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NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameNORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN
Plan identification number 001

NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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.
  • 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

NORTH COUNTRY HEALTHCARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTH COUNTRY HEALTHCARE, INC.
Employer identification number (EIN):860663432
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01ANNE NEWLAND
0012016-01-01ANNE NEWLAND
0012015-01-01ANNE NEWLAND
0012014-01-01DAVID BIANCO
0012013-01-01DAVID BIANCO
0012012-01-01DAVID BIANCO, MA, SPHR
0012011-01-01DAVID BIANCO
0012009-01-01DAVID BIANCO

Plan Statistics for NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN

401k plan membership statisitcs for NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN

Measure Date Value
2022: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01712
Total number of active participants reported on line 7a of the Form 55002022-01-01578
Number of retired or separated participants receiving benefits2022-01-019
Number of other retired or separated participants entitled to future benefits2022-01-01196
Total of all active and inactive participants2022-01-01783
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01783
Number of participants with account balances2022-01-01675
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01660
Total number of active participants reported on line 7a of the Form 55002021-01-01528
Number of retired or separated participants receiving benefits2021-01-0117
Number of other retired or separated participants entitled to future benefits2021-01-01166
Total of all active and inactive participants2021-01-01711
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01711
Number of participants with account balances2021-01-01625
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01627
Total number of active participants reported on line 7a of the Form 55002020-01-01496
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01144
Total of all active and inactive participants2020-01-01640
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01640
Number of participants with account balances2020-01-01606
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01584
Total number of active participants reported on line 7a of the Form 55002019-01-01490
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01121
Total of all active and inactive participants2019-01-01611
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01611
Number of participants with account balances2019-01-01572
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01562
Total number of active participants reported on line 7a of the Form 55002018-01-01462
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01107
Total of all active and inactive participants2018-01-01569
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01569
Number of participants with account balances2018-01-01525
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01552
Total number of active participants reported on line 7a of the Form 55002017-01-01469
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0190
Total of all active and inactive participants2017-01-01559
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01559
Number of participants with account balances2017-01-01500
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01554
Total number of active participants reported on line 7a of the Form 55002016-01-01454
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0184
Total of all active and inactive participants2016-01-01538
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01538
Number of participants with account balances2016-01-01463
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01471
Total number of active participants reported on line 7a of the Form 55002015-01-01452
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0188
Total of all active and inactive participants2015-01-01540
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01540
Number of participants with account balances2015-01-01449
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01433
Total number of active participants reported on line 7a of the Form 55002014-01-01406
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0152
Total of all active and inactive participants2014-01-01458
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01458
Number of participants with account balances2014-01-01365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01423
Total number of active participants reported on line 7a of the Form 55002013-01-01380
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0134
Total of all active and inactive participants2013-01-01414
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01414
Number of participants with account balances2013-01-01251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01385
Total number of active participants reported on line 7a of the Form 55002012-01-01387
Number of retired or separated participants receiving benefits2012-01-013
Number of other retired or separated participants entitled to future benefits2012-01-0127
Total of all active and inactive participants2012-01-01417
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01417
Number of participants with account balances2012-01-01211
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01377
Total number of active participants reported on line 7a of the Form 55002011-01-01357
Number of retired or separated participants receiving benefits2011-01-013
Number of other retired or separated participants entitled to future benefits2011-01-0129
Total of all active and inactive participants2011-01-01389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01389
Number of participants with account balances2011-01-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01276
Total number of active participants reported on line 7a of the Form 55002009-01-01283
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0113
Total of all active and inactive participants2009-01-01296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01296
Number of participants with account balances2009-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN

Measure Date Value
2022 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets2022-12-31$0
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
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,407,366
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$3,411,322
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,402,387
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$2,937,462
Value of total assets at end of year2022-12-31$19,552,715
Value of total assets at beginning of year2022-12-31$24,371,403
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$8,935
Total income from rents2022-12-31$0
Total interest from all sources2022-12-31$64,113
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
Administrative expenses professional fees incurred2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,912,053
Participant contributions at end of year2022-12-31$390,794
Participant contributions at beginning of year2022-12-31$359,916
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$204,065
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$8,935
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,818,688
Value of net assets at end of year (total assets less liabilities)2022-12-31$19,552,715
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$24,371,403
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$0
Value of interest in pooled separate accounts at end of year2022-12-31$17,716,183
Value of interest in pooled separate accounts at beginning of year2022-12-31$22,572,497
Interest on participant loans2022-12-31$16,976
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$47,137
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,445,738
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,438,990
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-4,408,941
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$821,344
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$3,402,387
Contract administrator fees2022-12-31$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 plan2022-12-31Disclaimer
Accountancy firm name2022-12-31FESTER AND CHAPMAN
Accountancy firm EIN2022-12-31821455657
2021 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$0
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
Expenses. Interest paid2021-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022021-12-31$0
Total income from all sources (including contributions)2021-12-31$6,083,373
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,672,509
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,665,808
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,090,827
Value of total assets at end of year2021-12-31$24,371,403
Value of total assets at beginning of year2021-12-31$19,960,539
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$6,701
Total income from rents2021-12-31$0
Total interest from all sources2021-12-31$68,302
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
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,627,156
Participant contributions at end of year2021-12-31$359,916
Participant contributions at beginning of year2021-12-31$394,109
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$712,458
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$6,701
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
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$4,410,864
Value of net assets at end of year (total assets less liabilities)2021-12-31$24,371,403
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$19,960,539
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$0
Value of interest in pooled separate accounts at end of year2021-12-31$22,572,497
Value of interest in pooled separate accounts at beginning of year2021-12-31$18,171,780
Interest on participant loans2021-12-31$21,376
Income. Interest from loans (other than to participants)2021-12-31$0
Interest earned on other investments2021-12-31$46,926
Income. Interest from US Government securities2021-12-31$0
Income. Interest from corporate debt instruments2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,438,990
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,394,650
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$2,924,244
Net investment gain or loss from common/collective trusts2021-12-31$0
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$751,213
Income. Dividends from preferred stock2021-12-31$0
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,665,808
Contract administrator fees2021-12-31$0
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
Aggregate proceeds on sale of assets2021-12-31$0
Aggregate carrying amount (costs) on sale of assets2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31FESTER AND CHAPMAN
Accountancy firm EIN2021-12-31821455657
2020 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$0
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Expenses. Interest paid2020-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-12-31$0
Total income from all sources (including contributions)2020-12-31$5,224,339
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$2,216,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$2,188,274
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$21,797
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,351,678
Value of total assets at end of year2020-12-31$19,960,539
Value of total assets at beginning of year2020-12-31$16,952,884
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,613
Total income from rents2020-12-31$0
Total interest from all sources2020-12-31$73,896
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$0
Administrative expenses professional fees incurred2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,455,975
Participant contributions at end of year2020-12-31$394,109
Participant contributions at beginning of year2020-12-31$425,950
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$213,060
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$6,613
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$3,007,655
Value of net assets at end of year (total assets less liabilities)2020-12-31$19,960,539
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,952,884
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$18,171,780
Value of interest in pooled separate accounts at beginning of year2020-12-31$14,696,092
Interest on participant loans2020-12-31$21,356
Income. Interest from loans (other than to participants)2020-12-31$0
Interest earned on other investments2020-12-31$52,540
Income. Interest from US Government securities2020-12-31$0
Income. Interest from corporate debt instruments2020-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,394,650
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,830,842
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$0
Net investment gain/loss from pooled separate accounts2020-12-31$2,798,765
Net investment gain or loss from common/collective trusts2020-12-31$0
Net gain/loss from 103.12 investment entities2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$682,643
Income. Dividends from preferred stock2020-12-31$0
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$2,188,274
Contract administrator fees2020-12-31$0
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$0
Aggregate carrying amount (costs) on sale of assets2020-12-31$0
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31FESTER AND CHAPMAN
Accountancy firm EIN2020-12-31821455657
2019 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Total income from all sources (including contributions)2019-12-31$5,222,970
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$2,086,392
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,079,790
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,238,437
Value of total assets at end of year2019-12-31$16,952,884
Value of total assets at beginning of year2019-12-31$13,816,306
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$6,602
Total income from rents2019-12-31$0
Total interest from all sources2019-12-31$80,386
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,351,325
Participant contributions at end of year2019-12-31$425,950
Participant contributions at beginning of year2019-12-31$415,736
Participant contributions at beginning of year2019-12-31$40,401
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$241,252
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$6,602
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$3,136,578
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,952,884
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$13,816,306
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$14,696,092
Value of interest in pooled separate accounts at beginning of year2019-12-31$12,091,534
Interest on participant loans2019-12-31$24,763
Income. Interest from loans (other than to participants)2019-12-31$0
Interest earned on other investments2019-12-31$55,623
Income. Interest from US Government securities2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,830,842
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,247,331
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$2,904,147
Net investment gain or loss from common/collective trusts2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$645,860
Employer contributions (assets) at beginning of year2019-12-31$21,304
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,079,790
Contract administrator fees2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31FESTER AND CHAPMAN
Accountancy firm EIN2019-12-31821455657
2018 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,324,107
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$2,020,303
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,013,375
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,139,766
Value of total assets at end of year2018-12-31$13,816,306
Value of total assets at beginning of year2018-12-31$14,512,502
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$6,928
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$68,685
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,276,544
Participant contributions at end of year2018-12-31$415,736
Participant contributions at beginning of year2018-12-31$267,631
Participant contributions at end of year2018-12-31$40,401
Participant contributions at beginning of year2018-12-31$37,584
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$244,027
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$6,928
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-696,196
Value of net assets at end of year (total assets less liabilities)2018-12-31$13,816,306
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$14,512,502
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$12,091,534
Value of interest in pooled separate accounts at beginning of year2018-12-31$12,783,504
Interest on participant loans2018-12-31$18,483
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$50,202
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,247,331
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,397,082
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-884,344
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$619,195
Employer contributions (assets) at end of year2018-12-31$21,304
Employer contributions (assets) at beginning of year2018-12-31$26,701
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$2,013,375
Contract administrator fees2018-12-31$0
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31FESTER AND CHAPMAN
Accountancy firm EIN2018-12-31821455657
2017 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$4,076,463
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,265,413
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,258,712
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,035,575
Value of total assets at end of year2017-12-31$14,512,502
Value of total assets at beginning of year2017-12-31$11,701,452
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$6,701
Total interest from all sources2017-12-31$46,408
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,294,221
Participant contributions at end of year2017-12-31$267,631
Participant contributions at beginning of year2017-12-31$181,132
Participant contributions at end of year2017-12-31$37,584
Participant contributions at beginning of year2017-12-31$43,823
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$173,667
Administrative expenses (other) incurred2017-12-31$6,701
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,811,050
Value of net assets at end of year (total assets less liabilities)2017-12-31$14,512,502
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$11,701,452
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$12,783,504
Value of interest in pooled separate accounts at beginning of year2017-12-31$10,446,296
Interest on participant loans2017-12-31$11,257
Interest earned on other investments2017-12-31$35,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,397,082
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$1,010,381
Net investment gain/loss from pooled separate accounts2017-12-31$1,994,480
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$567,687
Employer contributions (assets) at end of year2017-12-31$26,701
Employer contributions (assets) at beginning of year2017-12-31$19,820
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,258,712
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31FESTER AND CHAPMAN
Accountancy firm EIN2017-12-31821455657
2016 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$2,695,419
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,448,165
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,430,830
Value of total corrective distributions2016-12-31$13,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,942,522
Value of total assets at end of year2016-12-31$11,701,452
Value of total assets at beginning of year2016-12-31$10,454,198
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,261
Total interest from all sources2016-12-31$35,602
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,317,002
Participant contributions at end of year2016-12-31$181,132
Participant contributions at beginning of year2016-12-31$123,139
Participant contributions at end of year2016-12-31$43,823
Participant contributions at beginning of year2016-12-31$40,543
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$83,686
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Administrative expenses (other) incurred2016-12-31$4,261
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$0
Value of net income/loss2016-12-31$1,247,254
Value of net assets at end of year (total assets less liabilities)2016-12-31$11,701,452
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$10,454,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$10,446,296
Value of interest in pooled separate accounts at beginning of year2016-12-31$9,375,972
Interest on participant loans2016-12-31$6,335
Interest earned on other investments2016-12-31$29,267
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$1,010,381
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$898,054
Net investment gain/loss from pooled separate accounts2016-12-31$717,295
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Assets. Invements in employer securities at beginning of year2016-12-31$0
Assets. Value of employer real property at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$541,834
Employer contributions (assets) at end of year2016-12-31$19,820
Employer contributions (assets) at beginning of year2016-12-31$16,490
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,430,830
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$0
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2016-12-31860494040
2015 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$2,244,664
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$597,175
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$602,197
Value of total corrective distributions2015-12-31$592
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,352,589
Value of total assets at end of year2015-12-31$10,454,198
Value of total assets at beginning of year2015-12-31$8,806,709
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$-5,614
Total income from rents2015-12-31$0
Total interest from all sources2015-12-31$29,560
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$0
Assets. Real estate other than employer real property at beginning of year2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,257,103
Participant contributions at end of year2015-12-31$123,139
Participant contributions at beginning of year2015-12-31$155,632
Participant contributions at end of year2015-12-31$40,543
Participant contributions at beginning of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$591,433
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Assets. Loans (other than to participants) at beginning of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$-5,614
Liabilities. Value of operating payables at end of year2015-12-31$0
Liabilities. Value of operating payables at beginning of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Income. Non cash contributions2015-12-31$0
Value of net income/loss2015-12-31$1,647,489
Value of net assets at end of year (total assets less liabilities)2015-12-31$10,454,198
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,806,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Assets. partnership/joint venture interests at beginning of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$0
Value of interest in pooled separate accounts at end of year2015-12-31$9,375,972
Value of interest in pooled separate accounts at beginning of year2015-12-31$8,019,709
Interest on participant loans2015-12-31$5,652
Income. Interest from loans (other than to participants)2015-12-31$0
Interest earned on other investments2015-12-31$23,908
Income. Interest from US Government securities2015-12-31$0
Income. Interest from corporate debt instruments2015-12-31$0
Value of interest in master investment trust accounts at beginning of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$898,054
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$631,368
Asset value of US Government securities at beginning of year2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-137,485
Net investment gain or loss from common/collective trusts2015-12-31$0
Net gain/loss from 103.12 investment entities2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Assets. Value of employer real property at end of year2015-12-31$0
Assets. Value of employer real property at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$504,053
Employer contributions (assets) at end of year2015-12-31$16,490
Employer contributions (assets) at beginning of year2015-12-31$0
Income. Dividends from preferred stock2015-12-31$0
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$602,197
Asset. Corporate debt instrument preferred debt at beginning of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$0
Liabilities. Value of benefit claims payable at end of year2015-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$0
Aggregate carrying amount (costs) on sale of assets2015-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2015-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2015-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2015-12-31860494040
2014 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Expenses. Interest paid2014-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,958,699
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$590,326
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$587,209
Expenses. Certain deemed distributions of participant loans2014-12-31$0
Value of total corrective distributions2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,586,729
Value of total assets at end of year2014-12-31$8,806,709
Value of total assets at beginning of year2014-12-31$7,438,336
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$3,117
Total interest from all sources2014-12-31$28,076
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Assets. Real estate other than employer real property at end of year2014-12-31$0
Assets. Real estate other than employer real property at beginning of year2014-12-31$0
Administrative expenses professional fees incurred2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,083,512
Participant contributions at end of year2014-12-31$155,632
Participant contributions at beginning of year2014-12-31$181,274
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$81,082
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Assets. Loans (other than to participants) at end of year2014-12-31$0
Assets. Loans (other than to participants) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Administrative expenses (other) incurred2014-12-31$3,117
Liabilities. Value of operating payables at end of year2014-12-31$0
Liabilities. Value of operating payables at beginning of year2014-12-31$0
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Income. Non cash contributions2014-12-31$0
Value of net income/loss2014-12-31$1,368,373
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,806,709
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$7,438,336
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Assets. partnership/joint venture interests at end of year2014-12-31$0
Assets. partnership/joint venture interests at beginning of year2014-12-31$0
Investment advisory and management fees2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$8,019,709
Value of interest in pooled separate accounts at beginning of year2014-12-31$6,647,635
Interest on participant loans2014-12-31$7,193
Interest earned on other investments2014-12-31$20,883
Value of interest in master investment trust accounts at end of year2014-12-31$0
Value of interest in master investment trust accounts at beginning of year2014-12-31$0
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2014-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$631,368
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$609,427
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Asset value of US Government securities at end of year2014-12-31$0
Asset value of US Government securities at beginning of year2014-12-31$0
Net investment gain/loss from pooled separate accounts2014-12-31$343,894
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Assets. Invements in employer securities at end of year2014-12-31$0
Assets. Invements in employer securities at beginning of year2014-12-31$0
Assets. Value of employer real property at end of year2014-12-31$0
Assets. Value of employer real property at beginning of year2014-12-31$0
Contributions received in cash from employer2014-12-31$422,135
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$587,209
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$0
Contract administrator fees2014-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$0
Liabilities. Value of benefit claims payable at end of year2014-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$0
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Liabilities. Value of acquisition indebtedness at end of year2014-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2014-12-31860494040
2013 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$0
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Expenses. Interest paid2013-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-12-31$0
Total income from all sources (including contributions)2013-12-31$2,564,282
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$700,335
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$696,958
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Value of total corrective distributions2013-12-31$963
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,343,102
Value of total assets at end of year2013-12-31$7,438,336
Value of total assets at beginning of year2013-12-31$5,574,389
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,414
Total income from rents2013-12-31$0
Total interest from all sources2013-12-31$23,379
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$0
Assets. Real estate other than employer real property at end of year2013-12-31$0
Assets. Real estate other than employer real property at beginning of year2013-12-31$0
Administrative expenses professional fees incurred2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$863,705
Participant contributions at end of year2013-12-31$181,274
Participant contributions at beginning of year2013-12-31$79,602
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$917
Assets. Other investments not covered elsewhere at end of year2013-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$87,202
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Assets. Loans (other than to participants) at end of year2013-12-31$0
Assets. Loans (other than to participants) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$2,414
Liabilities. Value of operating payables at beginning of year2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$1,863,947
Value of net assets at end of year (total assets less liabilities)2013-12-31$7,438,336
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$5,574,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$0
Investment advisory and management fees2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$0
Value of interest in pooled separate accounts at end of year2013-12-31$6,647,635
Value of interest in pooled separate accounts at beginning of year2013-12-31$5,048,134
Interest on participant loans2013-12-31$4,793
Income. Interest from loans (other than to participants)2013-12-31$0
Interest earned on other investments2013-12-31$18,586
Income. Interest from US Government securities2013-12-31$0
Income. Interest from corporate debt instruments2013-12-31$0
Value of interest in master investment trust accounts at end of year2013-12-31$0
Value of interest in master investment trust accounts at beginning of year2013-12-31$0
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$609,427
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$444,961
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$1,197,801
Net investment gain or loss from common/collective trusts2013-12-31$0
Net gain/loss from 103.12 investment entities2013-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Assets. Invements in employer securities at beginning of year2013-12-31$0
Assets. Value of employer real property at beginning of year2013-12-31$0
Contributions received in cash from employer2013-12-31$392,195
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$775
Income. Dividends from preferred stock2013-12-31$0
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$696,958
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$0
Contract administrator fees2013-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$0
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$0
Aggregate carrying amount (costs) on sale of assets2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2013-12-31860494040
2012 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$0
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$0
Total transfer of assets from this plan2012-12-31$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
Expenses. Interest paid2012-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-12-31$0
Total income from all sources (including contributions)2012-12-31$1,791,640
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$402,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$396,266
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Value of total corrective distributions2012-12-31$4,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,199,901
Value of total assets at end of year2012-12-31$5,574,389
Value of total assets at beginning of year2012-12-31$4,185,232
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,683
Total income from rents2012-12-31$0
Total interest from all sources2012-12-31$15,878
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
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$0
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$200,000
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$739,828
Participant contributions at end of year2012-12-31$79,602
Participant contributions at beginning of year2012-12-31$61,102
Participant contributions at end of year2012-12-31$917
Participant contributions at beginning of year2012-12-31$31,335
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$90,068
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Assets. Loans (other than to participants) at end of year2012-12-31$0
Assets. Loans (other than to participants) at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$1,683
Liabilities. Value of operating payables at end of year2012-12-31$0
Liabilities. Value of operating payables at beginning of year2012-12-31$0
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Income. Non cash contributions2012-12-31$0
Value of net income/loss2012-12-31$1,389,157
Value of net assets at end of year (total assets less liabilities)2012-12-31$5,574,389
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$4,185,232
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
Assets. partnership/joint venture interests at end of year2012-12-31$0
Assets. partnership/joint venture interests at beginning of year2012-12-31$0
Investment advisory and management fees2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in pooled separate accounts at end of year2012-12-31$5,048,134
Value of interest in pooled separate accounts at beginning of year2012-12-31$3,776,311
Interest on participant loans2012-12-31$3,129
Income. Interest from loans (other than to participants)2012-12-31$0
Interest earned on other investments2012-12-31$12,749
Income. Interest from US Government securities2012-12-31$0
Income. Interest from corporate debt instruments2012-12-31$0
Value of interest in master investment trust accounts at end of year2012-12-31$0
Value of interest in master investment trust accounts at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2012-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$444,961
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$304,794
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Asset value of US Government securities at end of year2012-12-31$0
Asset value of US Government securities at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$575,861
Net investment gain or loss from common/collective trusts2012-12-31$0
Net gain/loss from 103.12 investment entities2012-12-31$0
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
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Assets. Value of employer real property at end of year2012-12-31$0
Assets. Value of employer real property at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$370,005
Employer contributions (assets) at end of year2012-12-31$775
Employer contributions (assets) at beginning of year2012-12-31$11,690
Income. Dividends from preferred stock2012-12-31$0
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$396,266
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$0
Contract administrator fees2012-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$0
Liabilities. Value of benefit claims payable at end of year2012-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$0
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
Aggregate proceeds on sale of assets2012-12-31$0
Aggregate carrying amount (costs) on sale of assets2012-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2012-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-12-31$0
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 name2012-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2012-12-31860494040
2011 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
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
Expenses. Interest paid2011-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022011-12-31$0
Total income from all sources (including contributions)2011-12-31$920,765
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$279,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$264,451
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Value of total corrective distributions2011-12-31$13,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$992,099
Value of total assets at end of year2011-12-31$4,185,232
Value of total assets at beginning of year2011-12-31$3,543,824
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$962
Total interest from all sources2011-12-31$3,497
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
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$0
Assets. Real estate other than employer real property at end of year2011-12-31$0
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$962
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$200,000
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$664,384
Participant contributions at end of year2011-12-31$61,102
Participant contributions at beginning of year2011-12-31$75,796
Participant contributions at end of year2011-12-31$31,335
Participant contributions at beginning of year2011-12-31$0
Assets. Other investments not covered elsewhere at end of year2011-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$21,902
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Assets. Loans (other than to participants) at end of year2011-12-31$0
Assets. Loans (other than to participants) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Other income not declared elsewhere2011-12-31$9,915
Administrative expenses (other) incurred2011-12-31$0
Liabilities. Value of operating payables at end of year2011-12-31$0
Liabilities. Value of operating payables at beginning of year2011-12-31$0
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Income. Non cash contributions2011-12-31$0
Value of net income/loss2011-12-31$641,408
Value of net assets at end of year (total assets less liabilities)2011-12-31$4,185,232
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,543,824
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
Assets. partnership/joint venture interests at end of year2011-12-31$0
Assets. partnership/joint venture interests at beginning of year2011-12-31$0
Investment advisory and management fees2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$0
Value of interest in pooled separate accounts at end of year2011-12-31$3,776,311
Value of interest in pooled separate accounts at beginning of year2011-12-31$3,230,894
Interest on participant loans2011-12-31$3,497
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$0
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Value of interest in master investment trust accounts at end of year2011-12-31$0
Value of interest in master investment trust accounts at beginning of year2011-12-31$0
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2011-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$304,794
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$237,134
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Asset value of US Government securities at end of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-84,746
Net gain/loss from 103.12 investment entities2011-12-31$0
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 contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Assets. Invements in employer securities at end of year2011-12-31$0
Assets. Invements in employer securities at beginning of year2011-12-31$0
Assets. Value of employer real property at end of year2011-12-31$0
Assets. Value of employer real property at beginning of year2011-12-31$0
Contributions received in cash from employer2011-12-31$305,813
Employer contributions (assets) at end of year2011-12-31$11,690
Employer contributions (assets) at beginning of year2011-12-31$0
Income. Dividends from preferred stock2011-12-31$0
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$264,451
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$0
Contract administrator fees2011-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$0
Liabilities. Value of benefit claims payable at end of year2011-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$0
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
Aggregate proceeds on sale of assets2011-12-31$0
Aggregate carrying amount (costs) on sale of assets2011-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2011-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
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 name2011-12-31FESTER AND CHAPMAN PC
Accountancy firm EIN2011-12-31860494040
2010 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
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
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,230,579
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$166,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$164,790
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$857,184
Value of total assets at end of year2010-12-31$3,543,824
Value of total assets at beginning of year2010-12-31$2,479,295
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,260
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$4,148
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
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$200,000
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$535,221
Participant contributions at end of year2010-12-31$75,796
Participant contributions at beginning of year2010-12-31$38,831
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$71,213
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$7,034
Administrative expenses (other) incurred2010-12-31$0
Liabilities. Value of operating payables at end of year2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Total non interest bearing cash at end of year2010-12-31$0
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$1,064,529
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,543,824
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,479,295
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
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Value of interest in pooled separate accounts at end of year2010-12-31$3,230,894
Value of interest in pooled separate accounts at beginning of year2010-12-31$2,287,425
Interest on participant loans2010-12-31$4,148
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$0
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$237,134
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$153,039
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Asset value of US Government securities at end of year2010-12-31$0
Asset value of US Government securities at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$362,213
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
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
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Assets. Value of employer real property at end of year2010-12-31$0
Assets. Value of employer real property at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$250,750
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$164,790
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$0
Contract administrator fees2010-12-31$1,260
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Liabilities. Value of benefit claims payable at end of year2010-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$0
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
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
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 name2010-12-31FESTER & CHAPMAN, P.C.
Accountancy firm EIN2010-12-31860494040
2009 : NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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 NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN

2022: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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 benefit arrangement – InsuranceYes
2016: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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 benefit arrangement – InsuranceYes
2015: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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 benefit arrangement – InsuranceYes
2013: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 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 benefit arrangement – InsuranceYes
2012: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: NORTH COUNTRY HEALTHCARE, INC. 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered675
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $47,475
Total amount of fees paid to insurance companyUSD $0
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 $41,283
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered625
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $49,995
Total amount of fees paid to insurance companyUSD $0
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 $43,474
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered606
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $38,034
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $33,073
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered572
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $40,046
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $34,822
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered525
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $56,877
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $40,033
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered500
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $54,403
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $35,480
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCARLEEN CONWAY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $43,487
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $28,361
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCARLEEN CONWAY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered365
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $35,991
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $23,472
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCARLEEN CONWAY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered251
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,931
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $18,216
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCARLEEN CONWAY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Number of Individuals Covered211
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $21,979
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $14,334
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCARLEEN CONWAY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17,839
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number246541
Policy instance 1
Insurance contract or identification number246541
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $11,468
Total amount of fees paid to insurance companyUSD $1,219
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

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