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EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 401k Plan overview

Plan NameEMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC
Plan identification number 001

EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC Benefits

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

401k Sponsoring company profile

CAMBRIA RESIDENTIAL SERVICES INC has sponsored the creation of one or more 401k plans.

Company Name:CAMBRIA RESIDENTIAL SERVICES INC
Employer identification number (EIN):251405563
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01JAMES J. COOK2020-10-02
0012018-01-01
0012017-01-01JAMES J. COOK
0012016-01-01JAMES J. COOK
0012015-01-01JAMES J. COOK
0012014-01-01JAMES J. COOK
0012013-01-01JAMES J. COOK
0012012-01-01JAMES J. COOK
0012011-01-01JAMES J. COOK
0012010-01-01JAMES J. COOK
0012009-01-01JAMES J. COOK

Plan Statistics for EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC

401k plan membership statisitcs for EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC

Measure Date Value
2018: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2018 401k membership
Total participants, beginning-of-year2018-01-01137
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0138
Total of all active and inactive participants2018-01-0138
Total participants2018-01-0138
Number of participants with account balances2018-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2017 401k membership
Total participants, beginning-of-year2017-01-01128
Total number of active participants reported on line 7a of the Form 55002017-01-01108
Number of retired or separated participants receiving benefits2017-01-014
Number of other retired or separated participants entitled to future benefits2017-01-0125
Total of all active and inactive participants2017-01-01137
Total participants2017-01-01137
Number of participants with account balances2017-01-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2016 401k membership
Total participants, beginning-of-year2016-01-01131
Total number of active participants reported on line 7a of the Form 55002016-01-01102
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0123
Total of all active and inactive participants2016-01-01128
Total participants2016-01-01128
Number of participants with account balances2016-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2015 401k membership
Total participants, beginning-of-year2015-01-01131
Total number of active participants reported on line 7a of the Form 55002015-01-01106
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-0122
Total of all active and inactive participants2015-01-01131
Total participants2015-01-01131
Number of participants with account balances2015-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2014 401k membership
Total participants, beginning-of-year2014-01-01131
Total number of active participants reported on line 7a of the Form 55002014-01-01103
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-0125
Total of all active and inactive participants2014-01-01131
Total participants2014-01-01131
Number of participants with account balances2014-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-014
2013: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2013 401k membership
Total participants, beginning-of-year2013-01-01150
Total number of active participants reported on line 7a of the Form 55002013-01-01104
Number of retired or separated participants receiving benefits2013-01-013
Number of other retired or separated participants entitled to future benefits2013-01-0124
Total of all active and inactive participants2013-01-01131
Total participants2013-01-01131
Number of participants with account balances2013-01-01128
2012: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2012 401k membership
Total participants, beginning-of-year2012-01-01148
Total number of active participants reported on line 7a of the Form 55002012-01-01125
Number of retired or separated participants receiving benefits2012-01-013
Number of other retired or separated participants entitled to future benefits2012-01-0122
Total of all active and inactive participants2012-01-01150
Total participants2012-01-01150
Number of participants with account balances2012-01-01150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-014
2011: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2011 401k membership
Total participants, beginning-of-year2011-01-01153
Total number of active participants reported on line 7a of the Form 55002011-01-01122
Number of retired or separated participants receiving benefits2011-01-014
Number of other retired or separated participants entitled to future benefits2011-01-0122
Total of all active and inactive participants2011-01-01148
Total participants2011-01-01148
Number of participants with account balances2011-01-01148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-014
2010: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2010 401k membership
Total participants, beginning-of-year2010-01-01154
Total number of active participants reported on line 7a of the Form 55002010-01-01125
Number of retired or separated participants receiving benefits2010-01-014
Number of other retired or separated participants entitled to future benefits2010-01-0124
Total of all active and inactive participants2010-01-01153
Total participants2010-01-01153
Number of participants with account balances2010-01-01153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-011
2009: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2009 401k membership
Total participants, beginning-of-year2009-01-01159
Total number of active participants reported on line 7a of the Form 55002009-01-01126
Number of retired or separated participants receiving benefits2009-01-014
Number of other retired or separated participants entitled to future benefits2009-01-0124
Total of all active and inactive participants2009-01-01154
Total participants2009-01-01154
Number of participants with account balances2009-01-01154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC

Measure Date Value
2018 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2018 401k financial data
Total transfer of assets from this plan2018-12-31$4,133,548
Total income from all sources (including contributions)2018-12-31$103,418
Total of all expenses incurred2018-12-31$1,061,670
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,060,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$163,472
Value of total assets at end of year2018-12-31$936,738
Value of total assets at beginning of year2018-12-31$6,028,538
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,370
Total interest from all sources2018-12-31$22,462
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2018-12-31$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
Funding deficiency by the employer to the plan for this plan year2018-12-31$0
Minimum employer required contribution for this plan year2018-12-31$163,473
Amount contributed by the employer to the plan for this plan year2018-12-31$163,473
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$17,381
Other income not declared elsewhere2018-12-31$11
Administrative expenses (other) incurred2018-12-31$1,370
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-958,252
Value of net assets at end of year (total assets less liabilities)2018-12-31$936,738
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$6,028,538
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$541,953
Value of interest in pooled separate accounts at beginning of year2018-12-31$3,462,370
Interest earned on other investments2018-12-31$22,462
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$394,785
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$2,566,168
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$265,760
Net investment gain/loss from pooled separate accounts2018-12-31$-82,527
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$163,472
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$777,159
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
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 name2018-12-31WESSEL & COMPANY
Accountancy firm EIN2018-12-31251390233
2017 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$797,390
Total of all expenses incurred2017-12-31$247,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$241,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$257,893
Value of total assets at end of year2017-12-31$6,028,538
Value of total assets at beginning of year2017-12-31$5,478,166
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$5,252
Total interest from all sources2017-12-31$25,656
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
Funding deficiency by the employer to the plan for this plan year2017-12-31$0
Minimum employer required contribution for this plan year2017-12-31$257,893
Amount contributed by the employer to the plan for this plan year2017-12-31$257,893
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Other income not declared elsewhere2017-12-31$1,726
Administrative expenses (other) incurred2017-12-31$5,252
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$550,372
Value of net assets at end of year (total assets less liabilities)2017-12-31$6,028,538
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$5,478,166
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 registered invesment companies (eg mutual funds) at end of year2017-12-31$3,462,370
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,847,530
Interest earned on other investments2017-12-31$25,656
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$2,566,168
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$2,630,636
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$241,766
Net investment gain/loss from pooled separate accounts2017-12-31$512,115
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$257,893
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
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 name2017-12-31WESSEL & COMPANY
Accountancy firm EIN2017-12-31251390233
2016 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$473,945
Total of all expenses incurred2016-12-31$482,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$475,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$240,490
Value of total assets at end of year2016-12-31$5,478,166
Value of total assets at beginning of year2016-12-31$5,486,940
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$6,780
Total interest from all sources2016-12-31$28,212
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$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Funding deficiency by the employer to the plan for this plan year2016-12-31$0
Minimum employer required contribution for this plan year2016-12-31$240,490
Amount contributed by the employer to the plan for this plan year2016-12-31$240,490
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Other income not declared elsewhere2016-12-31$2,485
Administrative expenses (other) incurred2016-12-31$6,780
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-8,774
Value of net assets at end of year (total assets less liabilities)2016-12-31$5,478,166
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$5,486,940
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$2,847,530
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,560,629
Interest earned on other investments2016-12-31$28,212
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$2,630,636
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$2,926,311
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$475,939
Net investment gain/loss from pooled separate accounts2016-12-31$202,758
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$240,490
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
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 name2016-12-31WESSEL & COMPANY
Accountancy firm EIN2016-12-31251390233
2015 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$280,082
Total of all expenses incurred2015-12-31$136,514
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$132,916
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$242,213
Value of total assets at end of year2015-12-31$5,486,940
Value of total assets at beginning of year2015-12-31$5,343,372
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$3,598
Total interest from all sources2015-12-31$28,671
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$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Funding deficiency by the employer to the plan for this plan year2015-12-31$0
Minimum employer required contribution for this plan year2015-12-31$261,509
Amount contributed by the employer to the plan for this plan year2015-12-31$261,509
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Other income not declared elsewhere2015-12-31$2,666
Administrative expenses (other) incurred2015-12-31$3,598
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$143,568
Value of net assets at end of year (total assets less liabilities)2015-12-31$5,486,940
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,343,372
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$2,560,629
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,459,427
Interest earned on other investments2015-12-31$28,671
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$2,926,311
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$2,864,649
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$132,916
Net investment gain/loss from pooled separate accounts2015-12-31$6,532
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$242,213
Employer contributions (assets) at beginning of year2015-12-31$19,296
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
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 name2015-12-31WESSEL & COMPANY
Accountancy firm EIN2015-12-31251390233
2014 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$452,696
Total of all expenses incurred2014-12-31$315,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$289,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$241,514
Value of total assets at end of year2014-12-31$5,343,372
Value of total assets at beginning of year2014-12-31$5,205,724
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$25,931
Total interest from all sources2014-12-31$28,621
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$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$241,514
Amount contributed by the employer to the plan for this plan year2014-12-31$241,514
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Other income not declared elsewhere2014-12-31$12,836
Administrative expenses (other) incurred2014-12-31$25,931
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$137,648
Value of net assets at end of year (total assets less liabilities)2014-12-31$5,343,372
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$5,205,724
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$2,459,427
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,211,781
Interest earned on other investments2014-12-31$28,621
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$2,864,649
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$2,993,943
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$289,117
Net investment gain/loss from pooled separate accounts2014-12-31$169,725
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$241,514
Employer contributions (assets) at end of year2014-12-31$19,296
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
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 name2014-12-31WESSEL & COMPANY
Accountancy firm EIN2014-12-31251390233
2013 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$734,453
Total of all expenses incurred2013-12-31$419,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$400,399
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$246,652
Value of total assets at end of year2013-12-31$5,205,724
Value of total assets at beginning of year2013-12-31$4,890,998
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$19,328
Total interest from all sources2013-12-31$33,016
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$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$246,652
Amount contributed by the employer to the plan for this plan year2013-12-31$246,652
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Other income not declared elsewhere2013-12-31$7,939
Administrative expenses (other) incurred2013-12-31$19,328
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$314,726
Value of net assets at end of year (total assets less liabilities)2013-12-31$5,205,724
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$4,890,998
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$2,211,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,813,889
Interest earned on other investments2013-12-31$33,016
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$2,993,943
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$3,077,109
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$400,399
Net investment gain/loss from pooled separate accounts2013-12-31$446,846
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$246,652
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
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 name2013-12-31WESSEL & COMPANY
Accountancy firm EIN2013-12-31251390233
2012 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$494,960
Total of all expenses incurred2012-12-31$154,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$147,372
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$249,982
Value of total assets at end of year2012-12-31$4,890,998
Value of total assets at beginning of year2012-12-31$4,551,034
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$7,624
Total interest from all sources2012-12-31$50,010
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$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$249,982
Amount contributed by the employer to the plan for this plan year2012-12-31$249,982
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Other income not declared elsewhere2012-12-31$5,333
Administrative expenses (other) incurred2012-12-31$7,624
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$339,964
Value of net assets at end of year (total assets less liabilities)2012-12-31$4,890,998
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$4,551,034
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$1,813,889
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,516,614
Interest earned on other investments2012-12-31$50,010
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$3,077,109
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$3,034,420
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$147,236
Net investment gain/loss from pooled separate accounts2012-12-31$189,635
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$249,982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$136
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
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 name2012-12-31WESSEL & COMPANY
Accountancy firm EIN2012-12-31251390233
2011 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$261,320
Total of all expenses incurred2011-12-31$323,387
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$310,775
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$246,958
Value of total assets at end of year2011-12-31$4,551,034
Value of total assets at beginning of year2011-12-31$4,613,101
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$12,612
Total interest from all sources2011-12-31$60,002
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$246,958
Amount contributed by the employer to the plan for this plan year2011-12-31$246,958
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Other income not declared elsewhere2011-12-31$6,155
Administrative expenses (other) incurred2011-12-31$12,612
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-62,067
Value of net assets at end of year (total assets less liabilities)2011-12-31$4,551,034
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,613,101
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,516,614
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,457,274
Interest earned on other investments2011-12-31$60,002
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$3,034,420
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$3,155,827
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$307,769
Net investment gain/loss from pooled separate accounts2011-12-31$-51,795
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$246,958
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$3,006
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31WESSEL & COMPANY
Accountancy firm EIN2011-12-31251390233
2010 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$527,918
Total of all expenses incurred2010-12-31$407,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$404,498
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$243,332
Value of total assets at end of year2010-12-31$4,613,101
Value of total assets at beginning of year2010-12-31$4,492,844
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$3,163
Total interest from all sources2010-12-31$87,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$243,332
Amount contributed by the employer to the plan for this plan year2010-12-31$243,332
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Other income not declared elsewhere2010-12-31$1,332
Administrative expenses (other) incurred2010-12-31$3,163
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$120,257
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,613,101
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$4,492,844
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,457,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,206,243
Interest earned on other investments2010-12-31$87,500
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$3,155,827
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$3,286,601
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$398,395
Net investment gain/loss from pooled separate accounts2010-12-31$195,754
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$243,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$6,103
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31WESSEL & COMPANY
Accountancy firm EIN2010-12-31251390233
2009 : EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$246,845
Amount contributed by the employer to the plan for this plan year2009-12-31$246,845

Form 5500 Responses for EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC

2018: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: EMPLOYEE BENEFITS PLAN OF CAMBRIA RESIDENTIAL SERV INC 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered38
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 $1,153
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1153
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 number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered137
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 $1,200
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1200
Additional information about fees paid to insurance brokerPORTION OF INVENTIVE COMPENSATION PROGRAM
Insurance broker organization code?3
Insurance broker namePITTSBURGH REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered131
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 $162
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees162
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?3
Insurance broker namePITTSBURGH REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered131
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 $147
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees147
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?3
Insurance broker namePITTSBURGH REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered131
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $910
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees910
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?3
Insurance broker namePITTSBURGH REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered150
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $269
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees84
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameDAVID HOLETS
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered148
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $285
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052426-H
Policy instance 1
Insurance contract or identification number052426-H
Number of Individuals Covered153
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $341
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees114
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameJOHN C HILZENDEGER

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