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403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 401k Plan overview

Plan Name403(B) THRIFT PLAN OF MADISON LUTHERAN HOME
Plan identification number 002

403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 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.

401k Sponsoring company profile

MADISON HEALTH CARE SERVICES has sponsored the creation of one or more 401k plans.

Company Name:MADISON HEALTH CARE SERVICES
Employer identification number (EIN):410706115
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 MADISON LUTHERAN HOME

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022009-01-01SCOTT LARSON

Plan Statistics for 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME

401k plan membership statisitcs for 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME

Measure Date Value
2009: 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 2009 401k membership
Total participants, beginning-of-year2009-01-01130
Total number of active participants reported on line 7a of the Form 55002009-01-01103
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-0122
Total of all active and inactive participants2009-01-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01126
Number of participants with account balances2009-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME

Measure Date Value
2010 : 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$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$729,960
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$303,998
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$303,998
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$331,045
Value of total assets at end of year2010-12-31$4,006,960
Value of total assets at beginning of year2010-12-31$3,580,998
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$34,337
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 year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$400,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$216,087
Other income not declared elsewhere2010-12-31$936
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$425,962
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,006,960
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,580,998
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$45,633
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$46,703
Value of interest in pooled separate accounts at end of year2010-12-31$3,934,672
Value of interest in pooled separate accounts at beginning of year2010-12-31$3,439,315
Interest earned on other investments2010-12-31$34,337
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$26,655
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$94,980
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$-1,442
Net investment gain/loss from pooled separate accounts2010-12-31$365,084
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$114,958
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$303,998
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31WIPFLI LLP
Accountancy firm EIN2010-12-31390758449
2009 : 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME

2009: 403(B) THRIFT PLAN OF MADISON LUTHERAN HOME 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

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