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403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 401k Plan overview

Plan Name403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING
Plan identification number 002

403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

SOUTH CENTRAL ALPHA HOUSING AND HEA LTH CARE, INC. D/B/A AVALON NURSIN has sponsored the creation of one or more 401k plans.

Company Name:SOUTH CENTRAL ALPHA HOUSING AND HEA LTH CARE, INC. D/B/A AVALON NURSIN
Employer identification number (EIN):251701701
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01EPIPHANY LEHMAN2023-06-12
0022021-01-01JOEY BOYLES2022-04-04 JOEY BOYLES2022-04-04
0022020-01-01JOEY BOYLES2021-03-22
0022019-01-01JOEY BOYLES2021-03-22
0022018-01-01JOEY BOYLES2020-07-14
0022017-01-01ADRIENNE HARAKAL2018-06-04 ADRIENNE HARAKAL2018-06-04
0022016-01-01ADRIENNE HARAKAL2017-06-27 ADRIENNE HARAKAL2017-06-27
0022015-01-01ADRIENNE HARAKAL2016-07-13 ADRIENNE HARAKAL2016-07-13
0022014-01-01ADRIENNE HARAKAL2015-06-10 ADRIENNE HARAKAL2015-06-10
0022013-01-01ADRIENNE HARAKAL ADRIENNE HARAKAL2014-07-10
0022012-01-01ADRIENNE HARAKAL ADRIENNE HARAKAL2013-07-16
0022011-01-01ADRIENNE HARAKAL ADRIENNE HARAKAL2012-10-02
0022010-01-01ADRIENNE HARAKAL2011-08-10 ADRIENNE HARAKAL2011-08-10

Plan Statistics for 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING

401k plan membership statisitcs for 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING

Measure Date Value
2013: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2013 401k membership
Total participants, beginning-of-year2013-01-01111
Total number of active participants reported on line 7a of the Form 55002013-01-0179
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0113
Total of all active and inactive participants2013-01-0192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0192
Number of participants with account balances2013-01-0192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-015
2012: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2012 401k membership
Total participants, beginning-of-year2012-01-01102
Total number of active participants reported on line 7a of the Form 55002012-01-0199
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 participants2012-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01111
Number of participants with account balances2012-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0111
2011: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2011 401k membership
Total participants, beginning-of-year2011-01-0193
Total number of active participants reported on line 7a of the Form 55002011-01-0190
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0111
Total of all active and inactive participants2011-01-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-01102
Number of participants with account balances2011-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-012

Financial Data on 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING

Measure Date Value
2013 : 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$311,692
Expenses. Total of all expenses incurred2013-12-31$68,145
Benefits paid (including direct rollovers)2013-12-31$65,508
Total plan assets at end of year2013-12-31$1,426,867
Total plan assets at beginning of year2013-12-31$1,183,320
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$111,613
Expenses. Other expenses not covered elsewhere2013-12-31$2,637
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$146,724
Net income (gross income less expenses)2013-12-31$243,547
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,426,867
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,183,320
Assets. Value of participant loans2013-12-31$77,921
Total contributions received or receivable from employer(s)2013-12-31$53,355
Value of certain deemed distributions of participant loans2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2012 401k financial data
Total income from all sources2012-12-31$268,782
Expenses. Total of all expenses incurred2012-12-31$49,397
Benefits paid (including direct rollovers)2012-12-31$28,480
Total plan assets at end of year2012-12-31$1,183,320
Total plan assets at beginning of year2012-12-31$963,935
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$113,426
Expenses. Other expenses not covered elsewhere2012-12-31$20,917
Contributions received from other sources (not participants or employers)2012-12-31$10,371
Other income received2012-12-31$78,586
Net income (gross income less expenses)2012-12-31$219,385
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,183,320
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$963,935
Assets. Value of participant loans2012-12-31$54,421
Total contributions received or receivable from employer(s)2012-12-31$66,399
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$182,838
Expenses. Total of all expenses incurred2011-12-31$70,834
Benefits paid (including direct rollovers)2011-12-31$70,007
Total plan assets at end of year2011-12-31$963,935
Total plan assets at beginning of year2011-12-31$851,931
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$111,513
Expenses. Other expenses not covered elsewhere2011-12-31$827
Contributions received from other sources (not participants or employers)2011-12-31$2,495
Other income received2011-12-31$6,928
Net income (gross income less expenses)2011-12-31$112,004
Net plan assets at end of year (total assets less liabilities)2011-12-31$963,935
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$851,931
Assets. Value of participant loans2011-12-31$66,070
Total contributions received or receivable from employer(s)2011-12-31$61,902
Value of certain deemed distributions of participant loans2011-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0

Form 5500 Responses for 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING

2013: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 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 benefit arrangement – InsuranceYes
2012: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 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 benefit arrangement – InsuranceYes
2011: 403(B) THRIFT PLAN OF SOUTH CENTRAL ALPHA HOUSING AND HEALTH CARE, INC. D/B/A AVALON NURSING 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number022383I
Policy instance 1
Insurance contract or identification number022383I
Number of Individuals Covered102
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $274
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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