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TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME 401k Plan overview

Plan NameTAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME
Plan identification number 002

TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME Benefits

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

401k Sponsoring company profile

ST VINCENT DE PAUL NURSING HOME has sponsored the creation of one or more 401k plans.

Company Name:ST VINCENT DE PAUL NURSING HOME
Employer identification number (EIN):026006981
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022013-01-01CHRYSTAL LOCKE2014-03-06
0022012-01-01CHRYSTAL LOCKE2013-10-02
0022011-01-01CHRYSTAL LOCKE2013-06-12
0022009-01-01LOUISE MARQUIS
0022009-01-01LOUISE MARQUIS

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME

Measure Date Value
2009: TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME 2009 401k membership
Total participants, beginning-of-year2009-01-0118
Total number of active participants reported on line 7a of the Form 55002009-01-0114
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0118
Number of participants with account balances2009-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME

Measure Date Value
2011 : TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$-43
Total of all expenses incurred2011-12-31$14,144
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$13,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$0
Value of total assets at end of year2011-12-31$65,783
Value of total assets at beginning of year2011-12-31$79,970
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$209
Total interest from all sources2011-12-31$-43
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$2,000,000
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$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-14,187
Value of net assets at end of year (total assets less liabilities)2011-12-31$65,783
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$79,970
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 pooled separate accounts at end of year2011-12-31$19,787
Value of interest in pooled separate accounts at beginning of year2011-12-31$35,132
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$-43
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$45,996
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$44,838
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$13,935
Contract administrator fees2011-12-31$209
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
2010 : TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$7,140
Total of all expenses incurred2010-12-31$12,043
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$11,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$0
Value of total assets at end of year2010-12-31$79,970
Value of total assets at beginning of year2010-12-31$84,873
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$251
Total interest from all sources2010-12-31$7,140
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$2,000,000
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$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-4,903
Value of net assets at end of year (total assets less liabilities)2010-12-31$79,970
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$84,873
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 pooled separate accounts at end of year2010-12-31$35,132
Value of interest in pooled separate accounts at beginning of year2010-12-31$41,162
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$7,140
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$44,838
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$43,711
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$11,792
Contract administrator fees2010-12-31$251
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 investment2010-12-31No
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

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME

2009: TAX DEFERRED ANNUITY PLAN OF ST VINCENT DE PAUL NURSING HOME 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007364G
Policy instance 1
Insurance contract or identification number007364G
Number of Individuals Covered15
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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