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FIRST CHOICE HOME CARE RETIREMENT PLAN 401k Plan overview

Plan NameFIRST CHOICE HOME CARE RETIREMENT PLAN
Plan identification number 001

FIRST CHOICE HOME CARE RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

FIRST CHOICE HOME CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:FIRST CHOICE HOME CARE, INC.
Employer identification number (EIN):113106262
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST CHOICE HOME CARE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012019-01-01
0012018-01-01
0012017-01-01VIOLETTE COPELMAN
0012016-01-01VIOLETTE COPELMAN2017-10-13

Plan Statistics for FIRST CHOICE HOME CARE RETIREMENT PLAN

401k plan membership statisitcs for FIRST CHOICE HOME CARE RETIREMENT PLAN

Measure Date Value
2022: FIRST CHOICE HOME CARE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01592
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-010
Number of participants with account balances2022-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: FIRST CHOICE HOME CARE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01622
Total number of active participants reported on line 7a of the Form 55002021-01-01336
Number of retired or separated participants receiving benefits2021-01-0124
Number of other retired or separated participants entitled to future benefits2021-01-01206
Total of all active and inactive participants2021-01-01566
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01566
Number of participants with account balances2021-01-01550
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: FIRST CHOICE HOME CARE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01669
Total number of active participants reported on line 7a of the Form 55002020-01-01533
Number of retired or separated participants receiving benefits2020-01-0110
Number of other retired or separated participants entitled to future benefits2020-01-01105
Total of all active and inactive participants2020-01-01648
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01648
Number of participants with account balances2020-01-01612
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: FIRST CHOICE HOME CARE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01318
Total number of active participants reported on line 7a of the Form 55002019-01-01637
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0116
Total of all active and inactive participants2019-01-01654
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01654
Number of participants with account balances2019-01-01646
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: FIRST CHOICE HOME CARE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01559
Total number of active participants reported on line 7a of the Form 55002018-01-01400
Number of retired or separated participants receiving benefits2018-01-0160
Number of other retired or separated participants entitled to future benefits2018-01-01127
Total of all active and inactive participants2018-01-01587
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01587
Number of participants with account balances2018-01-01537
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: FIRST CHOICE HOME CARE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01463
Total number of active participants reported on line 7a of the Form 55002017-01-01432
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01119
Total of all active and inactive participants2017-01-01551
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01551
Number of participants with account balances2017-01-01512
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on FIRST CHOICE HOME CARE RETIREMENT PLAN

Measure Date Value
2022 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total income from all sources (including contributions)2022-09-30$361,100
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$2,900,736
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$2,900,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$812,316
Value of total assets at end of year2022-09-30$0
Value of total assets at beginning of year2022-09-30$2,539,636
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$0
Total interest from all sources2022-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2022-09-30$0
Was this plan covered by a fidelity bond2022-09-30No
If this is an individual account plan, was there a blackout period2022-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2022-09-30$0
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Income. Received or receivable in cash from other sources (including rollovers)2022-09-30$6,739
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-2,539,636
Value of net assets at end of year (total assets less liabilities)2022-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$2,539,636
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-09-30$2,523,444
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-09-30$16,192
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-451,216
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$805,577
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$2,900,736
Did the plan have assets held for investment2022-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30Yes
Opinion of an independent qualified public accountant for this plan2022-09-30Disclaimer
Accountancy firm name2022-09-30BAS PARTNERS
Accountancy firm EIN2022-09-30208779390
2021 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$527,792
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$415,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$415,537
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$283,900
Value of total assets at end of year2021-12-31$2,539,636
Value of total assets at beginning of year2021-12-31$2,427,381
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$0
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$1,959
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$112,255
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,539,636
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,427,381
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$2,523,444
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$2,415,198
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$16,192
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$12,183
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$243,892
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$281,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$415,537
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31BAS PARTNERS
Accountancy firm EIN2021-12-31208779390
2020 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$866,464
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$601,017
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$601,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$552,712
Value of total assets at end of year2020-12-31$2,427,381
Value of total assets at beginning of year2020-12-31$2,161,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$0
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$1,934
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$265,447
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,427,381
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,161,934
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,415,198
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,159,964
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$12,183
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$313,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$552,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$599,083
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31BAS PARTNERS
Accountancy firm EIN2020-12-31208779390
2019 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$830,024
Total income from all sources (including contributions)2019-12-31$830,024
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$395,298
Total of all expenses incurred2019-12-31$395,298
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$313,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$313,957
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$523,885
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$523,885
Value of total assets at end of year2019-12-31$2,161,934
Value of total assets at end of year2019-12-31$2,161,934
Value of total assets at beginning of year2019-12-31$1,727,208
Value of total assets at beginning of year2019-12-31$1,727,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$81,341
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$81,341
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$0
Contributions received from participants2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$434,726
Value of net income/loss2019-12-31$434,726
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,161,934
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,161,934
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,727,208
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,727,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,159,964
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,159,964
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,726,249
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,726,249
Interest on participant loans2019-12-31$0
Interest on participant loans2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,970
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,970
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$959
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$959
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$306,139
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$306,139
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$523,885
Contributions received in cash from employer2019-12-31$523,885
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$313,957
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$313,957
Contract administrator fees2019-12-31$81,341
Contract administrator fees2019-12-31$81,341
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BAS PARTNERS
Accountancy firm name2019-12-31BAS PARTNERS
Accountancy firm EIN2019-12-31208779390
Accountancy firm EIN2019-12-31208779390
2018 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,083,268
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$359,956
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$281,133
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,172,888
Value of total assets at end of year2018-12-31$1,727,208
Value of total assets at beginning of year2018-12-31$1,003,896
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$78,823
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$1
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$108,013
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$108,013
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31No
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$0
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$3,459
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$723,312
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,727,208
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,003,896
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$1,726,249
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$1,003,896
Interest on participant loans2018-12-31$0
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$1
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$959
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-197,634
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$1,172,888
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$281,133
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$75,364
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31BAS PARTNERS
Accountancy firm EIN2018-12-31208779390
2017 : FIRST CHOICE HOME CARE RETIREMENT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$0
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Expenses. Interest paid2017-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-12-31$0
Total income from all sources (including contributions)2017-12-31$803,443
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$148,123
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$91,607
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Value of total corrective distributions2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$725,003
Value of total assets at end of year2017-12-31$1,003,896
Value of total assets at beginning of year2017-12-31$348,576
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$56,516
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$37,501
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$37,501
Assets. Real estate other than employer real property at end of year2017-12-31$0
Assets. Real estate other than employer real property at beginning of year2017-12-31$0
Administrative expenses professional fees incurred2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31No
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$0
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Assets. Other investments not covered elsewhere at end of year2017-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Assets. Loans (other than to participants) at end of year2017-12-31$0
Assets. Loans (other than to participants) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$1,667
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$655,320
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,003,896
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$348,576
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Assets. partnership/joint venture interests at end of year2017-12-31$0
Assets. partnership/joint venture interests at beginning of year2017-12-31$0
Investment advisory and management fees2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$1,003,896
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$348,576
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$0
Income. Interest from loans (other than to participants)2017-12-31$0
Interest earned on other investments2017-12-31$0
Income. Interest from US Government securities2017-12-31$0
Income. Interest from corporate debt instruments2017-12-31$0
Value of interest in master investment trust accounts at end of year2017-12-31$0
Value of interest in master investment trust accounts at beginning of year2017-12-31$0
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Asset value of US Government securities at end of year2017-12-31$0
Asset value of US Government securities at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$40,939
Net investment gain/loss from pooled separate accounts2017-12-31$0
Net investment gain or loss from common/collective trusts2017-12-31$0
Net gain/loss from 103.12 investment entities2017-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Assets. Value of employer real property at end of year2017-12-31$0
Assets. Value of employer real property at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$725,003
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$0
Income. Dividends from preferred stock2017-12-31$0
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$91,607
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$0
Contract administrator fees2017-12-31$54,849
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$0
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$0
Aggregate carrying amount (costs) on sale of assets2017-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31BAS PARTNERS
Accountancy firm EIN2017-12-31208779390

Form 5500 Responses for FIRST CHOICE HOME CARE RETIREMENT PLAN

2022: FIRST CHOICE HOME CARE RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingYes
2022-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: FIRST CHOICE HOME CARE RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: FIRST CHOICE HOME CARE RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: FIRST CHOICE HOME CARE RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: FIRST CHOICE HOME CARE RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: FIRST CHOICE HOME CARE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LQ1D
Policy instance 1
Insurance contract or identification numberGAP-CP-LQ1D
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $43
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
Commission paid to Insurance BrokerUSD $43
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LQ1D
Policy instance 1
Insurance contract or identification numberGAP-CP-LQ1D
Number of Individuals Covered550
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $38
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
Commission paid to Insurance BrokerUSD $38
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LQ1D
Policy instance 1
Insurance contract or identification numberGAP-CP-LQ1D
Number of Individuals Covered612
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $23
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
Commission paid to Insurance BrokerUSD $23
Insurance broker organization code?7
FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386997-01
Policy instance 1
Insurance contract or identification number386997-01
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $7,329
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?Yes
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
Commission paid to Insurance BrokerUSD $7,329
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LQ1D
Policy instance 2
Insurance contract or identification numberGAP-CP-LQ1D
Number of Individuals Covered646
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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
FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386997-01
Policy instance 1
Insurance contract or identification number386997-01
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4
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
Commission paid to Insurance BrokerUSD $4
Insurance broker organization code?3

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