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EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.
Plan identification number 001

EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • 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

LIFELINE HOMECARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:LIFELINE HOMECARE, INC.
Employer identification number (EIN):611161293
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01JAMES T. WILSON2021-10-12
0012019-01-01JAMES T. WILSON2020-10-05
0012018-01-01JAMES T. WILSON2019-10-10
0012017-01-01JAMES T. WILSON JAMES T. WILSON2018-07-13
0012016-01-01JAMES T. WILSON JAMES T. WILSON2017-07-26
0012015-01-01JAMES T. WILSON JAMES T. WILSON2016-07-27
0012014-01-01JAMES T. WILSON JAMES T. WILSON2015-05-13
0012013-01-01JAMES T. WILSON JAMES T. WILSON2014-10-02
0012012-01-01JAMES T. WILSON JAMES T. WILSON2013-10-14
0012011-01-01JAMES T. WILSON JAMES T. WILSON2012-10-12
0012009-01-01JAMES T. WILSON JAMES T. WILSON2010-10-13

Plan Statistics for EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.

Measure Date Value
2022: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-010
Total number of active participants reported on line 7a of the Form 55002022-01-0129
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0172
Total of all active and inactive participants2022-01-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01101
Number of participants with account balances2022-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-014
2021: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-01132
Total number of active participants reported on line 7a of the Form 55002021-01-01112
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0122
Total of all active and inactive participants2021-01-01134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01134
Number of participants with account balances2021-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-013
2017: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-0184
Total number of active participants reported on line 7a of the Form 55002017-01-0159
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0115
Total of all active and inactive participants2017-01-0174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0174
Number of participants with account balances2017-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-0196
Total number of active participants reported on line 7a of the Form 55002016-01-0160
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0124
Total of all active and inactive participants2016-01-0184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0184
Number of participants with account balances2016-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-015
2015: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-0185
Total number of active participants reported on line 7a of the Form 55002015-01-0176
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0120
Total of all active and inactive participants2015-01-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0196
Number of participants with account balances2015-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-014
2014: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-0195
Total number of active participants reported on line 7a of the Form 55002014-01-0169
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0116
Total of all active and inactive participants2014-01-0185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0185
Number of participants with account balances2014-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013
2013: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-0199
Total number of active participants reported on line 7a of the Form 55002013-01-0183
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0112
Total of all active and inactive participants2013-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0195
Number of participants with account balances2013-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01117
Total number of active participants reported on line 7a of the Form 55002012-01-0180
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0119
Total of all active and inactive participants2012-01-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0199
Number of participants with account balances2012-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-014
2011: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01131
Total number of active participants reported on line 7a of the Form 55002011-01-01110
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-017
Total of all active and inactive participants2011-01-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01117
Number of participants with account balances2011-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-014
2009: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01138
Total number of active participants reported on line 7a of the Form 55002009-01-01110
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01114
Number of participants with account balances2009-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.

Measure Date Value
2022 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$12,775
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$13,131
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$12,570
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Value of total corrective distributions2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$53,075
Value of total assets at end of year2022-12-31$315,030
Value of total assets at beginning of year2022-12-31$315,386
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$561
Total interest from all sources2022-12-31$-50
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
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$0
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$75,000
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$53,075
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$561
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
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-356
Value of net assets at end of year (total assets less liabilities)2022-12-31$315,030
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$315,386
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
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$222,385
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$227,755
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$0
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$-50
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$92,645
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$87,631
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-40,250
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
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$0
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$12,570
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
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
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31GARRETY & ASSOCIATES CPAS LLC
Accountancy firm EIN2022-12-31721510008
2021 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$79,584
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$25,883
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$24,736
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$50,478
Value of total assets at end of year2021-12-31$315,386
Value of total assets at beginning of year2021-12-31$261,685
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,147
Total interest from all sources2021-12-31$938
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$75,000
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$32,691
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$0
Other income not declared elsewhere2021-12-31$158
Administrative expenses (other) incurred2021-12-31$1,147
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$53,701
Value of net assets at end of year (total assets less liabilities)2021-12-31$315,386
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$261,685
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$227,755
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$169,172
Interest on participant loans2021-12-31$0
Interest earned on other investments2021-12-31$938
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$87,631
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$92,513
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$28,010
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 contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$17,787
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$24,736
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 plan2021-12-31Disclaimer
Accountancy firm name2021-12-31THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN2021-12-31814229648
2017 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$76,321
Expenses. Total of all expenses incurred2017-12-31$12,153
Benefits paid (including direct rollovers)2017-12-31$11,519
Total plan assets at end of year2017-12-31$420,088
Total plan assets at beginning of year2017-12-31$355,920
Value of fidelity bond covering the plan2017-12-31$75,000
Total contributions received or receivable from participants2017-12-31$38,439
Expenses. Other expenses not covered elsewhere2017-12-31$634
Contributions received from other sources (not participants or employers)2017-12-31$48
Other income received2017-12-31$23,629
Net income (gross income less expenses)2017-12-31$64,168
Net plan assets at end of year (total assets less liabilities)2017-12-31$420,088
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$355,920
Assets. Value of participant loans2017-12-31$521
Total contributions received or receivable from employer(s)2017-12-31$14,205
Value of certain deemed distributions of participant loans2017-12-31$0
2016 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$51,511
Expenses. Total of all expenses incurred2016-12-31$26,853
Benefits paid (including direct rollovers)2016-12-31$24,804
Total plan assets at end of year2016-12-31$355,920
Total plan assets at beginning of year2016-12-31$331,262
Value of fidelity bond covering the plan2016-12-31$75,000
Total contributions received or receivable from participants2016-12-31$29,291
Expenses. Other expenses not covered elsewhere2016-12-31$2,049
Contributions received from other sources (not participants or employers)2016-12-31$2,043
Other income received2016-12-31$9,506
Net income (gross income less expenses)2016-12-31$24,658
Net plan assets at end of year (total assets less liabilities)2016-12-31$355,920
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$331,262
Assets. Value of participant loans2016-12-31$1,697
Total contributions received or receivable from employer(s)2016-12-31$10,671
Value of certain deemed distributions of participant loans2016-12-31$0
2015 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$44,824
Expenses. Total of all expenses incurred2015-12-31$66,875
Benefits paid (including direct rollovers)2015-12-31$66,458
Total plan assets at end of year2015-12-31$331,262
Total plan assets at beginning of year2015-12-31$353,313
Value of fidelity bond covering the plan2015-12-31$75,000
Total contributions received or receivable from participants2015-12-31$32,045
Expenses. Other expenses not covered elsewhere2015-12-31$417
Contributions received from other sources (not participants or employers)2015-12-31$443
Other income received2015-12-31$-533
Net income (gross income less expenses)2015-12-31$-22,051
Net plan assets at end of year (total assets less liabilities)2015-12-31$331,262
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$353,313
Assets. Value of participant loans2015-12-31$5,556
Total contributions received or receivable from employer(s)2015-12-31$12,869
Value of certain deemed distributions of participant loans2015-12-31$0
2014 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$66,260
Expenses. Total of all expenses incurred2014-12-31$16,355
Benefits paid (including direct rollovers)2014-12-31$15,849
Total plan assets at end of year2014-12-31$353,313
Total plan assets at beginning of year2014-12-31$303,408
Value of fidelity bond covering the plan2014-12-31$75,000
Total contributions received or receivable from participants2014-12-31$26,382
Expenses. Other expenses not covered elsewhere2014-12-31$506
Contributions received from other sources (not participants or employers)2014-12-31$529
Other income received2014-12-31$11,147
Net income (gross income less expenses)2014-12-31$49,905
Net plan assets at end of year (total assets less liabilities)2014-12-31$353,313
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$303,408
Assets. Value of participant loans2014-12-31$13,398
Total contributions received or receivable from employer(s)2014-12-31$28,202
Value of certain deemed distributions of participant loans2014-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$68,658
Expenses. Total of all expenses incurred2013-12-31$149,908
Benefits paid (including direct rollovers)2013-12-31$139,730
Total plan assets at end of year2013-12-31$303,408
Total plan assets at beginning of year2013-12-31$384,658
Value of fidelity bond covering the plan2013-12-31$75,000
Total contributions received or receivable from participants2013-12-31$30,390
Expenses. Other expenses not covered elsewhere2013-12-31$10,178
Contributions received from other sources (not participants or employers)2013-12-31$7,408
Other income received2013-12-31$30,645
Net income (gross income less expenses)2013-12-31$-81,250
Net plan assets at end of year (total assets less liabilities)2013-12-31$303,408
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$384,658
Assets. Value of participant loans2013-12-31$11,968
Total contributions received or receivable from employer(s)2013-12-31$215
Value of certain deemed distributions of participant loans2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$74,563
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$37,396
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$27,321
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$46,589
Value of total assets at end of year2012-12-31$384,658
Value of total assets at beginning of year2012-12-31$347,491
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$10,075
Total interest from all sources2012-12-31$3,111
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$40,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$27,874
Participant contributions at end of year2012-12-31$13,322
Participant contributions at beginning of year2012-12-31$12,832
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$0
Other income not declared elsewhere2012-12-31$7,042
Administrative expenses (other) incurred2012-12-31$10,075
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$37,167
Value of net assets at end of year (total assets less liabilities)2012-12-31$384,658
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$347,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$181,472
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$182,611
Interest on participant loans2012-12-31$519
Interest earned on other investments2012-12-31$2,592
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$189,864
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$152,048
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$17,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$18,715
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$27,321
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CAMPBELL, MYERS, RUTLEDGE PLLC
Accountancy firm EIN2012-12-31610975454
2011 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$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$58,605
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$21,322
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$13,174
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Value of total corrective distributions2011-12-31$245
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$54,606
Value of total assets at end of year2011-12-31$347,491
Value of total assets at beginning of year2011-12-31$310,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$7,903
Total interest from all sources2011-12-31$3,187
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 year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$40,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$37,764
Participant contributions at end of year2011-12-31$12,832
Participant contributions at beginning of year2011-12-31$11,393
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$0
Other income not declared elsewhere2011-12-31$4,261
Administrative expenses (other) incurred2011-12-31$7,903
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$37,283
Value of net assets at end of year (total assets less liabilities)2011-12-31$347,491
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$310,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$182,611
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$168,930
Interest on participant loans2011-12-31$353
Interest earned on other investments2011-12-31$2,834
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$152,048
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$129,885
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-3,449
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$16,842
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$13,174
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31CAMPBELL, MYERS, & RUTLEDGE, PLLC
Accountancy firm EIN2011-12-31610975454
2010 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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$72,912
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$40,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$36,014
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$245
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$46,426
Value of total assets at end of year2010-12-31$310,208
Value of total assets at beginning of year2010-12-31$277,394
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$3,839
Total interest from all sources2010-12-31$3,747
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$40,000
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$33,900
Participant contributions at end of year2010-12-31$11,393
Participant contributions at beginning of year2010-12-31$2,340
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Other income not declared elsewhere2010-12-31$2,350
Administrative expenses (other) incurred2010-12-31$3,839
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$32,814
Value of net assets at end of year (total assets less liabilities)2010-12-31$310,208
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$277,394
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$168,930
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$158,155
Interest on participant loans2010-12-31$291
Interest earned on other investments2010-12-31$3,456
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$129,885
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$116,899
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$20,389
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$12,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$36,014
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 name2010-12-31CAMPBELL, MYERS AND RUTLEDGE, CPA
Accountancy firm EIN2010-12-31610975454
2009 : EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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 EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC.

2022: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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 benefit arrangement – InsuranceYes
2021: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2017: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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
2014: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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
2011: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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 – InsuranceYes
2009: EMPLOYEE BENEFIT PLAN OF LIFELINE HOMECARE, INC. 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

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008
Policy instance 1
Insurance contract or identification number057008
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $145
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 Administration1
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
Amount paid for insurance broker fees145
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered111
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $219
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered74
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $71
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees71
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameCINCINNATI REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered59
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $57
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameCINCINNATI REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered37
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $47
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees47
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameCINCINNATI REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered38
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $44
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees44
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameCINCINNATI REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered48
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 $52
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees27
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameJASON PINSON
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered46
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 $51
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 Administration1
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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057008D
Policy instance 1
Insurance contract or identification number057008D
Number of Individuals Covered47
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 $48
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 Administration1
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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