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HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 401k Plan overview

Plan NameHOSPICE OF THE MIAMI VALLEY 401(K) PLAN
Plan identification number 001

HOSPICE OF THE MIAMI VALLEY 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.
  • 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

HOSPICE OF THE MIAMI VALLEY, LLC has sponsored the creation of one or more 401k plans.

Company Name:HOSPICE OF THE MIAMI VALLEY, LLC
Employer identification number (EIN):262846696
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPICE OF THE MIAMI VALLEY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01KIMBERLY JONES2020-10-06
0012018-01-01KIMBERLY JONES2019-10-10
0012017-01-01REX RADERSTORF
0012016-01-01REX RADERSTORF2017-10-11
0012015-01-01REX RADERSTORF2016-10-11
0012014-01-01REX RADERSTORF2015-07-17
0012013-01-01REX RADERSTORF2014-07-24

Plan Statistics for HOSPICE OF THE MIAMI VALLEY 401(K) PLAN

401k plan membership statisitcs for HOSPICE OF THE MIAMI VALLEY 401(K) PLAN

Measure Date Value
2019: HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01155
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0194
Total number of active participants reported on line 7a of the Form 55002018-01-0189
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0164
Total of all active and inactive participants2018-01-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01155
Number of participants with account balances2018-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01131
Total number of active participants reported on line 7a of the Form 55002017-01-01103
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0150
Total of all active and inactive participants2017-01-01153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01153
Number of participants with account balances2017-01-01141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on HOSPICE OF THE MIAMI VALLEY 401(K) PLAN

Measure Date Value
2019 : HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-12$0
Total unrealized appreciation/depreciation of assets2019-12-12$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-12$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-12$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-12$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-12$0
Total income from all sources (including contributions)2019-12-12$322,082
Total income from all sources (including contributions)2019-12-12$322,082
Total loss/gain on sale of assets2019-12-12$0
Total loss/gain on sale of assets2019-12-12$0
Total of all expenses incurred2019-12-12$1,529,247
Total of all expenses incurred2019-12-12$1,529,247
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-12$1,510,652
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-12$1,510,652
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-12$116,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-12$116,130
Value of total assets at end of year2019-12-12$0
Value of total assets at end of year2019-12-12$0
Value of total assets at beginning of year2019-12-12$1,207,165
Value of total assets at beginning of year2019-12-12$1,207,165
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-12$18,595
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-12$18,595
Total interest from all sources2019-12-12$428
Total interest from all sources2019-12-12$428
Total dividends received (eg from common stock, registered investment company shares)2019-12-12$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-12$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-12Yes
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-12Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-12$0
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-12$0
Total dividends received from registered investment company shares (eg mutual funds)2019-12-12$0
Total dividends received from registered investment company shares (eg mutual funds)2019-12-12$0
Was this plan covered by a fidelity bond2019-12-12Yes
Was this plan covered by a fidelity bond2019-12-12Yes
Value of fidelity bond cover2019-12-12$121,000
Value of fidelity bond cover2019-12-12$121,000
If this is an individual account plan, was there a blackout period2019-12-12No
If this is an individual account plan, was there a blackout period2019-12-12No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-12$0
Were there any nonexempt tranactions with any party-in-interest2019-12-12No
Were there any nonexempt tranactions with any party-in-interest2019-12-12No
Contributions received from participants2019-12-12$55,825
Contributions received from participants2019-12-12$55,825
Participant contributions at end of year2019-12-12$0
Participant contributions at end of year2019-12-12$0
Participant contributions at beginning of year2019-12-12$19,730
Participant contributions at beginning of year2019-12-12$19,730
Other income not declared elsewhere2019-12-12$12
Other income not declared elsewhere2019-12-12$12
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-12No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-12No
Value of net income/loss2019-12-12$-1,207,165
Value of net income/loss2019-12-12$-1,207,165
Value of net assets at end of year (total assets less liabilities)2019-12-12$0
Value of net assets at end of year (total assets less liabilities)2019-12-12$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-12$1,207,165
Value of net assets at beginning of year (total assets less liabilities)2019-12-12$1,207,165
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-12No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-12No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-12No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-12No
Were any leases to which the plan was party in default or uncollectible2019-12-12No
Were any leases to which the plan was party in default or uncollectible2019-12-12No
Value of interest in pooled separate accounts at end of year2019-12-12$0
Value of interest in pooled separate accounts at end of year2019-12-12$0
Value of interest in pooled separate accounts at beginning of year2019-12-12$1,187,406
Value of interest in pooled separate accounts at beginning of year2019-12-12$1,187,406
Interest on participant loans2019-12-12$428
Interest on participant loans2019-12-12$428
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-12$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-12$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-12$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-12$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-12$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-12$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-12$205,512
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-12$205,512
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-12No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-12No
Was there a failure to transmit to the plan any participant contributions2019-12-12No
Was there a failure to transmit to the plan any participant contributions2019-12-12No
Has the plan failed to provide any benefit when due under the plan2019-12-12No
Has the plan failed to provide any benefit when due under the plan2019-12-12No
Contributions received in cash from employer2019-12-12$60,305
Contributions received in cash from employer2019-12-12$60,305
Employer contributions (assets) at end of year2019-12-12$0
Employer contributions (assets) at end of year2019-12-12$0
Employer contributions (assets) at beginning of year2019-12-12$29
Employer contributions (assets) at beginning of year2019-12-12$29
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-12$1,510,652
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-12$1,510,652
Contract administrator fees2019-12-12$18,595
Contract administrator fees2019-12-12$18,595
Did the plan have assets held for investment2019-12-12No
Did the plan have assets held for investment2019-12-12No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-12No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-12No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-12Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-12Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-12Yes
Opinion of an independent qualified public accountant for this plan2019-12-12Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-12Disclaimer
Accountancy firm name2019-12-12MAHLE WACK & ZAIDAIN
Accountancy firm name2019-12-12MAHLE WACK & ZAIDAIN
Accountancy firm EIN2019-12-12311307168
Accountancy firm EIN2019-12-12311307168
2018 : HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$308,312
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$63,630
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$55,698
Expenses. Certain deemed distributions of participant loans2018-12-31$1,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$347,996
Value of total assets at end of year2018-12-31$1,207,165
Value of total assets at beginning of year2018-12-31$962,483
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$6,683
Total interest from all sources2018-12-31$1,038
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$3,408
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$372
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$121,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$117,156
Participant contributions at end of year2018-12-31$19,730
Participant contributions at beginning of year2018-12-31$13,332
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$89,259
Other income not declared elsewhere2018-12-31$4,855
Administrative expenses (other) incurred2018-12-31$6,403
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$244,682
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,207,165
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$962,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$730,389
Value of interest in pooled separate accounts at end of year2018-12-31$1,187,406
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$1,038
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$40,275
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$178,487
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$178,487
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-51,481
Net investment gain or loss from common/collective trusts2018-12-31$2,496
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$141,581
Employer contributions (assets) at end of year2018-12-31$29
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from common stock2018-12-31$3,036
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$55,698
Contract administrator fees2018-12-31$280
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MAHLE WACK & ZAIDAIN
Accountancy firm EIN2018-12-31311307168
2017 : HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$0
Total transfer of assets from this plan2017-12-31$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$322,101
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$29,258
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$28,329
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$219,814
Value of total assets at end of year2017-12-31$962,483
Value of total assets at beginning of year2017-12-31$669,640
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$929
Total interest from all sources2017-12-31$656
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$30,431
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$30,431
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$67,000
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$95,518
Participant contributions at end of year2017-12-31$13,332
Participant contributions at beginning of year2017-12-31$7,555
Other income not declared elsewhere2017-12-31$354
Administrative expenses (other) incurred2017-12-31$929
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$292,843
Value of net assets at end of year (total assets less liabilities)2017-12-31$962,483
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$669,640
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$730,389
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$474,659
Interest on participant loans2017-12-31$317
Value of interest in common/collective trusts at end of year2017-12-31$40,275
Value of interest in common/collective trusts at beginning of year2017-12-31$24,328
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$178,487
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$163,098
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$163,098
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$339
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$65,318
Net investment gain or loss from common/collective trusts2017-12-31$5,528
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$124,296
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$28,329
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 name2017-12-31MAHLE WACK & ZAIDAIN
Accountancy firm EIN2017-12-31311307168

Form 5500 Responses for HOSPICE OF THE MIAMI VALLEY 401(K) PLAN

2019: HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HOSPICE OF THE MIAMI VALLEY 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HOSPICE OF THE MIAMI VALLEY 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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81B702
Policy instance 1
Insurance contract or identification number81B702
Number of Individuals Covered163
Insurance policy start date2019-01-01
Insurance policy end date2019-12-12
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,216
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
Amount paid for insurance broker fees3216
Additional information about fees paid to insurance brokerSERVICE REIMBURSEMENT
Insurance broker organization code?5
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81B702
Policy instance 1
Insurance contract or identification number81B702
Number of Individuals Covered154
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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

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