401k Plan data: HOME INSTEAD 401(K) PLAN plan

HOME INSTEAD 401(K) PLAN 401k Plan overview

Plan Name	HOME INSTEAD 401(K) PLAN
Plan identification number	001

HOME INSTEAD 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ROTH SENIOR CARE, LLC DBA HOME INSTEAD SENIOR CARE has sponsored the creation of one or more 401k plans.

Company Name: ROTH SENIOR CARE, LLC DBA HOME INSTEAD SENIOR CARE

Employer identification number (EIN): 262679126

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about ROTH SENIOR CARE, LLC DBA HOME INSTEAD SENIOR CARE

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2008-05-27

Company Identification Number: 52128296

Legal Registered Office Address: 10415 SE STARK ST STE A

PORTLAND
United States of America (USA)
97216

More information about ROTH SENIOR CARE, LLC DBA HOME INSTEAD SENIOR CARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOME INSTEAD 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 PRESTON ROTH 2024-07-09
001 2022-01-01 PRESTON ROTH 2023-09-25
001 2021-01-01 PRESTON ROTH 2022-08-25 PRESTON ROTH 2022-08-25
001 2020-01-01 PRESTON ROTH 2021-10-11
001 2019-01-01 PRESTON ROTH 2020-09-03
001 2018-01-01 PRESTON ROTH 2019-09-27
001 2017-01-01 PRESTON ROTH
001 2016-01-01 PRESTON ROTH
001 2016-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	PRESTON ROTH	2024-07-09
001	2022-01-01	PRESTON ROTH	2023-09-25
001	2021-01-01	PRESTON ROTH	2022-08-25	PRESTON ROTH	2022-08-25
001	2020-01-01	PRESTON ROTH	2021-10-11
001	2019-01-01	PRESTON ROTH	2020-09-03
001	2018-01-01	PRESTON ROTH	2019-09-27
001	2017-01-01	PRESTON ROTH
001	2016-01-01	PRESTON ROTH
001	2016-01-01

Plan Statistics for HOME INSTEAD 401(K) PLAN

401k plan membership statisitcs for HOME INSTEAD 401(K) PLAN

Measure Date Value
2025: HOME INSTEAD 401(K) PLAN 2025 401k membership
Total number of particpants at beginning of year 2025-07-28 92
Total number of particpants at end of year 2025-07-28 99
Number of Participants With Account Balances 2025-07-28 40
2024: HOME INSTEAD 401(K) PLAN 2024 401k membership
Total number of particpants at beginning of year 2024-07-09 97
Total number of particpants at end of year 2024-07-09 92
Number of Participants With Account Balances 2024-07-09 39
2017: HOME INSTEAD 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 79
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 3
Total of all active and inactive participants 2017-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 82
Number of participants with account balances 2017-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: HOME INSTEAD 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 111
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 112
Number of participants with account balances 2016-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2025: HOME INSTEAD 401(K) PLAN 2025 401k membership
Total number of particpants at beginning of year	2025-07-28	92
Total number of particpants at end of year	2025-07-28	99
Number of Participants With Account Balances	2025-07-28	40
2024: HOME INSTEAD 401(K) PLAN 2024 401k membership
Total number of particpants at beginning of year	2024-07-09	97
Total number of particpants at end of year	2024-07-09	92
Number of Participants With Account Balances	2024-07-09	39
2017: HOME INSTEAD 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	79
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	3
Total of all active and inactive participants	2017-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	82
Number of participants with account balances	2017-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: HOME INSTEAD 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	111
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	112
Number of participants with account balances	2016-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on HOME INSTEAD 401(K) PLAN

Measure	Date	Value
2025 : HOME INSTEAD 401(K) PLAN 2025 401k financial data
Total liabilities as of the end of the plan year	2025-07-28	244
Total liabilities as of the beginning of the plan year	2025-07-28	0
Total expenses incurred by plan in this plan year	2025-07-28	65289
Net assets as of the end of the plan year	2025-07-28	1332520
Total assets as of the beginning of the plan year	2025-07-28	1040517
Value of plan covered by a fidelity bond	2025-07-28	150000
Participant contributions to plan in this plan year	2025-07-28	116813
Value of participant loans at end of plan year	2025-07-28	3687
Other income to plan in this plan year	2025-07-28	190350
Plan net income in this plan year	2025-07-28	291759
Net assets as of the end of the plan year	2025-07-28	1332276
Net assets as of the beginning of the plan year	2025-07-28	1040517
Value of contributions failed to transmitted timely	2025-07-28	132
Employer contributions to plan in this plan year	2025-07-28	49885
Fees paid to broker by Benefit Provider	2025-07-28	7
Expensese paid to adminstrative service provicers from plan in this plan year	2025-07-28	11080
2024 : HOME INSTEAD 401(K) PLAN 2024 401k financial data
Total expenses incurred by plan in this plan year	2024-07-09	25002
Net assets as of the end of the plan year	2024-07-09	1040517
Total assets as of the beginning of the plan year	2024-07-09	730986
Value of plan covered by a fidelity bond	2024-07-09	150000
Participant contributions to plan in this plan year	2024-07-09	93834
Other income to plan in this plan year	2024-07-09	196628
Plan net income in this plan year	2024-07-09	309531
Net assets as of the end of the plan year	2024-07-09	1040517
Net assets as of the beginning of the plan year	2024-07-09	730986
Employer contributions to plan in this plan year	2024-07-09	44071
Expensese paid to adminstrative service provicers from plan in this plan year	2024-07-09	7246
2017 : HOME INSTEAD 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$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	$86,667
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$3,956
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$860
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$58,670
Value of total assets at end of year	2017-12-31	$268,488
Value of total assets at beginning of year	2017-12-31	$185,777
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,096
Total interest from all sources	2017-12-31	$137
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$46,840
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$82,711
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$268,488
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$185,777
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$167,638
Value of interest in pooled separate accounts at end of year	2017-12-31	$242,035
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest earned on other investments	2017-12-31	$137
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$25,836
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$16,130
Net investment gain/loss from pooled separate accounts	2017-12-31	$27,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$11,830
Employer contributions (assets) at end of year	2017-12-31	$617
Employer contributions (assets) at beginning of year	2017-12-31	$1,356
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$860
Contract administrator fees	2017-12-31	$3,096
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CRAMER & ASSOCIATES
Accountancy firm EIN	2017-12-31	272044619
2016 : HOME INSTEAD 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$188,549
Total of all expenses incurred	2016-12-31	$1,997
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$166,238
Value of total assets at end of year	2016-12-31	$186,552
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,997
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$26,282
Participant contributions at end of year	2016-12-31	$1,353
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$129,145
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$186,552
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$186,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$167,638
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$16,130
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$22,311
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$10,811
Employer contributions (assets) at end of year	2016-12-31	$1,431
Contract administrator fees	2016-12-31	$1,997
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CRAMER & ASSOCIATES
Accountancy firm EIN	2016-12-31	272044619

Form 5500 Responses for HOME INSTEAD 401(K) PLAN

2017: HOME INSTEAD 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: HOME INSTEAD 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	601894-000
Policy instance	1

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Company Name:	ROTH SENIOR CARE, LLC DBA HOME INSTEAD SENIOR CARE
Employer identification number (EIN):	262679126
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2008-05-27
Company Identification Number:	52128296
Legal Registered Office Address:	10415 SE STARK ST STE A PORTLAND United States of America (USA) 97216