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TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 401k Plan overview

Plan NameTIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN
Plan identification number 001

TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

TIBURCIO VASQUEZ HEALTH CENTER, INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:TIBURCIO VASQUEZ HEALTH CENTER, INCORPORATED
Employer identification number (EIN):237118361
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN

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
0012018-01-01ANDREA SCHWAB-GALINDO2019-10-08
0012018-01-01ANDREA SCHWAB-GALINDO2021-10-30
0012017-01-01
0012017-01-01ANDREA SCHWAB-GALINDO2019-05-28
0012017-01-01ANDREA SCHWAB-GALINDO2021-10-30
0012016-01-01ANDREA SCHWAB-GALINDO2019-05-28
0012016-01-01ANDREA SCHWAB-GALINDO2021-07-08
0012015-01-01ANDREA SCHWAB-GALINDO2019-08-22
0012015-01-01ANDREA SCHWAB-GALINDO2021-07-08
0012014-01-01ANDREA SCHWAB-GALINDO2019-08-22
0012014-01-01ANDREA SCHWAB-GALINDO2021-07-08
0012013-01-01ANDREA SCHWAB-GALINDO2019-08-22
0012013-01-01ANDREA SCHWAB-GALINDO2021-07-08
0012013-01-01ANDREA SCHWAB-GALINDO2021-07-08
0012012-01-01
0012011-01-01MARIA LOURDES MARTINEZ
0012010-01-01MARIA LOURDES MARTINEZ
0012009-01-01MARIA LOURDES MARTINEZ

Plan Statistics for TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN

401k plan membership statisitcs for TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN

Measure Date Value
2022: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01542
Total number of active participants reported on line 7a of the Form 55002022-01-01430
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01243
Total of all active and inactive participants2022-01-01673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01673
Number of participants with account balances2022-01-01619
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0121
2021: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01432
Total number of active participants reported on line 7a of the Form 55002021-01-01429
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01137
Total of all active and inactive participants2021-01-01566
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-013
Total participants2021-01-01569
Number of participants with account balances2021-01-01542
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0118
2020: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01416
Total number of active participants reported on line 7a of the Form 55002020-01-01313
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01117
Total of all active and inactive participants2020-01-01430
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-012
Total participants2020-01-01432
Number of participants with account balances2020-01-01410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0123
2019: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01334
Total number of active participants reported on line 7a of the Form 55002019-01-01315
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01100
Total of all active and inactive participants2019-01-01415
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01416
Number of participants with account balances2019-01-01370
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0172
2018: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01369
Total number of active participants reported on line 7a of the Form 55002018-01-01249
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0185
Total of all active and inactive participants2018-01-01334
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01334
Number of participants with account balances2018-01-01179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01330
Total number of active participants reported on line 7a of the Form 55002017-01-01254
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0172
Total of all active and inactive participants2017-01-01326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01326
Number of participants with account balances2017-01-01162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01296
Total number of active participants reported on line 7a of the Form 55002016-01-01219
Number of other retired or separated participants entitled to future benefits2016-01-0160
Total of all active and inactive participants2016-01-01279
Total participants2016-01-01279
Number of participants with account balances2016-01-01153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01277
Total number of active participants reported on line 7a of the Form 55002015-01-01206
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0154
Total of all active and inactive participants2015-01-01262
Total participants2015-01-01262
Number of participants with account balances2015-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-019
2014: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01300
Total number of active participants reported on line 7a of the Form 55002014-01-01235
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-0136
Total of all active and inactive participants2014-01-01274
Total participants2014-01-01274
Number of participants with account balances2014-01-01140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0112
2013: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01208
Total number of active participants reported on line 7a of the Form 55002013-01-01248
Number of other retired or separated participants entitled to future benefits2013-01-0126
Total of all active and inactive participants2013-01-01274
Total participants2013-01-01274
Number of participants with account balances2013-01-01134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014
2011: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01100
Total number of active participants reported on line 7a of the Form 55002011-01-0188
Number of other retired or separated participants entitled to future benefits2011-01-0123
Total of all active and inactive participants2011-01-01111
Total participants2011-01-01111
2010: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0193
Total number of active participants reported on line 7a of the Form 55002010-01-0193
Total of all active and inactive participants2010-01-0193
Total participants2010-01-0193

Financial Data on TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN

Measure Date Value
2022 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 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 to this plan2022-12-31$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$330,300
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$487,902
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$482,769
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$2,109,670
Value of total assets at end of year2022-12-31$10,537,209
Value of total assets at beginning of year2022-12-31$10,694,811
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$5,133
Total interest from all sources2022-12-31$2,346
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$1,400,242
Participant contributions at end of year2022-12-31$1,347
Participant contributions at beginning of year2022-12-31$3,946
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$233,893
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$17,449
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
Administrative expenses (other) incurred2022-12-31$5,133
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$0
Value of net income/loss2022-12-31$-157,602
Value of net assets at end of year (total assets less liabilities)2022-12-31$10,537,209
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$10,694,811
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$9,987,539
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$10,261,993
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
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$2,346
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$548,323
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$428,872
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$0
Net investment gain/loss from pooled separate accounts2022-12-31$-1,781,716
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 contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$475,535
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$465,320
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 investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2022-12-31MOSS ADAMS, LLP
Accountancy firm EIN2022-12-31910189318
2021 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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$3,454,763
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$409,110
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$403,789
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,127,452
Value of total assets at end of year2021-12-31$10,694,811
Value of total assets at beginning of year2021-12-31$7,649,158
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$5,321
Total interest from all sources2021-12-31$6,412
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$1,107,388
Participant contributions at end of year2021-12-31$3,946
Participant contributions at beginning of year2021-12-31$13,178
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$123,203
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$5,321
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$3,045,653
Value of net assets at end of year (total assets less liabilities)2021-12-31$10,694,811
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,649,158
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$10,261,993
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,796,740
Interest on participant loans2021-12-31$0
Interest earned on other investments2021-12-31$6,412
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$428,872
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$839,240
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$2,400
Net investment gain/loss from pooled separate accounts2021-12-31$1,320,899
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$896,861
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$401,389
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 name2021-12-31MOSS ADAMS, LLP
Accountancy firm EIN2021-12-31910189318
2020 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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$2,591,958
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$432,460
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$428,939
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,670,979
Value of total assets at end of year2020-12-31$7,649,158
Value of total assets at beginning of year2020-12-31$5,489,660
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$3,521
Total interest from all sources2020-12-31$6,266
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$1,090,496
Participant contributions at end of year2020-12-31$13,178
Participant contributions at beginning of year2020-12-31$12,545
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$177,011
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$3,521
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$2,159,498
Value of net assets at end of year (total assets less liabilities)2020-12-31$7,649,158
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$5,489,660
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$6,796,740
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,145,473
Interest on participant loans2020-12-31$0
Interest earned on other investments2020-12-31$6,266
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$839,240
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$331,642
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$35,729
Net investment gain/loss from pooled separate accounts2020-12-31$914,713
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$403,472
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$393,210
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 name2020-12-31MOSS ADAMS, LLP
Accountancy firm EIN2020-12-31910189318
2019 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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$1,959,575
Total income from all sources (including contributions)2019-12-31$1,959,575
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$151,989
Total of all expenses incurred2019-12-31$151,989
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$151,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$151,160
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,096,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,096,905
Value of total assets at end of year2019-12-31$5,489,660
Value of total assets at end of year2019-12-31$5,489,660
Value of total assets at beginning of year2019-12-31$3,682,074
Value of total assets at beginning of year2019-12-31$3,682,074
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$829
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$829
Total interest from all sources2019-12-31$858
Total interest from all sources2019-12-31$858
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$639,622
Contributions received from participants2019-12-31$639,622
Participant contributions at end of year2019-12-31$12,545
Participant contributions at end of year2019-12-31$12,545
Participant contributions at beginning of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$287,442
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$287,442
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$2,771
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$2,771
Other income not declared elsewhere2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$829
Administrative expenses (other) incurred2019-12-31$829
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$1,807,586
Value of net income/loss2019-12-31$1,807,586
Value of net assets at end of year (total assets less liabilities)2019-12-31$5,489,660
Value of net assets at end of year (total assets less liabilities)2019-12-31$5,489,660
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,682,074
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,682,074
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$5,145,473
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$5,145,473
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,452,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,452,274
Interest on participant loans2019-12-31$0
Interest on participant loans2019-12-31$0
Interest earned on other investments2019-12-31$858
Interest earned on other investments2019-12-31$858
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$331,642
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$331,642
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$229,800
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$229,800
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$861,812
Net investment gain/loss from pooled separate accounts2019-12-31$861,812
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 contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
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$169,841
Contributions received in cash from employer2019-12-31$169,841
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$148,389
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$148,389
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 name2019-12-31MOSS ADAMS, LLP
Accountancy firm name2019-12-31MOSS ADAMS, LLP
Accountancy firm EIN2019-12-31910189318
Accountancy firm EIN2019-12-31910189318
2018 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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 transfer of assets to this plan2018-12-31$0
Total transfer of assets from this plan2018-12-31$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$213,806
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$115,636
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$115,636
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$408,112
Value of total assets at end of year2018-12-31$3,682,074
Value of total assets at beginning of year2018-12-31$3,583,904
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$0
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$6,519
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
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$0
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 bond2018-12-31Yes
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$337,965
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$1,001
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$39,562
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$0
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
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$98,170
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,682,074
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,583,904
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$3,452,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,378,186
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
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$6,519
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$229,800
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$205,718
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$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-200,825
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 contributions2018-12-31Yes
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$69,146
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$76,074
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$0
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 name2018-12-31ARMANINO LLP
Accountancy firm EIN2018-12-31946214841
2017 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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 transfer of assets to this plan2017-12-31$0
Total transfer of assets from this plan2017-12-31$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$850,701
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$190,513
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$190,513
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$390,910
Value of total assets at end of year2017-12-31$3,544,341
Value of total assets at beginning of year2017-12-31$2,884,153
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$0
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$3,445
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$36,747
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$36,747
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$289,324
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$25,251
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$34,018
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$0
Liabilities. Value of operating payables at end of year2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$0
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$660,188
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,544,341
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,884,153
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$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,858,902
Value of interest in pooled separate accounts at end of year2017-12-31$3,338,623
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$3,445
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
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$205,718
Value of funds held in insurance company general accounts (unallocated contracts) 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$419,599
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$67,568
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$190,513
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$0
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 name2017-12-31ARMANINO LLP
Accountancy firm EIN2017-12-31946214841
2016 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$483,950
Total of all expenses incurred2016-12-31$176,025
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$176,025
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$326,813
Value of total assets at end of year2016-12-31$2,884,153
Value of total assets at beginning of year2016-12-31$2,576,228
Total interest from all sources2016-12-31$4,845
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 bond2016-12-31No
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$271,228
Participant contributions at end of year2016-12-31$25,251
Participant contributions at beginning of year2016-12-31$76,388
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$307,925
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,884,153
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,576,228
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$2,858,902
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,499,840
Interest on participant loans2016-12-31$4,845
Interest earned on other investments2016-12-31$4,845
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$182,451
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$158,563
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$152,292
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 contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$55,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$176,025
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 name2016-12-31MOSS ADAMS LLP
Accountancy firm EIN2016-12-31910189318
2015 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$297,784
Total of all expenses incurred2015-12-31$121,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$121,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$283,145
Value of total assets at end of year2015-12-31$2,576,228
Value of total assets at beginning of year2015-12-31$2,399,854
Total interest from all sources2015-12-31$4,477
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 bond2015-12-31No
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$217,965
Participant contributions at end of year2015-12-31$76,388
Participant contributions at beginning of year2015-12-31$28,568
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$176,374
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,576,228
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,399,854
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$2,499,840
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,371,286
Interest on participant loans2015-12-31$4,477
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$10,162
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$65,180
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$121,410
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
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MOSS ADAMS LLP
Accountancy firm EIN2015-12-31910189318
2014 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$464,838
Total of all expenses incurred2014-12-31$308,555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$308,555
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$336,513
Value of total assets at end of year2014-12-31$2,399,854
Value of total assets at beginning of year2014-12-31$2,243,571
Total interest from all sources2014-12-31$-4,349
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 bond2014-12-31No
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$237,457
Participant contributions at end of year2014-12-31$28,568
Participant contributions at beginning of year2014-12-31$54,784
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$25,775
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$156,283
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,399,854
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,243,571
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$2,371,286
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,188,787
Interest on participant loans2014-12-31$1,379
Interest earned on other investments2014-12-31$-5,728
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$132,674
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$73,281
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$308,555
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
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MOSS ADAMS LLP
Accountancy firm EIN2014-12-31910189318
2013 : TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$715
Total unrealized appreciation/depreciation of assets2013-12-31$715
Total income from all sources (including contributions)2013-12-31$748,948
Total of all expenses incurred2013-12-31$353,169
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$353,169
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$418,093
Value of total assets at end of year2013-12-31$2,243,571
Value of total assets at beginning of year2013-12-31$1,847,792
Total interest from all sources2013-12-31$3,243
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 bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$268,170
Participant contributions at end of year2013-12-31$54,784
Participant contributions at beginning of year2013-12-31$41,542
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$65,341
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$395,779
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,243,571
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,847,792
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$2,188,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,806,250
Interest on participant loans2013-12-31$3,243
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$326,897
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$84,582
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$353,169
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
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MOSS ADAMS LLP
Accountancy firm EIN2013-12-31910189318

Form 5500 Responses for TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN

2022: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
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 planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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 benefit arrangement – InsuranceYes
2020: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) 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 benefit arrangement – InsuranceYes
2019: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 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: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
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: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2011: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: TIBURCIO VASQUEZ HEALTH CENTER, INC. 403(B) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number061860
Policy instance 1
Insurance contract or identification number061860
Number of Individuals Covered673
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 $9,900
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
Amount paid for insurance broker fees9900
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 number061860C
Policy instance 1
Insurance contract or identification number061860C
Number of Individuals Covered569
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 $7,927
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 fees7927
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 number061860C
Policy instance 1
Insurance contract or identification number061860C
Number of Individuals Covered432
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 $7,927
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 fees7927
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 number061860C
Policy instance 1
Insurance contract or identification number061860C
Number of Individuals Covered416
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 $828
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 fees828
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6821
Policy instance 1
Insurance contract or identification numberVF6821
Number of Individuals Covered163
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,048
Total amount of fees paid to insurance companyUSD $213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,048
Amount paid for insurance broker fees213
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
Insurance broker nameKESTRA INVESTMENT SERVICES, LLC
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6821
Policy instance 1
Insurance contract or identification numberVF6821
Number of Individuals Covered153
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $6,852
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $6,020
Insurance broker organization code?7
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6821
Policy instance 1
Insurance contract or identification numberVF6821
Number of Individuals Covered145
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,028
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $5,028
Insurance broker organization code?7

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