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GOOD SHEPHERD RETIREMENT PLAN 401k Plan overview

Plan NameGOOD SHEPHERD RETIREMENT PLAN
Plan identification number 001

GOOD SHEPHERD RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • 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

GOOD SHEPHERD GERIATRIC CENTER has sponsored the creation of one or more 401k plans.

Company Name:GOOD SHEPHERD GERIATRIC CENTER
Employer identification number (EIN):420725236
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOD SHEPHERD RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01NAN KLOUSE NAN KLOUSE2016-10-17
0012013-01-01NAN KLOUSE2014-07-30 NAN KLOUSE2014-07-30
0012012-01-01NAN KLOUSE2014-08-22 NAN KLOUSE2014-08-22
0012011-01-01NAN KLOUSE2014-08-21 NAN KLOUSE2014-08-21
0012010-01-01NAN KLOUSE2014-08-21 NAN KLOUSE2014-08-21
0012009-01-01NAN KLOUSE2014-09-08 NAN KLOUSE2014-09-08
0012008-01-01NAN KLOUSE NAN KLOUSE2014-09-08

Plan Statistics for GOOD SHEPHERD RETIREMENT PLAN

401k plan membership statisitcs for GOOD SHEPHERD RETIREMENT PLAN

Measure Date Value
2015: GOOD SHEPHERD RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01298
Total number of active participants reported on line 7a of the Form 55002015-01-01303
Number of retired or separated participants receiving benefits2015-01-016
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-01310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01310
Number of participants with account balances2015-01-01308
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2008: GOOD SHEPHERD RETIREMENT PLAN 2008 401k membership
Total of all active and inactive participants2008-01-010
Total participants2008-01-010

Financial Data on GOOD SHEPHERD RETIREMENT PLAN

Measure Date Value
2015 : GOOD SHEPHERD RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$123,371
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$19,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$18,552
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$159,292
Value of total assets at end of year2015-12-31$1,086,356
Value of total assets at beginning of year2015-12-31$982,492
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$955
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$135,331
Administrative expenses (other) incurred2015-12-31$955
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$103,864
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,086,356
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$982,492
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,062,692
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$967,846
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$23,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$14,646
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-35,921
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$23,961
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$18,552
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No

Form 5500 Responses for GOOD SHEPHERD RETIREMENT PLAN

2015: GOOD SHEPHERD RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2008: GOOD SHEPHERD RETIREMENT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo

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