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FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 401k Plan overview

Plan NameFAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN
Plan identification number 001

FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) 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.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock 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.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

FAIR HAVEN COMMUNITY HEALTH CLINIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:FAIR HAVEN COMMUNITY HEALTH CLINIC, INC.
Employer identification number (EIN):060883545
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01
0012020-07-01
0012019-07-01
0012018-07-01
0012017-07-01
0012016-07-01SUZANNE LAGARDE SUZANNE LAGARDE2018-04-11
0012015-07-01SUZANNE LAGARDE SUZANNE LAGARDE2017-04-17
0012014-07-01SUZANNE LAGARDE SUZANNE LAGARDE2016-04-15
0012013-07-01ROBERTA PACE ROBERTA PACE2015-04-15
0012012-07-01ROBERTA PACE ROBERTA PACE2014-04-14
0012011-07-01ROBERTA PACE ROBERTA PACE2013-04-12
0012009-07-01ROBERTA PACE KATRINA CLARK2011-04-14

Plan Statistics for FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN

401k plan membership statisitcs for FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN

Measure Date Value
2021: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01266
Total number of active participants reported on line 7a of the Form 55002021-07-01235
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0154
Total of all active and inactive participants2021-07-01289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01289
Number of participants with account balances2021-07-01180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-016
2020: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01234
Total number of active participants reported on line 7a of the Form 55002020-07-01216
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0150
Total of all active and inactive participants2020-07-01266
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01266
Number of participants with account balances2020-07-01157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-019
2019: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01238
Total number of active participants reported on line 7a of the Form 55002019-07-01193
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0141
Total of all active and inactive participants2019-07-01234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01234
Number of participants with account balances2019-07-01161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-018
2018: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01233
Total number of active participants reported on line 7a of the Form 55002018-07-01205
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-0133
Total of all active and inactive participants2018-07-01238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01238
Number of participants with account balances2018-07-01138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010
2017: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01243
Total number of active participants reported on line 7a of the Form 55002017-07-01204
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-0129
Total of all active and inactive participants2017-07-01233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-01233
Number of participants with account balances2017-07-01144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01216
Total number of active participants reported on line 7a of the Form 55002016-07-01210
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-0133
Total of all active and inactive participants2016-07-01243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-01243
Number of participants with account balances2016-07-01160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01216
Total number of active participants reported on line 7a of the Form 55002015-07-01187
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-0129
Total of all active and inactive participants2015-07-01216
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01216
Number of participants with account balances2015-07-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01201
Total number of active participants reported on line 7a of the Form 55002014-07-01192
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0122
Total of all active and inactive participants2014-07-01214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01214
Number of participants with account balances2014-07-01151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01205
Total number of active participants reported on line 7a of the Form 55002013-07-01174
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-0125
Total of all active and inactive participants2013-07-01199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-01199
Number of participants with account balances2013-07-01150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01216
Total number of active participants reported on line 7a of the Form 55002012-07-01201
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-0121
Total of all active and inactive participants2012-07-01222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-01222
Number of participants with account balances2012-07-01153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-014
2011: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01217
Total number of active participants reported on line 7a of the Form 55002011-07-01206
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0120
Total of all active and inactive participants2011-07-01226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-01226
Number of participants with account balances2011-07-01154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-016
2009: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01196
Total number of active participants reported on line 7a of the Form 55002009-07-01165
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-0110
Total of all active and inactive participants2009-07-01175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01175
Number of participants with account balances2009-07-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN

Measure Date Value
2022 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$1,500
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$9,391
Total income from all sources (including contributions)2022-06-30$-145,565
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$1,411,836
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$1,342,092
Expenses. Certain deemed distributions of participant loans2022-06-30$61,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$935,800
Value of total assets at end of year2022-06-30$7,107,324
Value of total assets at beginning of year2022-06-30$8,672,616
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$8,304
Total interest from all sources2022-06-30$6,171
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$150,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2022-06-30$150,520
Administrative expenses professional fees incurred2022-06-30$8,304
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$700,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$774,481
Participant contributions at end of year2022-06-30$124,445
Participant contributions at beginning of year2022-06-30$141,217
Participant contributions at beginning of year2022-06-30$1,091
Income. Received or receivable in cash from other sources (including rollovers)2022-06-30$2,795
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-06-30$1,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-06-30$4,779
Other income not declared elsewhere2022-06-30$6,544
Total non interest bearing cash at end of year2022-06-30$1,431
Total non interest bearing cash at beginning of year2022-06-30$1,567
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$-1,557,401
Value of net assets at end of year (total assets less liabilities)2022-06-30$7,105,824
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$8,663,225
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-06-30$6,377,076
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-06-30$7,951,947
Interest on participant loans2022-06-30$6,171
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-06-30$18,439
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-06-30$18,916
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-06-30$18,916
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-06-30$585,933
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-06-30$557,375
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-06-30$-1,244,600
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30Yes
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$158,524
Employer contributions (assets) at beginning of year2022-06-30$503
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$1,342,092
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$4,612
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Disclaimer
Accountancy firm name2022-06-30VISCONTI & ASSOCIATES, P. C.
Accountancy firm EIN2022-06-30061354191
2021 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$9,391
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$650
Total income from all sources (including contributions)2021-06-30$2,732,283
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$476,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$460,848
Expenses. Certain deemed distributions of participant loans2021-06-30$6,517
Value of total corrective distributions2021-06-30$412
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$1,007,743
Value of total assets at end of year2021-06-30$8,672,616
Value of total assets at beginning of year2021-06-30$6,407,966
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$8,597
Total interest from all sources2021-06-30$6,767
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$301,677
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2021-06-30$301,677
Administrative expenses professional fees incurred2021-06-30$8,597
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$700,000
If this is an individual account plan, was there a blackout period2021-06-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$637,440
Participant contributions at end of year2021-06-30$141,217
Participant contributions at beginning of year2021-06-30$130,263
Participant contributions at end of year2021-06-30$1,091
Participant contributions at beginning of year2021-06-30$248
Income. Received or receivable in cash from other sources (including rollovers)2021-06-30$221,443
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-06-30$4,779
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-06-30$650
Other income not declared elsewhere2021-06-30$7,064
Total non interest bearing cash at end of year2021-06-30$1,567
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$2,255,909
Value of net assets at end of year (total assets less liabilities)2021-06-30$8,663,225
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$6,407,316
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-06-30$7,951,947
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-06-30$5,754,531
Interest on participant loans2021-06-30$6,767
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-06-30$18,916
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-06-30$2,523
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-06-30$2,523
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-06-30$557,375
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-06-30$520,313
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-06-30$1,409,032
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30Yes
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$148,860
Employer contributions (assets) at end of year2021-06-30$503
Employer contributions (assets) at beginning of year2021-06-30$88
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$460,848
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-06-30Yes
Liabilities. Value of benefit claims payable at end of year2021-06-30$4,612
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Unqualified
Accountancy firm name2021-06-30VISCONTI & ASSOCIATES, P. C.
Accountancy firm EIN2021-06-30061354191
2020 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$650
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$2,178
Total income from all sources (including contributions)2020-06-30$989,359
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$547,178
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$524,427
Value of total corrective distributions2020-06-30$13,030
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$759,169
Value of total assets at end of year2020-06-30$6,407,966
Value of total assets at beginning of year2020-06-30$5,967,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$9,721
Total interest from all sources2020-06-30$8,045
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$95,025
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-06-30$95,025
Administrative expenses professional fees incurred2020-06-30$9,721
Was this plan covered by a fidelity bond2020-06-30Yes
Value of fidelity bond cover2020-06-30$700,000
If this is an individual account plan, was there a blackout period2020-06-30Yes
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$615,613
Participant contributions at end of year2020-06-30$130,263
Participant contributions at beginning of year2020-06-30$144,351
Participant contributions at end of year2020-06-30$248
Participant contributions at beginning of year2020-06-30$18,005
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$13,900
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-06-30$78,424
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-06-30$650
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-06-30$2,178
Other income not declared elsewhere2020-06-30$10,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$442,181
Value of net assets at end of year (total assets less liabilities)2020-06-30$6,407,316
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$5,965,135
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$5,754,531
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$5,108,120
Interest on participant loans2020-06-30$8,045
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-06-30$2,523
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-06-30$520,313
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-06-30$618,413
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-06-30$116,802
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30Yes
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$129,656
Employer contributions (assets) at end of year2020-06-30$88
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$524,427
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-06-30Yes
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30VISCONTI & ASSOCIATES, P. C.
Accountancy firm EIN2020-06-30061354191
2019 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$2,178
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$842,323
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$1,019,284
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$969,642
Expenses. Certain deemed distributions of participant loans2019-06-30$41,898
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$520,394
Value of total assets at end of year2019-06-30$5,967,313
Value of total assets at beginning of year2019-06-30$6,142,096
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$7,744
Total interest from all sources2019-06-30$8,405
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$92,010
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-06-30$92,010
Administrative expenses professional fees incurred2019-06-30$7,744
Was this plan covered by a fidelity bond2019-06-30Yes
Value of fidelity bond cover2019-06-30$700,000
If this is an individual account plan, was there a blackout period2019-06-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Contributions received from participants2019-06-30$441,970
Participant contributions at end of year2019-06-30$144,351
Participant contributions at beginning of year2019-06-30$202,753
Participant contributions at end of year2019-06-30$18,005
Participant contributions at beginning of year2019-06-30$18,405
Income. Received or receivable in cash from other sources (including rollovers)2019-06-30$78,424
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-06-30$78,424
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-06-30$2,178
Other income not declared elsewhere2019-06-30$11,813
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$-176,961
Value of net assets at end of year (total assets less liabilities)2019-06-30$5,965,135
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$6,142,096
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-06-30$5,108,120
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-06-30$5,237,501
Interest on participant loans2019-06-30$8,401
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-06-30$231
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-06-30$231
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-06-30$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-06-30$618,413
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-06-30$683,206
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-06-30$209,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$969,642
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-06-30Yes
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30Yes
Opinion of an independent qualified public accountant for this plan2019-06-30Disclaimer
Accountancy firm name2019-06-30VISCONTI & ASSOCIATES, P. C.
Accountancy firm EIN2019-06-30061354191
2018 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$969,093
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$1,204,937
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$1,175,667
Expenses. Certain deemed distributions of participant loans2018-06-30$19,889
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$502,791
Value of total assets at end of year2018-06-30$6,142,096
Value of total assets at beginning of year2018-06-30$6,377,940
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$9,381
Total interest from all sources2018-06-30$21,411
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$102,587
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2018-06-30$102,587
Administrative expenses professional fees incurred2018-06-30$9,381
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$700,000
If this is an individual account plan, was there a blackout period2018-06-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Contributions received from participants2018-06-30$502,791
Participant contributions at end of year2018-06-30$202,753
Participant contributions at beginning of year2018-06-30$209,668
Participant contributions at end of year2018-06-30$18,405
Participant contributions at beginning of year2018-06-30$22,570
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$-235,844
Value of net assets at end of year (total assets less liabilities)2018-06-30$6,142,096
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$6,377,940
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$5,237,501
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$5,475,862
Interest on participant loans2018-06-30$9,836
Interest earned on other investments2018-06-30$11,573
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-06-30$231
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-06-30$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-06-30$683,206
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-06-30$669,840
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-06-30$342,304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30Yes
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$1,175,667
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-06-30Yes
Did the plan have assets held for investment2018-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30Yes
Opinion of an independent qualified public accountant for this plan2018-06-30Disclaimer
Accountancy firm name2018-06-30VISCONTI & ASSOCIATES, P. C.
Accountancy firm EIN2018-06-30061354191
2017 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total income from all sources (including contributions)2017-06-30$1,246,763
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$1,704,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$1,681,011
Expenses. Certain deemed distributions of participant loans2017-06-30$17,425
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$577,610
Value of total assets at end of year2017-06-30$6,377,940
Value of total assets at beginning of year2017-06-30$6,835,663
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$6,050
Total interest from all sources2017-06-30$20,337
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$69,796
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-06-30$69,796
Administrative expenses professional fees incurred2017-06-30$1,531
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$700,000
If this is an individual account plan, was there a blackout period2017-06-30Yes
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Contributions received from participants2017-06-30$557,785
Participant contributions at end of year2017-06-30$209,668
Participant contributions at beginning of year2017-06-30$162,252
Participant contributions at end of year2017-06-30$22,570
Income. Received or receivable in cash from other sources (including rollovers)2017-06-30$19,825
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$-457,723
Value of net assets at end of year (total assets less liabilities)2017-06-30$6,377,940
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$6,835,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$5,475,862
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$5,696,948
Interest on participant loans2017-06-30$6,909
Interest earned on other investments2017-06-30$13,428
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-06-30$669,840
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-06-30$976,463
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$579,020
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30Yes
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$1,681,011
Contract administrator fees2017-06-30$4,519
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-06-30Yes
Did the plan have assets held for investment2017-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30Yes
Opinion of an independent qualified public accountant for this plan2017-06-30Disclaimer
Accountancy firm name2017-06-30VISCONTI & ASSOCIATES, P.C.
Accountancy firm EIN2017-06-30061354191
2016 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-06-30$0
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total transfer of assets to this plan2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total income from all sources (including contributions)2016-06-30$500,482
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$591,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$587,397
Expenses. Certain deemed distributions of participant loans2016-06-30$0
Value of total corrective distributions2016-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$547,801
Value of total assets at end of year2016-06-30$6,835,663
Value of total assets at beginning of year2016-06-30$6,927,057
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$4,479
Total income from rents2016-06-30$0
Total interest from all sources2016-06-30$29,667
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$62,690
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-06-30$62,690
Administrative expenses professional fees incurred2016-06-30$0
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$700,000
If this is an individual account plan, was there a blackout period2016-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Amount of non-exempt transactions with any party-in-interest2016-06-30$0
Contributions received from participants2016-06-30$529,874
Participant contributions at end of year2016-06-30$162,252
Participant contributions at beginning of year2016-06-30$185,572
Participant contributions at end of year2016-06-30$0
Participant contributions at beginning of year2016-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2016-06-30$17,927
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-06-30$0
Other income not declared elsewhere2016-06-30$0
Administrative expenses (other) incurred2016-06-30$0
Liabilities. Value of operating payables at beginning of year2016-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-91,394
Value of net assets at end of year (total assets less liabilities)2016-06-30$6,835,663
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$6,927,057
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2016-06-30$0
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2016-06-30$0
Investment advisory and management fees2016-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$5,696,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$5,837,427
Interest on participant loans2016-06-30$7,117
Income. Interest from loans (other than to participants)2016-06-30$0
Interest earned on other investments2016-06-30$22,550
Income. Interest from US Government securities2016-06-30$0
Income. Interest from corporate debt instruments2016-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-06-30$976,463
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-06-30$904,058
Expenses. Payments to insurance carriers foe the provision of benefits2016-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$-139,676
Net investment gain/loss from pooled separate accounts2016-06-30$0
Net investment gain or loss from common/collective trusts2016-06-30$0
Net gain/loss from 103.12 investment entities2016-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30Yes
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$0
Employer contributions (assets) at end of year2016-06-30$0
Employer contributions (assets) at beginning of year2016-06-30$0
Income. Dividends from preferred stock2016-06-30$0
Income. Dividends from common stock2016-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$587,397
Contract administrator fees2016-06-30$4,479
Liabilities. Value of benefit claims payable at beginning of year2016-06-30$0
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Aggregate proceeds on sale of assets2016-06-30$0
Aggregate carrying amount (costs) on sale of assets2016-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30Yes
Opinion of an independent qualified public accountant for this plan2016-06-30Disclaimer
Accountancy firm name2016-06-30VISCONTI & ASSOCIATES, P.C.
Accountancy firm EIN2016-06-30061354191
2015 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2015-06-30$0
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total transfer of assets to this plan2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total income from all sources (including contributions)2015-06-30$665,902
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$705,592
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$700,747
Expenses. Certain deemed distributions of participant loans2015-06-30$-432
Value of total corrective distributions2015-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$490,458
Value of total assets at end of year2015-06-30$6,927,057
Value of total assets at beginning of year2015-06-30$6,966,747
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$5,277
Total income from rents2015-06-30$0
Total interest from all sources2015-06-30$30,522
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$100,695
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-06-30$100,695
Administrative expenses professional fees incurred2015-06-30$0
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$700,000
If this is an individual account plan, was there a blackout period2015-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Amount of non-exempt transactions with any party-in-interest2015-06-30$0
Contributions received from participants2015-06-30$490,458
Participant contributions at end of year2015-06-30$185,572
Participant contributions at beginning of year2015-06-30$117,119
Participant contributions at end of year2015-06-30$0
Participant contributions at beginning of year2015-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2015-06-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-06-30$0
Other income not declared elsewhere2015-06-30$0
Administrative expenses (other) incurred2015-06-30$0
Liabilities. Value of operating payables at beginning of year2015-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-39,690
Value of net assets at end of year (total assets less liabilities)2015-06-30$6,927,057
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$6,966,747
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2015-06-30$0
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2015-06-30$0
Investment advisory and management fees2015-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$5,837,427
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$5,968,841
Interest on participant loans2015-06-30$7,022
Income. Interest from loans (other than to participants)2015-06-30$0
Interest earned on other investments2015-06-30$23,500
Income. Interest from US Government securities2015-06-30$0
Income. Interest from corporate debt instruments2015-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-06-30$904,058
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-06-30$880,787
Expenses. Payments to insurance carriers foe the provision of benefits2015-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$44,227
Net investment gain/loss from pooled separate accounts2015-06-30$0
Net investment gain or loss from common/collective trusts2015-06-30$0
Net gain/loss from 103.12 investment entities2015-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30Yes
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$0
Employer contributions (assets) at end of year2015-06-30$0
Employer contributions (assets) at beginning of year2015-06-30$0
Income. Dividends from preferred stock2015-06-30$0
Income. Dividends from common stock2015-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$700,747
Contract administrator fees2015-06-30$5,277
Liabilities. Value of benefit claims payable at beginning of year2015-06-30$0
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Aggregate proceeds on sale of assets2015-06-30$0
Aggregate carrying amount (costs) on sale of assets2015-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2015-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30Yes
Opinion of an independent qualified public accountant for this plan2015-06-30Disclaimer
Accountancy firm name2015-06-30VISCONTI ASSOCIATES PC
Accountancy firm EIN2015-06-30061354191
2014 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2014-06-30$0
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total transfer of assets to this plan2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total income from all sources (including contributions)2014-06-30$1,280,442
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$608,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$603,382
Expenses. Certain deemed distributions of participant loans2014-06-30$0
Value of total corrective distributions2014-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$372,434
Value of total assets at end of year2014-06-30$6,966,747
Value of total assets at beginning of year2014-06-30$6,294,454
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$4,767
Total income from rents2014-06-30$0
Total interest from all sources2014-06-30$32,034
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$77,699
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-06-30$77,699
Administrative expenses professional fees incurred2014-06-30$0
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$700,000
If this is an individual account plan, was there a blackout period2014-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Amount of non-exempt transactions with any party-in-interest2014-06-30$0
Contributions received from participants2014-06-30$372,198
Participant contributions at end of year2014-06-30$117,119
Participant contributions at beginning of year2014-06-30$157,482
Participant contributions at end of year2014-06-30$0
Participant contributions at beginning of year2014-06-30$15,772
Income. Received or receivable in cash from other sources (including rollovers)2014-06-30$236
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-30$0
Other income not declared elsewhere2014-06-30$-11
Administrative expenses (other) incurred2014-06-30$0
Liabilities. Value of operating payables at beginning of year2014-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$672,293
Value of net assets at end of year (total assets less liabilities)2014-06-30$6,966,747
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$6,294,454
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2014-06-30$0
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2014-06-30$0
Investment advisory and management fees2014-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$5,968,841
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$5,204,079
Interest on participant loans2014-06-30$5,554
Income. Interest from loans (other than to participants)2014-06-30$0
Interest earned on other investments2014-06-30$26,480
Income. Interest from US Government securities2014-06-30$0
Income. Interest from corporate debt instruments2014-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-30$880,787
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-30$917,121
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$798,286
Net investment gain/loss from pooled separate accounts2014-06-30$0
Net investment gain or loss from common/collective trusts2014-06-30$0
Net gain/loss from 103.12 investment entities2014-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30Yes
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$0
Employer contributions (assets) at end of year2014-06-30$0
Employer contributions (assets) at beginning of year2014-06-30$0
Income. Dividends from preferred stock2014-06-30$0
Income. Dividends from common stock2014-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$603,382
Contract administrator fees2014-06-30$4,767
Liabilities. Value of benefit claims payable at beginning of year2014-06-30$0
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Aggregate proceeds on sale of assets2014-06-30$0
Aggregate carrying amount (costs) on sale of assets2014-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30Yes
Opinion of an independent qualified public accountant for this plan2014-06-30Disclaimer
Accountancy firm name2014-06-30VISCONTI AND ASSOCIATES, P.C.
Accountancy firm EIN2014-06-30061354191
2013 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-06-30$0
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total transfer of assets to this plan2013-06-30$0
Total transfer of assets from this plan2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total income from all sources (including contributions)2013-06-30$1,039,002
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$756,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$748,601
Expenses. Certain deemed distributions of participant loans2013-06-30$0
Value of total corrective distributions2013-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$389,170
Value of total assets at end of year2013-06-30$6,294,454
Value of total assets at beginning of year2013-06-30$6,011,598
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$7,545
Total income from rents2013-06-30$0
Total interest from all sources2013-06-30$35,921
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$90,545
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$90,545
Administrative expenses professional fees incurred2013-06-30$0
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$700,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Amount of non-exempt transactions with any party-in-interest2013-06-30$0
Contributions received from participants2013-06-30$372,753
Participant contributions at end of year2013-06-30$157,482
Participant contributions at beginning of year2013-06-30$201,328
Participant contributions at end of year2013-06-30$15,772
Participant contributions at beginning of year2013-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$16,417
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$0
Other income not declared elsewhere2013-06-30$0
Administrative expenses (other) incurred2013-06-30$0
Liabilities. Value of operating payables at beginning of year2013-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$282,856
Value of net assets at end of year (total assets less liabilities)2013-06-30$6,294,454
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$6,011,598
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2013-06-30$0
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2013-06-30$0
Investment advisory and management fees2013-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$5,204,079
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$4,843,990
Interest on participant loans2013-06-30$8,073
Income. Interest from loans (other than to participants)2013-06-30$0
Interest earned on other investments2013-06-30$27,848
Income. Interest from US Government securities2013-06-30$0
Income. Interest from corporate debt instruments2013-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$917,121
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$966,280
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$523,366
Net investment gain/loss from pooled separate accounts2013-06-30$0
Net investment gain or loss from common/collective trusts2013-06-30$0
Net gain/loss from 103.12 investment entities2013-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30Yes
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$0
Employer contributions (assets) at end of year2013-06-30$0
Employer contributions (assets) at beginning of year2013-06-30$0
Income. Dividends from preferred stock2013-06-30$0
Income. Dividends from common stock2013-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$748,601
Contract administrator fees2013-06-30$7,545
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$0
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Aggregate proceeds on sale of assets2013-06-30$0
Aggregate carrying amount (costs) on sale of assets2013-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30VISCONTI & ASSOCIATES, PC
Accountancy firm EIN2013-06-30061354191
2012 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-06-30$0
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total transfer of assets to this plan2012-06-30$0
Total transfer of assets from this plan2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total income from all sources (including contributions)2012-06-30$420,368
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$547,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$536,354
Expenses. Certain deemed distributions of participant loans2012-06-30$0
Value of total corrective distributions2012-06-30$36
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$411,176
Value of total assets at end of year2012-06-30$6,011,598
Value of total assets at beginning of year2012-06-30$6,139,058
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$11,438
Total income from rents2012-06-30$0
Total interest from all sources2012-06-30$33,640
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$81,416
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$81,416
Administrative expenses professional fees incurred2012-06-30$0
Was this plan covered by a fidelity bond2012-06-30No
Value of fidelity bond cover2012-06-30$0
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Amount of non-exempt transactions with any party-in-interest2012-06-30$0
Contributions received from participants2012-06-30$407,698
Participant contributions at end of year2012-06-30$201,328
Participant contributions at beginning of year2012-06-30$205,188
Participant contributions at end of year2012-06-30$0
Participant contributions at beginning of year2012-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$3,478
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$0
Other income not declared elsewhere2012-06-30$625
Administrative expenses (other) incurred2012-06-30$0
Liabilities. Value of operating payables at beginning of year2012-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-127,460
Value of net assets at end of year (total assets less liabilities)2012-06-30$6,011,598
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$6,139,058
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2012-06-30$0
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2012-06-30$0
Investment advisory and management fees2012-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$4,843,990
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$5,223,601
Interest on participant loans2012-06-30$8,851
Income. Interest from loans (other than to participants)2012-06-30$0
Interest earned on other investments2012-06-30$24,789
Income. Interest from US Government securities2012-06-30$0
Income. Interest from corporate debt instruments2012-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$966,280
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$710,269
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-106,489
Net investment gain/loss from pooled separate accounts2012-06-30$0
Net investment gain or loss from common/collective trusts2012-06-30$0
Net gain/loss from 103.12 investment entities2012-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30Yes
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$0
Employer contributions (assets) at end of year2012-06-30$0
Employer contributions (assets) at beginning of year2012-06-30$0
Income. Dividends from preferred stock2012-06-30$0
Income. Dividends from common stock2012-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$536,354
Contract administrator fees2012-06-30$11,438
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$0
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Aggregate proceeds on sale of assets2012-06-30$0
Aggregate carrying amount (costs) on sale of assets2012-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30PIKAART VISCONTI AND ASSOC. P.C
Accountancy firm EIN2012-06-30061354191
2011 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-06-30$0
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total transfer of assets to this plan2011-06-30$0
Total transfer of assets from this plan2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total income from all sources (including contributions)2011-06-30$1,452,281
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$312,802
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$301,968
Expenses. Certain deemed distributions of participant loans2011-06-30$0
Value of total corrective distributions2011-06-30$2,348
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$453,735
Value of total assets at end of year2011-06-30$6,139,058
Value of total assets at beginning of year2011-06-30$4,999,579
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$8,486
Total income from rents2011-06-30$0
Total interest from all sources2011-06-30$25,813
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$61,910
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-06-30$61,910
Administrative expenses professional fees incurred2011-06-30$0
Was this plan covered by a fidelity bond2011-06-30No
Value of fidelity bond cover2011-06-30$0
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Amount of non-exempt transactions with any party-in-interest2011-06-30$0
Contributions received from participants2011-06-30$450,908
Participant contributions at end of year2011-06-30$205,188
Participant contributions at beginning of year2011-06-30$177,041
Participant contributions at end of year2011-06-30$0
Participant contributions at beginning of year2011-06-30$41,511
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$3,585
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$0
Other income not declared elsewhere2011-06-30$1,059
Administrative expenses (other) incurred2011-06-30$0
Liabilities. Value of operating payables at beginning of year2011-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$1,139,479
Value of net assets at end of year (total assets less liabilities)2011-06-30$6,139,058
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$4,999,579
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2011-06-30$0
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2011-06-30$0
Investment advisory and management fees2011-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$5,223,601
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$4,160,601
Interest on participant loans2011-06-30$9,933
Income. Interest from loans (other than to participants)2011-06-30$0
Interest earned on other investments2011-06-30$15,880
Income. Interest from US Government securities2011-06-30$0
Income. Interest from corporate debt instruments2011-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$710,269
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$483,826
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$909,764
Net investment gain/loss from pooled separate accounts2011-06-30$0
Net investment gain or loss from common/collective trusts2011-06-30$0
Net gain/loss from 103.12 investment entities2011-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30Yes
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$-758
Employer contributions (assets) at end of year2011-06-30$0
Employer contributions (assets) at beginning of year2011-06-30$136,600
Income. Dividends from preferred stock2011-06-30$0
Income. Dividends from common stock2011-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$301,968
Contract administrator fees2011-06-30$8,486
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$0
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Aggregate proceeds on sale of assets2011-06-30$0
Aggregate carrying amount (costs) on sale of assets2011-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30PIKAART VISCONTI AND ASSOC. P.C.
Accountancy firm EIN2011-06-30061354191
2010 : FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-06-30$0

Form 5500 Responses for FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN

2021: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: FAIR HAVEN COMMUNITY HEALTH CENTER 403(B) PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63988
Policy instance 1
Insurance contract or identification numberGA-63988
Number of Individuals Covered20
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
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 Administration0
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?Yes
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63988
Policy instance 1
Insurance contract or identification numberGA-63988
Number of Individuals Covered21
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
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 Administration0
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?Yes
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63988
Policy instance 1
Insurance contract or identification numberGA-63988
Number of Individuals Covered20
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 Administration0
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?Yes
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63988
Policy instance 1
Insurance contract or identification numberGA-63988
Number of Individuals Covered19
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 Administration0
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?Yes
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63988
Policy instance 2
Insurance contract or identification numberGA-63988
Number of Individuals Covered6
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 Administration0
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?Yes
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 Administration0
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?Yes
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered216
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,305
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,305
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered214
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,207
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,207
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered199
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $14,300
Total amount of fees paid to insurance companyUSD $1,746
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,997
Amount paid for insurance broker fees1746
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered222
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $13,617
Total amount of fees paid to insurance companyUSD $1,382
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,261
Amount paid for insurance broker fees1382
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered226
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $9,373
Total amount of fees paid to insurance companyUSD $1,591
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered201
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $11,596
Total amount of fees paid to insurance companyUSD $4,357
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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