401k Plan data: BRETHREN CARE VILLAGE RETIREMENT PLAN plan

BRETHREN CARE VILLAGE RETIREMENT PLAN 401k Plan overview

Plan Name	BRETHREN CARE VILLAGE RETIREMENT PLAN
Plan identification number	001

BRETHREN CARE VILLAGE RETIREMENT PLAN Benefits

401k Plan Type

Defined 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.
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

BRETHREN CARE MANAGEMENT SERVICES has sponsored the creation of one or more 401k plans.

Company Name: BRETHREN CARE MANAGEMENT SERVICES

Employer identification number (EIN): 821085269

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRETHREN CARE VILLAGE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 MINDY SCURLOCK 2023-10-11
001 2021-01-01
001 2020-01-01 TROY SNYDER 2021-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	MINDY SCURLOCK	2023-10-11
001	2021-01-01
001	2020-01-01	TROY SNYDER	2021-10-15

Plan Statistics for BRETHREN CARE VILLAGE RETIREMENT PLAN

401k plan membership statisitcs for BRETHREN CARE VILLAGE RETIREMENT PLAN

Measure Date Value
2022: BRETHREN CARE VILLAGE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 292
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 13
Total of all active and inactive participants 2022-01-01 305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 305
Number of participants with account balances 2022-01-01 200
2021: BRETHREN CARE VILLAGE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 263
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 186
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 22
Total of all active and inactive participants 2021-01-01 209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 209
Number of participants with account balances 2021-01-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 19
2020: BRETHREN CARE VILLAGE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 270
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 216
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 42
Total of all active and inactive participants 2020-01-01 258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 258
Number of participants with account balances 2020-01-01 207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 45

Measure	Date	Value
2022: BRETHREN CARE VILLAGE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	292
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	13
Total of all active and inactive participants	2022-01-01	305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	305
Number of participants with account balances	2022-01-01	200
2021: BRETHREN CARE VILLAGE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	263
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	186
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	22
Total of all active and inactive participants	2021-01-01	209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	209
Number of participants with account balances	2021-01-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	19
2020: BRETHREN CARE VILLAGE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	270
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	216
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	42
Total of all active and inactive participants	2020-01-01	258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	258
Number of participants with account balances	2020-01-01	207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	45

Financial Data on BRETHREN CARE VILLAGE RETIREMENT PLAN

Measure	Date	Value
2022 : BRETHREN CARE VILLAGE RETIREMENT PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-47,817
Total of all expenses incurred	2022-12-31	$242,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$227,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$313,534
Value of total assets at end of year	2022-12-31	$2,130,903
Value of total assets at beginning of year	2022-12-31	$2,421,111
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$15,098
Total interest from all sources	2022-12-31	$1,299
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$51,538
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$51,538
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$250,803
Participant contributions at end of year	2022-12-31	$29,635
Participant contributions at beginning of year	2022-12-31	$32,239
Total non interest bearing cash at end of year	2022-12-31	$11,873
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-290,208
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,130,903
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,421,111
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$14,398
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,084,458
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,385,275
Interest on participant loans	2022-12-31	$1,299
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$4,937
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$3,597
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$3,597
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-414,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$62,731
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$227,293
Contract administrator fees	2022-12-31	$700
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	HW&CO.
Accountancy firm EIN	2022-12-31	341663157
2021 : BRETHREN CARE VILLAGE RETIREMENT PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$614,796
Total of all expenses incurred	2021-12-31	$222,278
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$201,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$346,651
Value of total assets at end of year	2021-12-31	$2,421,111
Value of total assets at beginning of year	2021-12-31	$2,028,593
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$21,090
Total interest from all sources	2021-12-31	$1,494
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$61,984
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$61,984
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$221,471
Participant contributions at end of year	2021-12-31	$32,239
Participant contributions at beginning of year	2021-12-31	$28,768
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$69,825
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$11,167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$392,518
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,421,111
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,028,593
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$13,099
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,385,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,985,781
Interest on participant loans	2021-12-31	$1,492
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$3,597
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$2,877
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$2,877
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$2
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$204,667
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$55,355
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$201,188
Contract administrator fees	2021-12-31	$7,991
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	HW&CO.
Accountancy firm EIN	2021-12-31	341663157
2020 : BRETHREN CARE VILLAGE RETIREMENT PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$516,089
Total of all expenses incurred	2020-12-31	$337,846
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$317,730
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$297,912
Value of total assets at end of year	2020-12-31	$2,028,593
Value of total assets at beginning of year	2020-12-31	$1,850,350
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$20,116
Total interest from all sources	2020-12-31	$1,500
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$22,232
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$22,232
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$237,603
Participant contributions at end of year	2020-12-31	$28,768
Participant contributions at beginning of year	2020-12-31	$31,633
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$896
Other income not declared elsewhere	2020-12-31	$3,963
Total non interest bearing cash at end of year	2020-12-31	$11,167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$178,243
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,028,593
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,850,350
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$10,468
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$1,985,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,815,478
Interest on participant loans	2020-12-31	$1,479
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$2,877
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$3,239
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$3,239
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$21
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$190,482
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$59,413
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$317,730
Contract administrator fees	2020-12-31	$9,648
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	HW & CO.
Accountancy firm EIN	2020-12-31	341663157

Form 5500 Responses for BRETHREN CARE VILLAGE RETIREMENT PLAN

2022: BRETHREN CARE VILLAGE RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BRETHREN CARE VILLAGE RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BRETHREN CARE VILLAGE RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	BRETHREN CARE MANAGEMENT SERVICES
Employer identification number (EIN):	821085269
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities