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NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 401k Plan overview

Plan NameNEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN
Plan identification number 001

NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock 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.
  • 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

NEIGHBORHOOD HEALTH ASSOCIATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:NEIGHBORHOOD HEALTH ASSOCIATION, INC.
Employer identification number (EIN):237272741
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-10-01
0012020-10-01
0012019-10-01
0012018-10-01
0012017-10-01
0012016-10-01NICHOLE JUNIO NICHOLE JUNIO2018-07-16
0012015-10-01AMIE GOHLIKE2016-12-16 AMIE GOHLIKE2016-12-16
0012014-10-01AMIE GOHLIKE2016-12-13 AMIE GOHLIKE2016-12-13
0012013-10-01AMIE GOHLIKE2014-12-08 AMIE GOHLIKE2014-12-08
0012012-10-01AMIE GOHLIKE2014-04-21 AMIE GOHLIKE2014-04-21
0012011-10-01AMIE GOHLIKE2013-04-29 AMIE GOHLIKE2013-04-29

Plan Statistics for NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN

401k plan membership statisitcs for NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN

Measure Date Value
2021: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01131
Total number of active participants reported on line 7a of the Form 55002021-10-01100
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-0115
Total of all active and inactive participants2021-10-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-10-010
Total participants2021-10-01115
Number of participants with account balances2021-10-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-10-019
2020: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01142
Total number of active participants reported on line 7a of the Form 55002020-10-01113
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-0116
Total of all active and inactive participants2020-10-01129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-10-010
Total participants2020-10-01129
Number of participants with account balances2020-10-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-10-018
2019: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01187
Total number of active participants reported on line 7a of the Form 55002019-10-01140
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-018
Total of all active and inactive participants2019-10-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-10-010
Total participants2019-10-01148
Number of participants with account balances2019-10-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-10-013
2018: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01138
Total number of active participants reported on line 7a of the Form 55002018-10-01127
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-019
Total of all active and inactive participants2018-10-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-10-010
Total participants2018-10-01136
Number of participants with account balances2018-10-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-10-012
2017: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01132
Total number of active participants reported on line 7a of the Form 55002017-10-01112
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-017
Total of all active and inactive participants2017-10-01119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-10-010
Total participants2017-10-01119
Number of participants with account balances2017-10-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-10-015
2016: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01123
Total number of active participants reported on line 7a of the Form 55002016-10-01120
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-0111
Total of all active and inactive participants2016-10-01131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-10-010
Total participants2016-10-01131
Number of participants with account balances2016-10-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-10-015

Financial Data on NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN

Measure Date Value
2022 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total income from all sources (including contributions)2022-09-30$-400,913
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$170,692
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$129,791
Value of total corrective distributions2022-09-30$11,066
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$255,412
Value of total assets at end of year2022-09-30$2,262,822
Value of total assets at beginning of year2022-09-30$2,834,427
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$29,835
Total interest from all sources2022-09-30$16
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$10,182
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2022-09-30$10,182
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$150,000
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$200,601
Participant contributions at beginning of year2022-09-30$8,643
Income. Received or receivable in cash from other sources (including rollovers)2022-09-30$4,769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-571,605
Value of net assets at end of year (total assets less liabilities)2022-09-30$2,262,822
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$2,834,427
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-09-30$563,341
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-09-30$593,453
Value of interest in pooled separate accounts at end of year2022-09-30$1,699,121
Value of interest in pooled separate accounts at beginning of year2022-09-30$2,229,808
Interest earned on other investments2022-09-30$16
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-09-30$360
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-09-30$350
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-144,877
Net investment gain/loss from pooled separate accounts2022-09-30$-521,646
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30Yes
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$50,042
Employer contributions (assets) at beginning of year2022-09-30$2,173
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$129,791
Contract administrator fees2022-09-30$29,835
Did the plan have assets held for investment2022-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-09-30410746749
2021 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$0
Total income from all sources (including contributions)2021-09-30$819,538
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$221,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$187,400
Value of total corrective distributions2021-09-30$4,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$265,587
Value of total assets at end of year2021-09-30$2,834,427
Value of total assets at beginning of year2021-09-30$2,236,841
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$30,303
Total interest from all sources2021-09-30$46
Total dividends received (eg from common stock, registered investment company shares)2021-09-30$4,192
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2021-09-30$4,192
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$150,000
If this is an individual account plan, was there a blackout period2021-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-09-30$0
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$208,369
Participant contributions at end of year2021-09-30$8,643
Participant contributions at beginning of year2021-09-30$30,173
Income. Received or receivable in cash from other sources (including rollovers)2021-09-30$722
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$597,586
Value of net assets at end of year (total assets less liabilities)2021-09-30$2,834,427
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$2,236,841
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-09-30$593,453
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-09-30$407,333
Value of interest in pooled separate accounts at end of year2021-09-30$2,229,808
Value of interest in pooled separate accounts at beginning of year2021-09-30$1,779,886
Interest earned on other investments2021-09-30$46
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-09-30$350
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-09-30$11,037
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-09-30$106,394
Net investment gain/loss from pooled separate accounts2021-09-30$443,319
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30Yes
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$56,496
Employer contributions (assets) at end of year2021-09-30$2,173
Employer contributions (assets) at beginning of year2021-09-30$8,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$187,400
Contract administrator fees2021-09-30$30,303
Did the plan have assets held for investment2021-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Disclaimer
Accountancy firm name2021-09-30GILMORE JASION MAHLER, LTD
Accountancy firm EIN2021-09-30341827159
2020 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-09-30$0
Total unrealized appreciation/depreciation of assets2020-09-30$0
Total transfer of assets to this plan2020-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Expenses. Interest paid2020-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-09-30$0
Total income from all sources (including contributions)2020-09-30$522,848
Total loss/gain on sale of assets2020-09-30$0
Total of all expenses incurred2020-09-30$359,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$332,319
Value of total corrective distributions2020-09-30$4,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$233,305
Value of total assets at end of year2020-09-30$2,236,841
Value of total assets at beginning of year2020-09-30$2,073,833
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$23,037
Total income from rents2020-09-30$0
Total interest from all sources2020-09-30$373
Total dividends received (eg from common stock, registered investment company shares)2020-09-30$4,129
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-09-30$4,129
Administrative expenses professional fees incurred2020-09-30$0
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$150,000
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Amount of non-exempt transactions with any party-in-interest2020-09-30$0
Contributions received from participants2020-09-30$189,264
Participant contributions at end of year2020-09-30$30,173
Participant contributions at beginning of year2020-09-30$7,734
Income. Received or receivable in cash from other sources (including rollovers)2020-09-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-09-30$0
Other income not declared elsewhere2020-09-30$612
Administrative expenses (other) incurred2020-09-30$0
Liabilities. Value of operating payables at beginning of year2020-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Income. Non cash contributions2020-09-30$0
Value of net income/loss2020-09-30$163,008
Value of net assets at end of year (total assets less liabilities)2020-09-30$2,236,841
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$2,073,833
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2020-09-30$0
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2020-09-30$0
Investment advisory and management fees2020-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-09-30$407,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-09-30$370,806
Value of interest in pooled separate accounts at end of year2020-09-30$1,779,886
Value of interest in pooled separate accounts at beginning of year2020-09-30$1,654,612
Income. Interest from loans (other than to participants)2020-09-30$0
Interest earned on other investments2020-09-30$373
Income. Interest from US Government securities2020-09-30$0
Income. Interest from corporate debt instruments2020-09-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-09-30$11,037
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-09-30$39,364
Expenses. Payments to insurance carriers foe the provision of benefits2020-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-09-30$25,640
Net investment gain/loss from pooled separate accounts2020-09-30$258,789
Net investment gain or loss from common/collective trusts2020-09-30$0
Net gain/loss from 103.12 investment entities2020-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30Yes
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$44,041
Employer contributions (assets) at end of year2020-09-30$8,412
Employer contributions (assets) at beginning of year2020-09-30$1,317
Income. Dividends from preferred stock2020-09-30$0
Income. Dividends from common stock2020-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$332,319
Contract administrator fees2020-09-30$23,037
Liabilities. Value of benefit claims payable at beginning of year2020-09-30$0
Did the plan have assets held for investment2020-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Aggregate proceeds on sale of assets2020-09-30$0
Aggregate carrying amount (costs) on sale of assets2020-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30Yes
Opinion of an independent qualified public accountant for this plan2020-09-30Disclaimer
Accountancy firm name2020-09-30GILMORE JASION MAHLER LTD
Accountancy firm EIN2020-09-30341827159
2019 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-09-30$0
Total unrealized appreciation/depreciation of assets2019-09-30$0
Total transfer of assets to this plan2019-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$0
Expenses. Interest paid2019-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-09-30$0
Total income from all sources (including contributions)2019-09-30$407,933
Total loss/gain on sale of assets2019-09-30$0
Total of all expenses incurred2019-09-30$41,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$16,272
Value of total corrective distributions2019-09-30$5,482
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$299,516
Value of total assets at end of year2019-09-30$2,073,833
Value of total assets at beginning of year2019-09-30$1,707,853
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$20,199
Total income from rents2019-09-30$0
Total interest from all sources2019-09-30$737
Total dividends received (eg from common stock, registered investment company shares)2019-09-30$2,300
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-09-30$2,300
Administrative expenses professional fees incurred2019-09-30$0
Was this plan covered by a fidelity bond2019-09-30Yes
Value of fidelity bond cover2019-09-30$150,000
If this is an individual account plan, was there a blackout period2019-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-09-30$0
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Amount of non-exempt transactions with any party-in-interest2019-09-30$0
Contributions received from participants2019-09-30$173,923
Participant contributions at end of year2019-09-30$7,734
Participant contributions at beginning of year2019-09-30$12,111
Income. Received or receivable in cash from other sources (including rollovers)2019-09-30$83,794
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-09-30$0
Other income not declared elsewhere2019-09-30$0
Administrative expenses (other) incurred2019-09-30$0
Liabilities. Value of operating payables at beginning of year2019-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Income. Non cash contributions2019-09-30$0
Value of net income/loss2019-09-30$365,980
Value of net assets at end of year (total assets less liabilities)2019-09-30$2,073,833
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$1,707,853
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2019-09-30$0
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2019-09-30$0
Investment advisory and management fees2019-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-09-30$370,806
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-09-30$206,580
Value of interest in pooled separate accounts at end of year2019-09-30$1,654,612
Value of interest in pooled separate accounts at beginning of year2019-09-30$1,450,734
Income. Interest from loans (other than to participants)2019-09-30$0
Interest earned on other investments2019-09-30$737
Income. Interest from US Government securities2019-09-30$0
Income. Interest from corporate debt instruments2019-09-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-09-30$39,364
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-09-30$36,411
Expenses. Payments to insurance carriers foe the provision of benefits2019-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-09-30$9,373
Net investment gain/loss from pooled separate accounts2019-09-30$96,007
Net investment gain or loss from common/collective trusts2019-09-30$0
Net gain/loss from 103.12 investment entities2019-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30No
Was there a failure to transmit to the plan any participant contributions2019-09-30Yes
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$41,799
Employer contributions (assets) at end of year2019-09-30$1,317
Employer contributions (assets) at beginning of year2019-09-30$2,017
Income. Dividends from preferred stock2019-09-30$0
Income. Dividends from common stock2019-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-09-30$16,272
Contract administrator fees2019-09-30$20,199
Liabilities. Value of benefit claims payable at beginning of year2019-09-30$0
Did the plan have assets held for investment2019-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Aggregate proceeds on sale of assets2019-09-30$0
Aggregate carrying amount (costs) on sale of assets2019-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30Yes
Opinion of an independent qualified public accountant for this plan2019-09-30Disclaimer
Accountancy firm name2019-09-30GILMORE JASION MAHLER, LTD
Accountancy firm EIN2019-09-30341827159
2018 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-09-30$0
Total unrealized appreciation/depreciation of assets2018-09-30$0
Total transfer of assets to this plan2018-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$0
Expenses. Interest paid2018-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-09-30$0
Total income from all sources (including contributions)2018-09-30$405,753
Total loss/gain on sale of assets2018-09-30$0
Total of all expenses incurred2018-09-30$125,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$101,516
Value of total corrective distributions2018-09-30$4,253
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$211,962
Value of total assets at end of year2018-09-30$1,707,853
Value of total assets at beginning of year2018-09-30$1,427,707
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$19,838
Total income from rents2018-09-30$0
Total interest from all sources2018-09-30$764
Total dividends received (eg from common stock, registered investment company shares)2018-09-30$1,986
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2018-09-30$1,986
Administrative expenses professional fees incurred2018-09-30$0
Was this plan covered by a fidelity bond2018-09-30Yes
Value of fidelity bond cover2018-09-30$150,000
If this is an individual account plan, was there a blackout period2018-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-09-30$0
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Amount of non-exempt transactions with any party-in-interest2018-09-30$0
Contributions received from participants2018-09-30$161,451
Participant contributions at end of year2018-09-30$12,111
Participant contributions at beginning of year2018-09-30$3,606
Income. Received or receivable in cash from other sources (including rollovers)2018-09-30$21,273
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-09-30$0
Other income not declared elsewhere2018-09-30$0
Administrative expenses (other) incurred2018-09-30$0
Liabilities. Value of operating payables at beginning of year2018-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Income. Non cash contributions2018-09-30$0
Value of net income/loss2018-09-30$280,146
Value of net assets at end of year (total assets less liabilities)2018-09-30$1,707,853
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$1,427,707
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2018-09-30$0
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2018-09-30$0
Investment advisory and management fees2018-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-09-30$206,580
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-09-30$144,283
Value of interest in pooled separate accounts at end of year2018-09-30$1,450,734
Value of interest in pooled separate accounts at beginning of year2018-09-30$1,213,143
Income. Interest from loans (other than to participants)2018-09-30$0
Interest earned on other investments2018-09-30$764
Income. Interest from US Government securities2018-09-30$0
Income. Interest from corporate debt instruments2018-09-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-09-30$36,411
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-09-30$65,604
Expenses. Payments to insurance carriers foe the provision of benefits2018-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-09-30$16,385
Net investment gain/loss from pooled separate accounts2018-09-30$174,656
Net investment gain or loss from common/collective trusts2018-09-30$0
Net gain/loss from 103.12 investment entities2018-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30No
Was there a failure to transmit to the plan any participant contributions2018-09-30Yes
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$29,238
Employer contributions (assets) at end of year2018-09-30$2,017
Employer contributions (assets) at beginning of year2018-09-30$1,071
Income. Dividends from preferred stock2018-09-30$0
Income. Dividends from common stock2018-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-09-30$101,516
Contract administrator fees2018-09-30$19,838
Liabilities. Value of benefit claims payable at beginning of year2018-09-30$0
Did the plan have assets held for investment2018-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Aggregate proceeds on sale of assets2018-09-30$0
Aggregate carrying amount (costs) on sale of assets2018-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30Yes
Opinion of an independent qualified public accountant for this plan2018-09-30Disclaimer
Accountancy firm name2018-09-30GILMORE, JASION & MAHLER LTD
Accountancy firm EIN2018-09-30341827159
2017 : NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-09-30$0
Total unrealized appreciation/depreciation of assets2017-09-30$0
Total transfer of assets to this plan2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Expenses. Interest paid2017-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-09-30$0
Total income from all sources (including contributions)2017-09-30$384,511
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$74,628
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$45,349
Value of total corrective distributions2017-09-30$12,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$202,061
Value of total assets at end of year2017-09-30$1,427,707
Value of total assets at beginning of year2017-09-30$1,117,824
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$16,982
Total income from rents2017-09-30$0
Total interest from all sources2017-09-30$1,450
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$882
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-09-30$882
Administrative expenses professional fees incurred2017-09-30$0
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$150,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Amount of non-exempt transactions with any party-in-interest2017-09-30$0
Contributions received from participants2017-09-30$140,321
Participant contributions at end of year2017-09-30$3,606
Participant contributions at beginning of year2017-09-30$7,114
Income. Received or receivable in cash from other sources (including rollovers)2017-09-30$24,539
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-09-30$0
Other income not declared elsewhere2017-09-30$0
Administrative expenses (other) incurred2017-09-30$0
Liabilities. Value of operating payables at beginning of year2017-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Income. Non cash contributions2017-09-30$0
Value of net income/loss2017-09-30$309,883
Value of net assets at end of year (total assets less liabilities)2017-09-30$1,427,707
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$1,117,824
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2017-09-30$0
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2017-09-30$0
Investment advisory and management fees2017-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-09-30$144,283
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-09-30$94,282
Value of interest in pooled separate accounts at end of year2017-09-30$1,213,143
Value of interest in pooled separate accounts at beginning of year2017-09-30$974,973
Income. Interest from loans (other than to participants)2017-09-30$0
Interest earned on other investments2017-09-30$1,450
Income. Interest from US Government securities2017-09-30$0
Income. Interest from corporate debt instruments2017-09-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-09-30$65,604
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-09-30$40,392
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-09-30$16,100
Net investment gain/loss from pooled separate accounts2017-09-30$164,018
Net investment gain or loss from common/collective trusts2017-09-30$0
Net gain/loss from 103.12 investment entities2017-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30Yes
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contributions received in cash from employer2017-09-30$37,201
Employer contributions (assets) at end of year2017-09-30$1,071
Employer contributions (assets) at beginning of year2017-09-30$1,063
Income. Dividends from preferred stock2017-09-30$0
Income. Dividends from common stock2017-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$45,349
Contract administrator fees2017-09-30$16,982
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$0
Did the plan have assets held for investment2017-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Aggregate proceeds on sale of assets2017-09-30$0
Aggregate carrying amount (costs) on sale of assets2017-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30Yes
Opinion of an independent qualified public accountant for this plan2017-09-30Disclaimer
Accountancy firm name2017-09-30GILMORE, JASION, AND MAHLER LTD.
Accountancy firm EIN2017-09-30341827159

Form 5500 Responses for NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN

2021: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2019: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2018: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: NEIGHBORHOOD HEALTH ASSOCIATION, INC. PENSION PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441690
Policy instance 2
Insurance contract or identification number441690
Number of Individuals Covered115
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $5,439
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,439
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441465
Policy instance 1
Insurance contract or identification number441465
Number of Individuals Covered115
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441690
Policy instance 2
Insurance contract or identification number441690
Number of Individuals Covered129
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,958
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,958
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441465
Policy instance 1
Insurance contract or identification number441465
Number of Individuals Covered129
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $16
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441690
Policy instance 2
Insurance contract or identification number441690
Number of Individuals Covered148
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,048
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,048
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441465
Policy instance 1
Insurance contract or identification number441465
Number of Individuals Covered148
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $64
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441690
Policy instance 2
Insurance contract or identification number441690
Number of Individuals Covered136
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,567
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,567
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441465
Policy instance 1
Insurance contract or identification number441465
Number of Individuals Covered136
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $93
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441690
Policy instance 2
Insurance contract or identification number441690
Number of Individuals Covered119
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $3,226
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441465
Policy instance 1
Insurance contract or identification number441465
Number of Individuals Covered119
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $115
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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