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| Plan Name | NORTH COUNTRY INDEPENDENT LIVING, INC. SECTION 403(B) RETIREMENT PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | NORTH COUNTRY INDEPENDENT LIVING, INC. |
| Employer identification number (EIN): | 391658015 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2022-01-01 | JILL NYBERG | 2023-10-06 | ||
| 001 | 2021-01-01 | JILL NYBERG | 2022-09-16 | ||
| 001 | 2020-01-01 | JILL NYBERG | 2021-09-21 | ||
| 001 | 2019-01-01 | JILL NYBERG | 2020-04-19 | JILL NYBERG | 2020-04-19 |
| 001 | 2018-01-01 | JILL NYBERG | 2019-05-02 | JILL NYBERG | 2019-05-02 |
| 001 | 2018-01-01 | JILL NYBERG | 2020-04-19 | JILL NYBERG | 2020-04-19 |
| 001 | 2017-01-01 | JOHN NOUSAINE | 2018-07-24 | JOHN NOUSAINE | 2018-07-24 |
| 001 | 2016-01-01 | JOHN NOUSAINE | 2017-07-13 | JOHN NOUSAINE | 2017-07-13 |
| 001 | 2015-01-01 | JOHN NOUSAINE | 2016-07-13 | ||
| 001 | 2014-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2013-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2012-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2011-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2010-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2009-01-01 | JOHN NOUSAINE | 2015-10-27 | ||
| 001 | 2008-01-01 | JOHN NOUSAINE |
| Measure | Date | Value |
|---|---|---|
| 2008: NORTH COUNTRY INDEPENDENT LIVING, INC. SECTION 403(B) RETIREMENT PLAN 2008 401k membership | ||
| Total participants, beginning-of-year | 2008-01-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-01-01 | 10 |
| Total of all active and inactive participants | 2008-01-01 | 17 |
| Total participants | 2008-01-01 | 17 |
| Number of participants with account balances | 2008-01-01 | 16 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2008-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2008 : NORTH COUNTRY INDEPENDENT LIVING, INC. SECTION 403(B) RETIREMENT PLAN 2008 401k financial data | ||
| Total income from all sources | 2008-12-31 | $-101,429 |
| Expenses. Total of all expenses incurred | 2008-12-31 | $11,796 |
| Benefits paid (including direct rollovers) | 2008-12-31 | $11,451 |
| Total plan assets at end of year | 2008-12-31 | $298,080 |
| Total plan assets at beginning of year | 2008-12-31 | $411,305 |
| Value of fidelity bond covering the plan | 2008-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2008-12-31 | $17,285 |
| Expenses. Other expenses not covered elsewhere | 2008-12-31 | $345 |
| Other income received | 2008-12-31 | $-137,894 |
| Net income (gross income less expenses) | 2008-12-31 | $-113,225 |
| Net plan assets at end of year (total assets less liabilities) | 2008-12-31 | $298,080 |
| Net plan assets at beginning of year (total assets less liabilities) | 2008-12-31 | $411,305 |
| Total contributions received or receivable from employer(s) | 2008-12-31 | $19,180 |
| 2008: NORTH COUNTRY INDEPENDENT LIVING, INC. SECTION 403(B) RETIREMENT PLAN 2008 form 5500 responses | ||
|---|---|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | Submission has been amended | No |
| 2008-01-01 | This submission is the final filing | No |
| 2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-01-01 | Plan is a collectively bargained plan | No |
| 2008-01-01 | Plan funding arrangement – Trust | Yes |
| 2008-01-01 | Plan benefit arrangement - Trust | Yes |
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