of year2010-12-31$5,651
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$28,540
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$28,540
Total non interest bearing cash at end of year2010-12-31$2,192
Total non interest bearing cash at beginning of year2010-12-31$15,486
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-5,471
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,711,701
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,717,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$925
Value of interest in pooled separate accounts at end of year2010-12-31$1,651,165
Value of interest in pooled separate accounts at beginning of year2010-12-31$1,652,709
Interest on participant loans2010-12-31$246
Interest earned on other investments2010-12-31$1,556
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$26,685
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$43,326
Net investment gain/loss from pooled separate accounts2010-12-31$193,146
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$72,384
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$418,623
Contract administrator fees2010-12-31$10,919
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31SULLIVAN & COMPANY CPAS LLP
Accountancy firm EIN2010-12-31061470257

Form 5500 Responses for WEST VIEW NURSING HOME, INC. 401(K) PLAN

2017: WEST VIEW NURSING HOME, INC. 401(K) PLAN 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 funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: WEST VIEW NURSING HOME, INC. 401(K) PLAN 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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: WEST VIEW NURSING HOME, INC. 401(K) PLAN 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 funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2014 form 5500 responses
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 funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: WEST VIEW NURSING HOME, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333602-01
Policy instance 1
Insurance contract or identification number333602-01
Number of Individuals Covered175
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 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?Yes
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333602-01
Policy instance 1
Insurance contract or identification number333602-01
Number of Individuals Covered160
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?Yes
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333602-01
Policy instance 1
Insurance contract or identification number333602-01
Number of Individuals Covered149
Insurance policy start date2014-01-01
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?Yes
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333602-01
Policy instance 1
Insurance contract or identification number333602-01
Number of Individuals Covered157
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?Yes
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number45641
Policy instance 1
Insurance contract or identification number45641
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $81
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?Yes
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 $81
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
Insurance broker nameCORNERSTONE GROUP
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number333602-01
Policy instance 2
Insurance contract or identification number333602-01
Number of Individuals Covered65
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?Yes
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number45641
Policy instance 1
Insurance contract or identification number45641
Number of Individuals Covered62
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,331
Total amount of fees paid to insurance companyUSD $850
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?Yes
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number45641
Policy instance 1
Insurance contract or identification number45641
Number of Individuals Covered51
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,948
Total amount of fees paid to insurance companyUSD $1,745
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?Yes
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 $4,948
Insurance broker organization code?3
Amount paid for insurance broker fees1745
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameCORNERSTONE GROUP

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