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TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 401k Plan overview

Plan NameTAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,
Plan identification number 002

TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • 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

FAMILY HEALTH CARE CENTERS OF GREAT ER LOS ANGELES, INC. has sponsored the creation of one or more 401k plans.

Company Name:FAMILY HEALTH CARE CENTERS OF GREAT ER LOS ANGELES, INC.
Employer identification number (EIN):951641454
NAIC Classification:621491
NAIC Description:HMO Medical Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01YADIRA CHARIEZ2024-10-04
0022022-01-01
0022022-01-01YADIRA
0022021-01-01YADIRA2022-10-14
0022020-01-01SANTOS MARTINEZ2021-07-28
0022020-01-01YADIRA2022-10-14
0022019-01-01SANTOS MARTINEZ2020-09-21
0022018-01-01SANTOS MARTINEZ2019-09-12
0022018-01-01SANTOS MARTINEZ2020-09-21
0022017-01-01CARLOS GONZALEZ2018-07-25 CARLOS GONZALEZ2018-07-25
0022016-01-01CARLOS GONZALEZ2017-07-20 CARLOS GONZALEZ2017-07-20
0022015-01-01CARLOS GONZALEZ2016-07-08 CARLOS GONZALEZ2016-07-08
0022014-01-01CARLOS GONZALEZ2015-10-15 CARLOS GONZALEZ2015-10-15
0022013-01-01JEANNIE ZHAO2014-04-15
0022012-01-01JEANNIE ZHAO2013-03-08
0022011-01-01JEANNIE ZHAO2012-09-10 JEANNIE ZHAO2012-09-10
0022010-01-01JEANNIE ZHAO2012-09-11

Financial Data on TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,

Measure Date Value
2025 : TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 2025 401k financial data
Total transfers to/from plan in this plan year2025-05-160
Total liabilities as of the end of the plan year2025-05-160
Total liabilities as of the beginning of the plan year2025-05-160
Total expenses incurred by plan in this plan year2025-05-1671371
Net assets as of the end of the plan year2025-05-163893284
Total assets as of the beginning of the plan year2025-05-162722618
Value of plan covered by a fidelity bond2025-05-161000000
Participant contributions to plan in this plan year2025-05-16458023
Value of participant loans at end of plan year2025-05-1672801
Other expenses paid from plan in this plan year2025-05-160
Other contributions to plan in this plan year2025-05-1687057
Other income to plan in this plan year2025-05-16491825
Plan net income in this plan year2025-05-161170666
Net assets as of the end of the plan year2025-05-163893284
Net assets as of the beginning of the plan year2025-05-162722618
Employer contributions to plan in this plan year2025-05-16205132
Fees paid to broker by Benefit Provider2025-05-16271
Expensese paid to adminstrative service provicers from plan in this plan year2025-05-16383
2024 : TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 2024 401k financial data
Total transfers to/from plan in this plan year2024-10-040
Total liabilities as of the end of the plan year2024-10-040
Total liabilities as of the beginning of the plan year2024-10-040
Total expenses incurred by plan in this plan year2024-10-04115327
Net assets as of the end of the plan year2024-10-042617976
Total assets as of the beginning of the plan year2024-10-041749411
Value of plan covered by a fidelity bond2024-10-041000000
Participant contributions to plan in this plan year2024-10-04403001
Other expenses paid from plan in this plan year2024-10-040
Other contributions to plan in this plan year2024-10-043596
Other income to plan in this plan year2024-10-04396869
Plan net income in this plan year2024-10-04868565
Net assets as of the end of the plan year2024-10-042617976
Net assets as of the beginning of the plan year2024-10-041749411
Employer contributions to plan in this plan year2024-10-04180426
Expensese paid to adminstrative service provicers from plan in this plan year2024-10-04149
2022 : TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$182,701
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$49,531
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$49,364
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$549,611
Value of total assets at end of year2022-12-31$1,899,577
Value of total assets at beginning of year2022-12-31$1,766,407
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$167
Total interest from all sources2022-12-31$105
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$0
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$367,373
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Participant contributions at end of year2022-12-31$28,233
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$4,343
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$133,170
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,899,577
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,766,407
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,788,740
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,718,540
Interest on participant loans2022-12-31$0
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$105
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$52,120
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$47,867
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-367,015
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 contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$182,238
Employer contributions (assets) at end of year2022-12-31$30,484
Employer contributions (assets) at beginning of year2022-12-31$0
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$45,021
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PDM, LLP
Accountancy firm EIN2022-12-31330783700
Unrealized appreciation/depreciation of other (non real estate) assets2022-01-01$0
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total transfer of assets to this plan2022-01-01$0
Total transfer of assets from this plan2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$182,701
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$49,531
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$49,364
Expenses. Certain deemed distributions of participant loans2022-01-01$0
Value of total corrective distributions2022-01-01$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$549,611
Value of total assets at end of year2022-01-01$1,899,577
Value of total assets at beginning of year2022-01-01$1,766,407
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$167
Total interest from all sources2022-01-01$105
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Total dividends received from registered investment company shares (eg mutual funds)2022-01-01$0
Assets. Real estate other than employer real property at end of year2022-01-01$0
Assets. Real estate other than employer real property at beginning of year2022-01-01$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-01-01$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-01-01$0
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$1,000,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$367,373
Participant contributions at end of year2022-01-01$0
Participant contributions at beginning of year2022-01-01$0
Participant contributions at end of year2022-01-01$28,233
Participant contributions at beginning of year2022-01-01$0
Assets. Other investments not covered elsewhere at end of year2022-01-01$0
Assets. Other investments not covered elsewhere at beginning of year2022-01-01$0
Income. Received or receivable in cash from other sources (including rollovers)2022-01-01$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-01-01$4,343
Assets. Loans (other than to participants) at end of year2022-01-01$0
Assets. Loans (other than to participants) at beginning of year2022-01-01$0
Other income not declared elsewhere2022-01-01$0
Administrative expenses (other) incurred2022-01-01$167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Income. Non cash contributions2022-01-01$0
Value of net income/loss2022-01-01$133,170
Value of net assets at end of year (total assets less liabilities)2022-01-01$1,899,577
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$1,766,407
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Assets. partnership/joint venture interests at end of year2022-01-01$0
Assets. partnership/joint venture interests at beginning of year2022-01-01$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-01-01$1,788,740
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-01-01$1,718,540
Interest on participant loans2022-01-01$0
Income. Interest from loans (other than to participants)2022-01-01$0
Interest earned on other investments2022-01-01$105
Income. Interest from US Government securities2022-01-01$0
Income. Interest from corporate debt instruments2022-01-01$0
Value of interest in master investment trust accounts at end of year2022-01-01$0
Value of interest in master investment trust accounts at beginning of year2022-01-01$0
Value of interest in common/collective trusts at end of year2022-01-01$0
Value of interest in common/collective trusts at beginning of year2022-01-01$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-01-01$0
Assets. Value of investments in 103.12 investment entities at end of year2022-01-01$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-01-01$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-01-01$52,120
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-01$47,867
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-01$0
Asset value of US Government securities at end of year2022-01-01$0
Asset value of US Government securities at beginning of year2022-01-01$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-01-01$0
Net investment gain/loss from pooled separate accounts2022-01-01$-367,015
Net investment gain or loss from common/collective trusts2022-01-01$0
Net gain/loss from 103.12 investment entities2022-01-01$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01Yes
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$182,238
Employer contributions (assets) at end of year2022-01-01$30,484
Employer contributions (assets) at beginning of year2022-01-01$0
Income. Dividends from preferred stock2022-01-01$0
Income. Dividends from common stock2022-01-01$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$45,021
Asset. Corporate debt instrument preferred debt at end of year2022-01-01$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-01-01$0
Asset. Corporate debt instrument debt (other) at end of year2022-01-01$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-01-01$0
Assets. Corporate common stocks other than exployer securities at end of year2022-01-01$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-01-01$0
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Aggregate proceeds on sale of assets2022-01-01$0
Aggregate carrying amount (costs) on sale of assets2022-01-01$0
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01PDM, LLP
Accountancy firm EIN2022-01-01330783700

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,

2022: TAX DEFERRED ANNUITY PLAN OF FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 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

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number057788
Policy instance 1

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