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AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 401k Plan overview

Plan NameAMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN
Plan identification number 004

AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

AMERICAN HEALTH CARE ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN HEALTH CARE ASSOCIATION
Employer identification number (EIN):530260105
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about AMERICAN HEALTH CARE ASSOCIATION

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1956-07-27
Company Identification Number: 257069
Legal Registered Office Address: 50 W. BROAD ST
SUITE 1800
COLUMBUS
United States of America (USA)
43215

More information about AMERICAN HEALTH CARE ASSOCIATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042022-01-01
0042021-01-01
0042020-01-01
0042019-01-01
0042018-01-01
0042017-01-01RAE ANNE DAVIS2018-06-25
0042016-01-01RAE ANNE DAVIS2017-04-27
0042015-01-01RAE ANNE DAVIS2016-07-18
0042014-01-01RAE ANNE DAVIS2015-06-09
0042013-01-01RAE ANNE DAVIS2014-07-25 RAE ANNE DAVIS2014-07-25
0042012-01-01RAE ANNE DAVIS RAE ANNE DAVIS2013-10-03
0042011-01-01RAE ANNE DAVIS RAE ANNE DAVIS2012-08-31
0042009-01-012010-07-23
0042009-01-01EILEEN RAMAGE EILEEN RAMAGE2010-07-23

Plan Statistics for AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN

401k plan membership statisitcs for AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN

Measure Date Value
2022: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01119
Total number of active participants reported on line 7a of the Form 55002022-01-0184
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0143
Total of all active and inactive participants2022-01-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01128
Number of participants with account balances2022-01-01127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0111
2021: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01115
Total number of active participants reported on line 7a of the Form 55002021-01-0183
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0134
Total of all active and inactive participants2021-01-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01118
Number of participants with account balances2021-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01122
Total number of active participants reported on line 7a of the Form 55002020-01-0185
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0129
Total of all active and inactive participants2020-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01115
Number of participants with account balances2020-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01119
Total number of active participants reported on line 7a of the Form 55002019-01-0190
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-0130
Total of all active and inactive participants2019-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01122
Number of participants with account balances2019-01-01122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01122
Total number of active participants reported on line 7a of the Form 55002018-01-0184
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0133
Total of all active and inactive participants2018-01-01119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01119
Number of participants with account balances2018-01-01119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-017
2012: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01115
Total number of active participants reported on line 7a of the Form 55002012-01-0169
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0146
Total of all active and inactive participants2012-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01115
Number of participants with account balances2012-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-017
2011: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01115
Total number of active participants reported on line 7a of the Form 55002011-01-0171
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0144
Total of all active and inactive participants2011-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01115
Number of participants with account balances2011-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0117
2009: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01105
Total number of active participants reported on line 7a of the Form 55002009-01-0175
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0136
Total of all active and inactive participants2009-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01111
Number of participants with account balances2009-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-016

Financial Data on AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN

Measure Date Value
2022 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$10,377
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$19,989
Total income from all sources (including contributions)2022-12-31$-2,839,547
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,465,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,388,731
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,247,974
Value of total assets at end of year2022-12-31$27,730,451
Value of total assets at beginning of year2022-12-31$32,045,117
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$76,776
Total interest from all sources2022-12-31$22,914
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$1,006,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$1,006,601
Administrative expenses professional fees incurred2022-12-31$51,776
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,118,775
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$775
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$23,007
Other income not declared elsewhere2022-12-31$38,687
Liabilities. Value of operating payables at end of year2022-12-31$10,377
Liabilities. Value of operating payables at beginning of year2022-12-31$19,989
Total non interest bearing cash at end of year2022-12-31$35,987
Total non interest bearing cash at beginning of year2022-12-31$1,105
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,305,054
Value of net assets at end of year (total assets less liabilities)2022-12-31$27,720,074
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$32,025,128
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$25,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$26,135,927
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$30,494,371
Interest earned on other investments2022-12-31$22,914
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$954,513
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$956,412
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-6,155,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,106,192
Employer contributions (assets) at end of year2022-12-31$604,024
Employer contributions (assets) at beginning of year2022-12-31$592,454
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,388,731
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31ELLIN & TUCKER
Accountancy firm EIN2022-12-31520959934
2021 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$19,989
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$11,335
Total income from all sources (including contributions)2021-12-31$5,894,782
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$623,039
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$541,606
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,071,297
Value of total assets at end of year2021-12-31$32,045,117
Value of total assets at beginning of year2021-12-31$26,764,720
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$81,433
Total interest from all sources2021-12-31$20,141
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$931,611
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$931,611
Administrative expenses professional fees incurred2021-12-31$54,591
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,092,687
Participant contributions at end of year2021-12-31$775
Participant contributions at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$20
Other income not declared elsewhere2021-12-31$277
Liabilities. Value of operating payables at end of year2021-12-31$19,989
Liabilities. Value of operating payables at beginning of year2021-12-31$11,335
Total non interest bearing cash at end of year2021-12-31$1,105
Total non interest bearing cash at beginning of year2021-12-31$5,555
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$5,271,743
Value of net assets at end of year (total assets less liabilities)2021-12-31$32,025,128
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$26,753,385
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$26,842
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$30,494,371
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$25,876,243
Interest earned on other investments2021-12-31$20,141
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$956,412
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$882,117
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$2,871,456
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$978,590
Employer contributions (assets) at end of year2021-12-31$592,454
Employer contributions (assets) at beginning of year2021-12-31$805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$541,606
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31ELLIN & TUCKER
Accountancy firm EIN2021-12-31520959934
2020 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$11,335
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$4,361
Total income from all sources (including contributions)2020-12-31$4,881,896
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,033,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$963,741
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,457,774
Value of total assets at end of year2020-12-31$26,764,720
Value of total assets at beginning of year2020-12-31$22,908,948
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$69,357
Total interest from all sources2020-12-31$11,764
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$768,566
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$768,566
Administrative expenses professional fees incurred2020-12-31$41,849
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,069,715
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$2,156
Other income not declared elsewhere2020-12-31$1,130
Liabilities. Value of operating payables at end of year2020-12-31$11,335
Liabilities. Value of operating payables at beginning of year2020-12-31$4,361
Total non interest bearing cash at end of year2020-12-31$5,555
Total non interest bearing cash at beginning of year2020-12-31$752
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$3,848,798
Value of net assets at end of year (total assets less liabilities)2020-12-31$26,753,385
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$22,904,587
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$27,508
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$25,876,243
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$21,874,939
Interest earned on other investments2020-12-31$11,764
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$882,117
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$489,690
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,642,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$388,059
Employer contributions (assets) at end of year2020-12-31$805
Employer contributions (assets) at beginning of year2020-12-31$541,411
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$963,741
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31Yes
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31RSM US LLP
Accountancy firm EIN2020-12-31420714325
2019 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,361
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,361
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,937
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,937
Total income from all sources (including contributions)2019-12-31$5,981,876
Total income from all sources (including contributions)2019-12-31$5,981,876
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$3,137,135
Total of all expenses incurred2019-12-31$3,137,135
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,079,162
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,079,162
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,939,922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,939,922
Value of total assets at end of year2019-12-31$22,908,948
Value of total assets at end of year2019-12-31$22,908,948
Value of total assets at beginning of year2019-12-31$20,062,783
Value of total assets at beginning of year2019-12-31$20,062,783
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$57,973
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$57,973
Total interest from all sources2019-12-31$15,905
Total interest from all sources2019-12-31$15,905
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$470,810
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$470,810
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$470,810
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$470,810
Administrative expenses professional fees incurred2019-12-31$40,636
Administrative expenses professional fees incurred2019-12-31$40,636
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$997,497
Contributions received from participants2019-12-31$997,497
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$23,101
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$23,101
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$2,156
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$2,156
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,563
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,563
Liabilities. Value of operating payables at end of year2019-12-31$4,361
Liabilities. Value of operating payables at end of year2019-12-31$4,361
Liabilities. Value of operating payables at beginning of year2019-12-31$2,937
Liabilities. Value of operating payables at beginning of year2019-12-31$2,937
Total non interest bearing cash at end of year2019-12-31$752
Total non interest bearing cash at end of year2019-12-31$752
Total non interest bearing cash at beginning of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,844,741
Value of net income/loss2019-12-31$2,844,741
Value of net assets at end of year (total assets less liabilities)2019-12-31$22,904,587
Value of net assets at end of year (total assets less liabilities)2019-12-31$22,904,587
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$20,059,846
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$20,059,846
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$17,337
Investment advisory and management fees2019-12-31$17,337
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$21,874,939
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$21,874,939
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$18,799,720
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$18,799,720
Interest earned on other investments2019-12-31$15,905
Interest earned on other investments2019-12-31$15,905
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$489,690
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$489,690
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$778,678
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$3,555,239
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$3,555,239
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$919,324
Contributions received in cash from employer2019-12-31$919,324
Employer contributions (assets) at end of year2019-12-31$541,411
Employer contributions (assets) at end of year2019-12-31$541,411
Employer contributions (assets) at beginning of year2019-12-31$481,822
Employer contributions (assets) at beginning of year2019-12-31$481,822
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,079,162
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$3,079,162
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31RSM US LLP
Accountancy firm name2019-12-31RSM US LLP
Accountancy firm EIN2019-12-31420714325
Accountancy firm EIN2019-12-31420714325
2018 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION 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$2,937
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,001
Total income from all sources (including contributions)2018-12-31$571,925
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$988,635
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$927,540
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,753,824
Value of total assets at end of year2018-12-31$20,062,783
Value of total assets at beginning of year2018-12-31$20,479,557
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$61,095
Total interest from all sources2018-12-31$16,924
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$440,258
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$440,258
Administrative expenses professional fees incurred2018-12-31$38,358
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
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$922,720
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$402
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$2,563
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$1,650
Other income not declared elsewhere2018-12-31$15
Liabilities. Value of operating payables at end of year2018-12-31$2,937
Liabilities. Value of operating payables at beginning of year2018-12-31$3,001
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-416,710
Value of net assets at end of year (total assets less liabilities)2018-12-31$20,059,846
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$20,476,556
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
Investment advisory and management fees2018-12-31$22,737
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$18,799,720
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$19,378,425
Interest earned on other investments2018-12-31$16,924
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$778,678
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$622,785
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,639,096
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$830,702
Employer contributions (assets) at end of year2018-12-31$481,822
Employer contributions (assets) at beginning of year2018-12-31$476,697
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$927,540
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 name2018-12-31TATE & TRYON PC
Accountancy firm EIN2018-12-31521855942
2012 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2012 401k financial data
Total income from all sources2012-12-31$2,159,174
Expenses. Total of all expenses incurred2012-12-31$1,859,613
Benefits paid (including direct rollovers)2012-12-31$1,845,299
Total plan assets at end of year2012-12-31$10,418,719
Total plan assets at beginning of year2012-12-31$10,119,158
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$678,663
Contributions received from other sources (not participants or employers)2012-12-31$3,135
Other income received2012-12-31$1,281,717
Net income (gross income less expenses)2012-12-31$299,561
Net plan assets at end of year (total assets less liabilities)2012-12-31$10,418,719
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$10,119,158
Total contributions received or receivable from employer(s)2012-12-31$195,659
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$14,314
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2011 401k financial data
Total income from all sources2011-12-31$1,115,544
Expenses. Total of all expenses incurred2011-12-31$2,373,542
Benefits paid (including direct rollovers)2011-12-31$2,373,542
Total plan assets at end of year2011-12-31$10,119,158
Total plan assets at beginning of year2011-12-31$11,377,156
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$679,014
Other income received2011-12-31$-79,462
Net income (gross income less expenses)2011-12-31$-1,257,998
Net plan assets at end of year (total assets less liabilities)2011-12-31$10,119,158
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$11,377,156
Total contributions received or receivable from employer(s)2011-12-31$515,992
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2010 401k financial data
Total income from all sources2010-12-31$2,348,677
Expenses. Total of all expenses incurred2010-12-31$477,356
Benefits paid (including direct rollovers)2010-12-31$477,356
Total plan assets at end of year2010-12-31$11,377,156
Total plan assets at beginning of year2010-12-31$9,505,835
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$643,141
Contributions received from other sources (not participants or employers)2010-12-31$29,646
Other income received2010-12-31$1,165,283
Net income (gross income less expenses)2010-12-31$1,871,321
Net plan assets at end of year (total assets less liabilities)2010-12-31$11,377,156
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$9,505,835
Total contributions received or receivable from employer(s)2010-12-31$510,607
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN

2022: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION 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 filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION 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
2012: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: AMERICAN HEALTH CARE ASSOCIATION 401K AND DISCRETIONARY DEFINED CONTRIBUTION PLAN 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 - TrustYes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA-31582
Policy instance 1
Insurance contract or identification numberGA-31582
Number of Individuals Covered9
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA-31582
Policy instance 1
Insurance contract or identification numberGA-31582
Number of Individuals Covered9
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA-31582
Policy instance 1
Insurance contract or identification numberGA-31582
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA-31582
Policy instance 1
Insurance contract or identification numberGA-31582
Number of Individuals Covered7
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA-31582
Policy instance 1
Insurance contract or identification numberGA-31582
Number of Individuals Covered119
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31501
Policy instance 1
Insurance contract or identification number31501
Number of Individuals Covered106
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31501
Policy instance 1
Insurance contract or identification number31501
Number of Individuals Covered108
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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?No
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
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31501
Policy instance 1
Insurance contract or identification number31501
Number of Individuals Covered104
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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?No
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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