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OHI 403(B) TAX SHELTERED ANNUITY PLAN 401k Plan overview

Plan NameOHI 403(B) TAX SHELTERED ANNUITY PLAN
Plan identification number 001

OHI 403(B) TAX SHELTERED ANNUITY PLAN 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Participant-directed brokerage accounts provided as an investment option under the plan.

401k Sponsoring company profile

OHI has sponsored the creation of one or more 401k plans.

Company Name:OHI
Employer identification number (EIN):010362709
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OHI 403(B) TAX SHELTERED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012012-01-01TWILA M. ILLINGWORTH TWILA M. ILLINGWORTH2013-03-13
0012011-01-01TWILA M. ILLINGWORTH TWILA M. ILLINGWORTH2012-10-12
0012009-01-01TWILA M. ILLINGWORTH TWILA M. ILLINGWORTH2010-10-13

Plan Statistics for OHI 403(B) TAX SHELTERED ANNUITY PLAN

401k plan membership statisitcs for OHI 403(B) TAX SHELTERED ANNUITY PLAN

Measure Date Value
2012: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01332
Total number of active participants reported on line 7a of the Form 55002012-01-010
Total of all active and inactive participants2012-01-010
Total participants2012-01-010
Number of participants with account balances2012-01-010
2011: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01333
Total number of active participants reported on line 7a of the Form 55002011-01-01332
Total of all active and inactive participants2011-01-01332
Total participants2011-01-01332
Number of participants with account balances2011-01-01150
2009: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01202
Total number of active participants reported on line 7a of the Form 55002009-01-01298
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0184
Total of all active and inactive participants2009-01-01384
Total participants2009-01-01384
Number of participants with account balances2009-01-01178

Financial Data on OHI 403(B) TAX SHELTERED ANNUITY PLAN

Measure Date Value
2012 : OHI 403(B) TAX SHELTERED ANNUITY PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-05-01$97,342
Total of all expenses incurred2012-05-01$2,362,222
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-05-01$2,358,827
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-05-01$31,439
Value of total assets at end of year2012-05-01$0
Value of total assets at beginning of year2012-05-01$2,264,880
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-05-01$3,395
Total interest from all sources2012-05-01$8,919
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-01No
Administrative expenses professional fees incurred2012-05-01$3,395
Was this plan covered by a fidelity bond2012-05-01Yes
Value of fidelity bond cover2012-05-01$250,000
If this is an individual account plan, was there a blackout period2012-05-01No
Were there any nonexempt tranactions with any party-in-interest2012-05-01No
Contributions received from participants2012-05-01$31,439
Participant contributions at end of year2012-05-01$0
Participant contributions at beginning of year2012-05-01$102,208
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-01No
Value of net income/loss2012-05-01$-2,264,880
Value of net assets at end of year (total assets less liabilities)2012-05-01$0
Value of net assets at beginning of year (total assets less liabilities)2012-05-01$2,264,880
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-01No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-01No
Were any leases to which the plan was party in default or uncollectible2012-05-01No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-05-01$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-05-01$1,707,929
Interest earned on other investments2012-05-01$8,919
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-05-01$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-05-01$454,743
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-05-01$56,984
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-01No
Was there a failure to transmit to the plan any participant contributions2012-05-01No
Has the plan failed to provide any benefit when due under the plan2012-05-01No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-05-01$2,358,827
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-05-01No
Did the plan have assets held for investment2012-05-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-01Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-05-01Yes
Opinion of an independent qualified public accountant for this plan2012-05-01Disclaimer
Accountancy firm name2012-05-01BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2012-05-01010523282
2011 : OHI 403(B) TAX SHELTERED ANNUITY PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$77,155
Total of all expenses incurred2011-12-31$263,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$237,646
Expenses. Certain deemed distributions of participant loans2011-12-31$19,250
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$108,647
Value of total assets at end of year2011-12-31$2,264,880
Value of total assets at beginning of year2011-12-31$2,451,426
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$6,805
Total interest from all sources2011-12-31$20,928
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$6,805
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$250,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$105,447
Participant contributions at end of year2011-12-31$102,208
Participant contributions at beginning of year2011-12-31$99,511
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$3,200
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-186,546
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,264,880
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,451,426
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,707,929
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,878,971
Interest on participant loans2011-12-31$6,585
Interest earned on other investments2011-12-31$14,343
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$454,743
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$472,944
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-52,420
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$237,646
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2011-12-31010523282
2010 : OHI 403(B) TAX SHELTERED ANNUITY PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$378,563
Total of all expenses incurred2010-12-31$216,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$199,418
Expenses. Certain deemed distributions of participant loans2010-12-31$10,706
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$112,987
Value of total assets at end of year2010-12-31$2,451,426
Value of total assets at beginning of year2010-12-31$2,289,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$6,741
Total interest from all sources2010-12-31$18,427
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$6,741
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$250,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$110,989
Participant contributions at end of year2010-12-31$99,511
Participant contributions at beginning of year2010-12-31$48,821
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$1,998
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$161,698
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,451,426
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,289,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,878,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,755,093
Interest on participant loans2010-12-31$3,314
Interest earned on other investments2010-12-31$15,113
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$472,944
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$485,814
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$247,149
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$199,418
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2010-12-31010523282

Form 5500 Responses for OHI 403(B) TAX SHELTERED ANNUITY PLAN

2012: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: OHI 403(B) TAX SHELTERED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57652
Policy instance 1
Insurance contract or identification number57652
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57652
Policy instance 1
Insurance contract or identification number57652
Number of Individuals Covered150
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57652
Policy instance 1
Insurance contract or identification number57652
Number of Individuals Covered161
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,328
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,201
Insurance broker organization code?3
Insurance broker nameLIBUTTI, GREGG A

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