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403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 401k Plan overview

Plan Name403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.
Plan identification number 001

403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

NORTH COUNTRY TRANSITIONAL LIVING SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTH COUNTRY TRANSITIONAL LIVING SERVICES, INC.
Employer identification number (EIN):161104065
NAIC Classification:624200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01MAUREEN CEAN MAUREEN CEAN2018-10-15
0012016-01-01STEVIE KIGGINS STEVIE KIGGINS2017-10-12
0012015-01-01STEVIE KIGGINS STEVIE KIGGINS2016-10-14
0012014-01-01STEVIE SMITH
0012013-01-01STEVIE SMITH STEVIE SMITH2014-10-15
0012012-01-01AILEEN MARTIN AILEEN MARTIN2013-10-14
0012011-01-01JAN MOSHER2012-05-11
0012010-01-01JAN MOSHER2011-06-27

Plan Statistics for 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.

401k plan membership statisitcs for 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.

Measure Date Value
2022: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-01206
Total number of active participants reported on line 7a of the Form 55002022-01-01155
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-0185
Total of all active and inactive participants2022-01-01242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01242
Number of participants with account balances2022-01-01166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-01161
Total number of active participants reported on line 7a of the Form 55002021-01-0191
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0183
Total of all active and inactive participants2021-01-01174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-01175
Number of participants with account balances2021-01-01170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-01154
Total number of active participants reported on line 7a of the Form 55002020-01-0194
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0167
Total of all active and inactive participants2020-01-01161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01161
Number of participants with account balances2020-01-01158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-01149
Total number of active participants reported on line 7a of the Form 55002019-01-0189
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0165
Total of all active and inactive participants2019-01-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01154
Number of participants with account balances2019-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-01151
Total number of active participants reported on line 7a of the Form 55002018-01-0186
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0163
Total of all active and inactive participants2018-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01149
Number of participants with account balances2018-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-01149
Total number of active participants reported on line 7a of the Form 55002017-01-0187
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0164
Total of all active and inactive participants2017-01-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01151
Number of participants with account balances2017-01-01147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-01147
Total number of active participants reported on line 7a of the Form 55002016-01-0192
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0157
Total of all active and inactive participants2016-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01149
Number of participants with account balances2016-01-01146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0110
2015: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01150
Total number of active participants reported on line 7a of the Form 55002015-01-0194
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0153
Total of all active and inactive participants2015-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01147
Number of participants with account balances2015-01-01147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0115
2014: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01141
Total number of active participants reported on line 7a of the Form 55002014-01-0199
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0150
Total of all active and inactive participants2014-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-01150
Number of participants with account balances2014-01-01150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01113
Total number of active participants reported on line 7a of the Form 55002013-01-01102
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0138
Total of all active and inactive participants2013-01-01140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-01141
Number of participants with account balances2013-01-01141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01104
Total number of active participants reported on line 7a of the Form 55002012-01-0176
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0136
Total of all active and inactive participants2012-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-01113
Number of participants with account balances2012-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Financial Data on 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.

Measure Date Value
2022 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-426,467
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$179,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$177,727
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Value of total corrective distributions2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$397,791
Value of total assets at end of year2022-12-31$4,676,372
Value of total assets at beginning of year2022-12-31$5,282,088
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,522
Total interest from all sources2022-12-31$5,598
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$0
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$172,547
Participant contributions at end of year2022-12-31$57,057
Participant contributions at beginning of year2022-12-31$56,473
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$36,883
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$0
Administrative expenses (other) incurred2022-12-31$1,522
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-605,716
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,676,372
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,282,088
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,101,070
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,805,588
Interest on participant loans2022-12-31$0
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$5,598
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$518,245
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$420,027
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-829,856
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$188,361
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$177,727
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BONADIO & CO., LLP
Accountancy firm EIN2022-12-31161131146
2021 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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$1,051,718
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$286,776
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$284,507
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$407,365
Value of total assets at end of year2021-12-31$5,282,088
Value of total assets at beginning of year2021-12-31$4,517,146
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,269
Total interest from all sources2021-12-31$6,878
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 bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
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
Contributions received from participants2021-12-31$171,500
Participant contributions at end of year2021-12-31$56,473
Participant contributions at beginning of year2021-12-31$69,285
Participant contributions at beginning of year2021-12-31$6,244
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$52,691
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$2,269
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$764,942
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,282,088
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,517,146
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$4,805,588
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$4,015,397
Interest on participant loans2021-12-31$2,516
Interest earned on other investments2021-12-31$4,362
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$420,027
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$419,685
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$637,475
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$183,174
Employer contributions (assets) at beginning of year2021-12-31$6,535
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$284,507
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 plan2021-12-31Unqualified
Accountancy firm name2021-12-31BONADIO & CO., LLP
Accountancy firm EIN2021-12-31161131146
2020 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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$982,324
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$172,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$169,876
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$443,599
Value of total assets at end of year2020-12-31$4,517,146
Value of total assets at beginning of year2020-12-31$3,706,890
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,192
Total interest from all sources2020-12-31$6,156
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$500,000
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
Contributions received from participants2020-12-31$165,429
Participant contributions at end of year2020-12-31$69,285
Participant contributions at beginning of year2020-12-31$69,663
Participant contributions at end of year2020-12-31$6,244
Participant contributions at beginning of year2020-12-31$5,918
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$115,244
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$2,192
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$810,256
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,517,146
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,706,890
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 pooled separate accounts at end of year2020-12-31$4,015,397
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,288,652
Interest on participant loans2020-12-31$2,584
Interest earned on other investments2020-12-31$3,572
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$419,685
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$336,534
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from pooled separate accounts2020-12-31$532,569
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$162,926
Employer contributions (assets) at end of year2020-12-31$6,535
Employer contributions (assets) at beginning of year2020-12-31$6,123
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$169,876
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 name2020-12-31BONADIO & CO., LLP
Accountancy firm EIN2020-12-31161131146
2019 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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$936,929
Total income from all sources (including contributions)2019-12-31$936,929
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$309,228
Total of all expenses incurred2019-12-31$309,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$307,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$307,089
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$319,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$319,082
Value of total assets at end of year2019-12-31$3,706,890
Value of total assets at end of year2019-12-31$3,706,890
Value of total assets at beginning of year2019-12-31$3,079,189
Value of total assets at beginning of year2019-12-31$3,079,189
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,139
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,139
Total interest from all sources2019-12-31$8,012
Total interest from all sources2019-12-31$8,012
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 bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
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$143,274
Contributions received from participants2019-12-31$143,274
Participant contributions at end of year2019-12-31$5,918
Participant contributions at end of year2019-12-31$5,918
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$23,140
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$23,140
Other income not declared elsewhere2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$2,139
Administrative expenses (other) incurred2019-12-31$2,139
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$627,701
Value of net income/loss2019-12-31$627,701
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,706,890
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,706,890
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,079,189
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,079,189
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$3,288,652
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,288,652
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,681,695
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,681,695
Interest on participant loans2019-12-31$0
Interest on participant loans2019-12-31$0
Interest earned on other investments2019-12-31$8,012
Interest earned on other investments2019-12-31$8,012
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$406,197
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$406,197
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$397,494
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$397,494
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$609,835
Net investment gain/loss from pooled separate accounts2019-12-31$609,835
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
Contributions received in cash from employer2019-12-31$152,668
Contributions received in cash from employer2019-12-31$152,668
Employer contributions (assets) at end of year2019-12-31$6,123
Employer contributions (assets) at end of year2019-12-31$6,123
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$307,089
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$307,089
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 name2019-12-31BONADIO & CO., LLP
Accountancy firm name2019-12-31BONADIO & CO., LLP
Accountancy firm EIN2019-12-31131131146
Accountancy firm EIN2019-12-31131131146
2018 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2018 401k financial data
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
Total income from all sources (including contributions)2018-12-31$101,646
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$125,478
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$123,448
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$318,394
Value of total assets at end of year2018-12-31$3,079,189
Value of total assets at beginning of year2018-12-31$3,103,021
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,030
Total interest from all sources2018-12-31$4,614
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
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$167,967
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$4,023
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$2,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-23,832
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,079,189
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,103,021
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
Value of interest in pooled separate accounts at end of year2018-12-31$2,681,695
Value of interest in pooled separate accounts at beginning of year2018-12-31$2,764,925
Interest on participant loans2018-12-31$0
Interest earned on other investments2018-12-31$4,614
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$397,494
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$338,096
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-221,362
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
Contributions received in cash from employer2018-12-31$146,404
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$123,448
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
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 name2018-12-31BONADIO & CO., LLP
Accountancy firm EIN2018-12-31161131146
2017 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2017 401k financial data
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
Total income from all sources (including contributions)2017-12-31$792,006
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$193,902
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$191,835
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$417,922
Value of total assets at end of year2017-12-31$3,103,021
Value of total assets at beginning of year2017-12-31$2,504,917
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,067
Total interest from all sources2017-12-31$3,975
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$176,894
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$105,184
Administrative expenses (other) incurred2017-12-31$2,067
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
Value of net income/loss2017-12-31$598,104
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,103,021
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,504,917
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
Value of interest in pooled separate accounts at end of year2017-12-31$2,764,926
Value of interest in pooled separate accounts at beginning of year2017-12-31$2,130,927
Interest on participant loans2017-12-31$0
Interest earned on other investments2017-12-31$3,975
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$338,095
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$373,990
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from pooled separate accounts2017-12-31$370,109
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
Contributions received in cash from employer2017-12-31$135,844
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$191,835
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
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 name2017-12-31BONADIO & CO., LLP
Accountancy firm EIN2017-12-31161131146
2016 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$477,248
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$174,706
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$172,774
Expenses. Certain deemed distributions of participant loans2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$311,736
Value of total assets at end of year2016-12-31$2,504,917
Value of total assets at beginning of year2016-12-31$2,202,375
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,932
Total interest from all sources2016-12-31$4,105
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$350,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$153,033
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$21,042
Administrative expenses (other) incurred2016-12-31$1,932
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$302,542
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,504,917
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,202,375
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,130,927
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,855,625
Interest on participant loans2016-12-31$0
Interest earned on other investments2016-12-31$4,105
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$373,990
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$346,750
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$161,407
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$137,661
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$172,774
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BONADIO & CO., LLP
Accountancy firm EIN2016-12-31161131146
2015 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$263,699
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$394,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$392,000
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$272,024
Value of total assets at end of year2015-12-31$2,202,375
Value of total assets at beginning of year2015-12-31$2,332,690
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,014
Total interest from all sources2015-12-31$3,971
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$350,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$125,032
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$6,940
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$2,014
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-130,315
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,202,375
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,332,690
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,855,625
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,974,991
Interest on participant loans2015-12-31$0
Interest earned on other investments2015-12-31$3,971
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$346,750
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$357,699
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-12,296
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$140,052
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$392,000
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BONADIO & CO., LLP
Accountancy firm EIN2015-12-31161131146
2014 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$438,410
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$125,427
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$123,341
Expenses. Certain deemed distributions of participant loans2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$332,867
Value of total assets at end of year2014-12-31$2,332,690
Value of total assets at beginning of year2014-12-31$2,019,707
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,086
Total interest from all sources2014-12-31$3,572
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$350,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$135,434
Participant contributions at beginning of year2014-12-31$5,099
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$39,687
Administrative expenses (other) incurred2014-12-31$2,086
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$312,983
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,332,690
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,019,707
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,974,991
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,726,568
Interest on participant loans2014-12-31$0
Interest earned on other investments2014-12-31$3,572
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$357,699
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$282,251
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from pooled separate accounts2014-12-31$101,971
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$157,746
Employer contributions (assets) at beginning of year2014-12-31$5,789
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$123,341
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31BONADIO & CO., LLP
Accountancy firm EIN2014-12-31161131146
2013 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$586,236
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$105,279
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$103,579
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$259,974
Value of total assets at end of year2013-12-31$2,019,707
Value of total assets at beginning of year2013-12-31$1,538,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,700
Total interest from all sources2013-12-31$3,247
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$350,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$96,808
Participant contributions at end of year2013-12-31$5,099
Participant contributions at beginning of year2013-12-31$2,940
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$24,814
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$1,700
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$480,957
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,019,707
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,538,750
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,726,568
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,299,379
Interest on participant loans2013-12-31$0
Interest earned on other investments2013-12-31$3,247
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$282,251
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$231,996
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$323,015
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$138,352
Employer contributions (assets) at end of year2013-12-31$5,789
Employer contributions (assets) at beginning of year2013-12-31$4,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$103,579
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31BONADIO & CO., LLP
Accountancy firm EIN2013-12-31161131146
2012 : 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$380,172
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$128,555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$126,991
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$236,248
Value of total assets at end of year2012-12-31$1,538,750
Value of total assets at beginning of year2012-12-31$1,287,133
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,564
Total interest from all sources2012-12-31$4,550
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$250,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$87,932
Participant contributions at end of year2012-12-31$54,833
Participant contributions at beginning of year2012-12-31$48,106
Participant contributions at end of year2012-12-31$2,940
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$8,096
Administrative expenses (other) incurred2012-12-31$1,564
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$251,617
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,538,750
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,287,133
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,299,379
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,048,047
Interest on participant loans2012-12-31$0
Interest earned on other investments2012-12-31$4,550
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$177,163
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$190,980
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$139,374
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$140,220
Employer contributions (assets) at end of year2012-12-31$4,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$126,991
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31THE BONADIO GROUP
Accountancy firm EIN2012-12-31161131146

Form 5500 Responses for 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC.

2022: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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 benefit arrangement – InsuranceYes
2020: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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 benefit arrangement – InsuranceYes
2019: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
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 benefit arrangement – InsuranceYes
2018: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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 benefit arrangement – InsuranceYes
2017: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 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 – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: 403B THRIFT PLAN OF NORTH COUNTRY TRANSITIONAL LIVING SERVICE, INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980
Policy instance 1
Insurance contract or identification number007980
Number of Individuals Covered166
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,244
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 Administration1
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?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 $0
Amount paid for insurance broker fees1244
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered175
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $276
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 Administration1
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?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 $0
Amount paid for insurance broker fees276
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered161
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $276
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 Administration1
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?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 $0
Amount paid for insurance broker fees276
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered154
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 $1,927
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 Administration1
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?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 $0
Amount paid for insurance broker fees1927
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered149
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,349
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 Administration1
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?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 $0
Amount paid for insurance broker fees1349
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered151
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,566
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 Administration1
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?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 $0
Amount paid for insurance broker fees1566
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameROCHESTER REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered147
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $736
Are there contracts with allocated funds for individual policies?No
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 Administration1
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?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 $0
Amount paid for insurance broker fees736
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameROCHESTER REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number007980G
Policy instance 1
Insurance contract or identification number007980G
Number of Individuals Covered150
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $494
Are there contracts with allocated funds for individual policies?No
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 Administration1
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?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 $0
Amount paid for insurance broker fees494
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameROCHESTER REGIONAL OFFICE

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