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EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE
Plan identification number 001

EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • Profit-sharing

401k Sponsoring company profile

FOREST HEIGHTS LODGE has sponsored the creation of one or more 401k plans.

Company Name:FOREST HEIGHTS LODGE
Employer identification number (EIN):840439961
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about FOREST HEIGHTS LODGE

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1955-05-11
Company Identification Number: 19871129507
Legal Registered Office Address: 13922 Denver West Pkwy Ste 150

Lakewood
United States of America (USA)
80401

More information about FOREST HEIGHTS LODGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01LINDA CLEFISCH2016-07-13 LINDA CLEFISCH2016-07-13
0012015-01-01LINDA CLEFISCH2016-05-05 LINDA CLEFISCH2016-05-05
0012014-01-01LINDA CLEFISCH2015-04-07 LINDA CLEFISCH2015-04-07
0012014-01-01LINDA CLEFISCH2015-04-07
0012013-01-01LINDA CLEFISCH2014-06-10 LINDA CLEFISCH2014-06-10
0012012-01-01LINDA CLEFISCH
0012011-01-01LINDA CLEFISCH
0012009-01-01LINDA CLEFISCH
0012009-01-01LINDA CLEFISCH

Plan Statistics for EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE

Measure Date Value
2012: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2012 401k membership
Total participants, beginning-of-year2012-01-0152
Total number of active participants reported on line 7a of the Form 55002012-01-0118
Number of other retired or separated participants entitled to future benefits2012-01-0137
Total of all active and inactive participants2012-01-0155
Total participants2012-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2011 401k membership
Total participants, beginning-of-year2011-01-0154
Total number of active participants reported on line 7a of the Form 55002011-01-0119
Number of other retired or separated participants entitled to future benefits2011-01-0133
Total of all active and inactive participants2011-01-0152
Total participants2011-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-013
2009: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2009 401k membership
Total participants, beginning-of-year2009-01-0147
Total number of active participants reported on line 7a of the Form 55002009-01-0121
Number of other retired or separated participants entitled to future benefits2009-01-0126
Total of all active and inactive participants2009-01-0147
Total participants2009-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE

Measure Date Value
2012 : EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2012 401k financial data
Transfers to/from the plan2012-12-31$-24,967
Total income from all sources2012-12-31$275,340
Expenses. Total of all expenses incurred2012-12-31$8,922
Total plan assets at end of year2012-12-31$2,062,260
Total plan assets at beginning of year2012-12-31$1,820,809
Expenses. Other expenses not covered elsewhere2012-12-31$8,922
Other income received2012-12-31$182,505
Net income (gross income less expenses)2012-12-31$266,418
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,062,260
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,820,809
Total contributions received or receivable from employer(s)2012-12-31$92,835
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2011 401k financial data
Total income from all sources2011-12-31$75,674
Expenses. Total of all expenses incurred2011-12-31$42,541
Total plan assets at end of year2011-12-31$1,820,809
Total plan assets at beginning of year2011-12-31$1,787,676
Expenses. Other expenses not covered elsewhere2011-12-31$42,541
Other income received2011-12-31$-35,645
Net income (gross income less expenses)2011-12-31$33,133
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,820,809
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,787,676
Total contributions received or receivable from employer(s)2011-12-31$111,319
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2010 401k financial data
Total income from all sources2010-12-31$311,469
Expenses. Total of all expenses incurred2010-12-31$10,443
Total plan assets at end of year2010-12-31$1,787,676
Total plan assets at beginning of year2010-12-31$1,486,650
Expenses. Other expenses not covered elsewhere2010-12-31$10,443
Other income received2010-12-31$202,726
Net income (gross income less expenses)2010-12-31$301,026
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,787,676
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,486,650
Total contributions received or receivable from employer(s)2010-12-31$108,743
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE

2012: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: EMPLOYEE BENEFIT PLAN OF FOREST HEIGHTS LODGE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
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 number053900-D
Policy instance 1
Insurance contract or identification number053900-D
Number of Individuals Covered55
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $56
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees5
Insurance broker nameROSA R WEYMAN
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number053900-D
Policy instance 1
Insurance contract or identification number053900-D
Number of Individuals Covered52
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $237
Contracts With Unallocated Funds Deposit Administration1
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 number053900-D
Policy instance 1
Insurance contract or identification number053900-D
Number of Individuals Covered54
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $128
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees16
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameTERRY HOUSTON

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