| Plan Name | FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | FIRST COMMUNITY VILLAGE |
| Employer identification number (EIN): | 310655502 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about FIRST COMMUNITY VILLAGE
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 1961-03-17 |
| Company Identification Number: | 298822 |
| Legal Registered Office Address: |
904 MASTER DRIVE - GALLOWAY United States of America (USA) 43119 |
More information about FIRST COMMUNITY VILLAGE
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2012-01-01 | DAVID KAYUHA | |||
| 002 | 2011-01-01 | DAVID KAYUHA | |||
| 002 | 2009-01-01 | DIANE TOMLINSON | DIANE TOMLINSON | 2010-10-05 |
| Measure | Date | Value |
|---|---|---|
| 2012 : FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2012 401k financial data | ||
| Total income from all sources | 2012-05-03 | $-53 |
| Expenses. Total of all expenses incurred | 2012-05-03 | $20,564 |
| Benefits paid (including direct rollovers) | 2012-05-03 | $20,564 |
| Total plan assets at end of year | 2012-05-03 | $0 |
| Total plan assets at beginning of year | 2012-05-03 | $20,617 |
| Value of fidelity bond covering the plan | 2012-05-03 | $500,000 |
| Other income received | 2012-05-03 | $-53 |
| Net income (gross income less expenses) | 2012-05-03 | $-20,617 |
| Net plan assets at end of year (total assets less liabilities) | 2012-05-03 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-05-03 | $20,617 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-05-03 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2012-05-03 | $0 |
| Minimum employer required contribution for this plan year | 2012-05-03 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2012-05-03 | $0 |
| 2011 : FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2011 401k financial data | ||
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total income from all sources (including contributions) | 2011-12-31 | $27,451 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $2,841,611 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $2,831,591 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $0 |
| Value of total assets at end of year | 2011-12-31 | $20,617 |
| Value of total assets at beginning of year | 2011-12-31 | $2,834,777 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $10,020 |
| Total interest from all sources | 2011-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2011-12-31 | $0 |
| Administrative expenses professional fees incurred | 2011-12-31 | $10,020 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2011-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2011-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2011-12-31 | $0 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-2,814,160 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $20,617 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $2,834,777 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2011-12-31 | $20,617 |
| Value of interest in pooled separate accounts at beginning of year | 2011-12-31 | $1,775,730 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $964,114 |
| Net investment gain or loss from common/collective trusts | 2011-12-31 | $27,451 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Employer contributions (assets) at end of year | 2011-12-31 | $0 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $94,933 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $2,831,591 |
| Did the plan have assets held for investment | 2011-12-31 | 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 | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | HOWARD WERSHBALE & CO |
| Accountancy firm EIN | 2011-12-31 | 341663157 |
| 2010 : FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2010 401k financial data | ||
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total income from all sources (including contributions) | 2010-12-31 | $511,778 |
| Total loss/gain on sale of assets | 2010-12-31 | $0 |
| Total of all expenses incurred | 2010-12-31 | $366,422 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $366,422 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $316,456 |
| Value of total assets at end of year | 2010-12-31 | $2,834,777 |
| Value of total assets at beginning of year | 2010-12-31 | $2,689,421 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $0 |
| Total interest from all sources | 2010-12-31 | $26,966 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2010-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2010-12-31 | $307,446 |
| Amount contributed by the employer to the plan for this plan year | 2010-12-31 | $307,446 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $8,710 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $145,356 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $2,834,777 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,689,421 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2010-12-31 | $1,775,730 |
| Value of interest in pooled separate accounts at beginning of year | 2010-12-31 | $1,612,529 |
| Interest earned on other investments | 2010-12-31 | $26,966 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $964,114 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2010-12-31 | $970,960 |
| Net investment gain or loss from common/collective trusts | 2010-12-31 | $168,356 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $307,746 |
| Employer contributions (assets) at end of year | 2010-12-31 | $94,933 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $105,932 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $366,422 |
| Did the plan have assets held for investment | 2010-12-31 | 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 | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | HOWARD WERSHBALE & CO |
| Accountancy firm EIN | 2010-12-31 | 341663157 |
| 2009 : FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2009 401k financial data | ||
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2009-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2009-12-31 | $316,806 |
| Amount contributed by the employer to the plan for this plan year | 2009-12-31 | $316,806 |
| 2012: FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2012 form 5500 responses | ||
|---|---|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | Yes |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FIRST COMMUNITY VILLAGE FIRST COMMUNITY FINAL 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |