401k Plan data: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN plan

PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 401k Plan overview

Plan Name	PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN
Plan identification number	001

PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

PROVIDENT HOME HEALTHCARE, LLC has sponsored the creation of one or more 401k plans.

Company Name: PROVIDENT HOME HEALTHCARE, LLC

Employer identification number (EIN): 270832417

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 RAMONA ERICKSON RAMONA ERICKSON 2018-10-15
001 2017-01-01 RAMONA ERICKSON RAMONA ERICKSON 2018-10-15
001 2017-01-01 2018-10-12
001 2016-01-01 RAMONA ERICKSON RAMONA ERICKSON 2017-10-16
001 2015-01-01 RAMONA ERICKSON RAMONA ERICKSON 2016-10-14
001 2014-01-01 RAMONA ERICKSON 2015-07-02 RAMONA ERICKSON 2015-07-02
001 2013-01-01 RAMONA ERICKSON 2014-09-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	RAMONA ERICKSON		RAMONA ERICKSON	2018-10-15
001	2017-01-01	RAMONA ERICKSON		RAMONA ERICKSON	2018-10-15
001	2017-01-01		2018-10-12
001	2016-01-01	RAMONA ERICKSON		RAMONA ERICKSON	2017-10-16
001	2015-01-01	RAMONA ERICKSON		RAMONA ERICKSON	2016-10-14
001	2014-01-01	RAMONA ERICKSON	2015-07-02	RAMONA ERICKSON	2015-07-02
001	2013-01-01	RAMONA ERICKSON	2014-09-17

Plan Statistics for PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN

401k plan membership statisitcs for PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN

Measure Date Value
2022: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 275
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 206
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 52
Total of all active and inactive participants 2022-01-01 260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 260
Number of participants with account balances 2022-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 277
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 207
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 44
Total of all active and inactive participants 2021-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 252
Number of participants with account balances 2021-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 233
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 33
Total of all active and inactive participants 2020-01-01 267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 267
Number of participants with account balances 2020-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 255
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 202
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 29
Total of all active and inactive participants 2019-01-01 232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 232
Number of participants with account balances 2019-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 172
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 21
Total of all active and inactive participants 2018-01-01 193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 193
Number of participants with account balances 2018-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 204
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 13
Total of all active and inactive participants 2017-01-01 217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 217
Number of participants with account balances 2017-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 181
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 11
Total of all active and inactive participants 2016-01-01 193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 193
Number of participants with account balances 2016-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 158
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 161
Number of participants with account balances 2015-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2022: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	275
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	206
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	52
Total of all active and inactive participants	2022-01-01	260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	260
Number of participants with account balances	2022-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	277
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	207
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	44
Total of all active and inactive participants	2021-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	252
Number of participants with account balances	2021-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	233
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	33
Total of all active and inactive participants	2020-01-01	267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	267
Number of participants with account balances	2020-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	255
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	202
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	29
Total of all active and inactive participants	2019-01-01	232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	232
Number of participants with account balances	2019-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	172
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	21
Total of all active and inactive participants	2018-01-01	193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	193
Number of participants with account balances	2018-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	204
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	13
Total of all active and inactive participants	2017-01-01	217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	217
Number of participants with account balances	2017-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	181
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	11
Total of all active and inactive participants	2016-01-01	193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	193
Number of participants with account balances	2016-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	158
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	161
Number of participants with account balances	2015-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN

Measure	Date	Value
2022 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-105,437
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$205,584
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$202,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$394,334
Value of total assets at end of year	2022-12-31	$2,525,626
Value of total assets at beginning of year	2022-12-31	$2,836,647
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$3,216
Total interest from all sources	2022-12-31	$2,351
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 year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$250,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$280,813
Participant contributions at end of year	2022-12-31	$42,098
Participant contributions at beginning of year	2022-12-31	$45,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-311,021
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,525,626
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,836,647
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,321,512
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,712,210
Interest on participant loans	2022-12-31	$2,351
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$162,016
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$78,918
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-502,122
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$113,521
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$202,368
Contract administrator fees	2022-12-31	$3,216
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BOYUM BARENSCHEER PLLP
Accountancy firm EIN	2022-12-31	416192096
2021 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$665,195
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$147,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$144,798
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$412,117
Value of total assets at end of year	2021-12-31	$2,836,647
Value of total assets at beginning of year	2021-12-31	$2,318,997
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,747
Total interest from all sources	2021-12-31	$1,867
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 year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$250,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$286,995
Participant contributions at end of year	2021-12-31	$45,519
Participant contributions at beginning of year	2021-12-31	$35,574
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$517,650
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,836,647
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,318,997
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,712,210
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,201,012
Interest on participant loans	2021-12-31	$1,867
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$78,918
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$82,411
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$251,211
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$125,122
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$144,798
Contract administrator fees	2021-12-31	$2,747
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BOYUM AND BARENSCHEER, PLLP
Accountancy firm EIN	2021-12-31	416192096
2020 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$714,383
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$34,451
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$33,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$453,421
Value of total assets at end of year	2020-12-31	$2,318,997
Value of total assets at beginning of year	2020-12-31	$1,639,065
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,414
Total interest from all sources	2020-12-31	$1,080
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 year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$276,645
Participant contributions at end of year	2020-12-31	$35,574
Participant contributions at beginning of year	2020-12-31	$21,419
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$44,108
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$679,932
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,318,997
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,639,065
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,201,012
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,617,024
Interest on participant loans	2020-12-31	$1,080
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$1
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$82,411
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$621
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$259,882
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$132,668
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$33,037
Contract administrator fees	2020-12-31	$1,414
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PITZL & PITZL
Accountancy firm EIN	2020-12-31	261476088
2019 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	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 income from all sources (including contributions)	2019-12-31	$620,763
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$99,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$96,577
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$361,387
Value of total assets at end of year	2019-12-31	$1,639,065
Value of total assets at beginning of year	2019-12-31	$1,118,048
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$3,169
Total interest from all sources	2019-12-31	$1,144
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 year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$235,119
Participant contributions at end of year	2019-12-31	$21,419
Participant contributions at beginning of year	2019-12-31	$26,761
Participant contributions at beginning of year	2019-12-31	$7,182
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$12,394
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$59
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$521,017
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,639,065
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,118,048
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,617,024
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,078,113
Interest on participant loans	2019-12-31	$1,130
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$1
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$2,112
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$2,112
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$14
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$621
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$425
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$258,232
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$113,874
Employer contributions (assets) at beginning of year	2019-12-31	$3,396
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$96,577
Contract administrator fees	2019-12-31	$3,169
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	PITZL & PITZL
Accountancy firm EIN	2019-12-31	261476088
2018 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$169,264
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$33,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$32,473
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$280,994
Value of total assets at end of year	2018-12-31	$1,118,048
Value of total assets at beginning of year	2018-12-31	$982,025
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$768
Total interest from all sources	2018-12-31	$1,707
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 year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$188,183
Participant contributions at end of year	2018-12-31	$26,761
Participant contributions at beginning of year	2018-12-31	$16,003
Participant contributions at end of year	2018-12-31	$7,182
Participant contributions at beginning of year	2018-12-31	$7,485
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$2,186
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$59
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$136,023
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,118,048
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$982,025
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,078,113
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$954,835
Interest on participant loans	2018-12-31	$1,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$2,112
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$-1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$425
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-113,437
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$90,625
Employer contributions (assets) at end of year	2018-12-31	$3,396
Employer contributions (assets) at beginning of year	2018-12-31	$3,680
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$32,473
Contract administrator fees	2018-12-31	$768
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	PITZL & PITZL
Accountancy firm EIN	2018-12-31	261476088
2017 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$365,352
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$38,436
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$37,828
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$256,073
Value of total assets at end of year	2017-12-31	$982,025
Value of total assets at beginning of year	2017-12-31	$655,109
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$608
Total interest from all sources	2017-12-31	$866
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$173,155
Participant contributions at end of year	2017-12-31	$16,003
Participant contributions at beginning of year	2017-12-31	$16,406
Participant contributions at end of year	2017-12-31	$7,485
Participant contributions at beginning of year	2017-12-31	$5,103
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$326,916
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$982,025
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$655,109
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$954,835
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$631,198
Interest on participant loans	2017-12-31	$866
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$108,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$82,918
Employer contributions (assets) at end of year	2017-12-31	$3,680
Employer contributions (assets) at beginning of year	2017-12-31	$2,402
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$37,828
Contract administrator fees	2017-12-31	$608
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	PITZL & PITZL, PA
Accountancy firm EIN	2017-12-31	261476088
2016 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$397,228
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$15,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$14,439
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$358,232
Value of total assets at end of year	2016-12-31	$655,109
Value of total assets at beginning of year	2016-12-31	$273,732
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,412
Total interest from all sources	2016-12-31	$131
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$137,093
Participant contributions at end of year	2016-12-31	$16,406
Participant contributions at end of year	2016-12-31	$5,103
Participant contributions at beginning of year	2016-12-31	$4,240
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$155,925
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$381,377
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$655,109
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$273,732
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$631,198
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$267,482
Interest on participant loans	2016-12-31	$131
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$38,865
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$65,214
Employer contributions (assets) at end of year	2016-12-31	$2,402
Employer contributions (assets) at beginning of year	2016-12-31	$2,010
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$14,439
Contract administrator fees	2016-12-31	$1,412
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	PITZL & PITZL, PA
Accountancy firm EIN	2016-12-31	261476088
2015 : PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$139,239
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,692
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,494
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$148,615
Value of total assets at end of year	2015-12-31	$273,732
Value of total assets at beginning of year	2015-12-31	$137,185
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$198
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$20,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$101,509
Participant contributions at end of year	2015-12-31	$4,240
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$136,547
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$273,732
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$137,185
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$267,482
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$137,185
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-9,376
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$47,106
Employer contributions (assets) at end of year	2015-12-31	$2,010
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,494
Contract administrator fees	2015-12-31	$198
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	PITZL & PITZL PA
Accountancy firm EIN	2015-12-31	261476088

Form 5500 Responses for PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN

2022: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FR2S

Policy instance

Insurance contract or identification number	GAP-CP-FR2S
Number of Individuals Covered	120
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,251
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $1,251
Insurance broker organization code?	7

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FR2S

Policy instance

Insurance contract or identification number	GAP-CP-FR2S
Number of Individuals Covered	118
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $853
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $853
Insurance broker organization code?	7

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FR2S

Policy instance

Insurance contract or identification number	GAP-CP-FR2S
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $579
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $579
Insurance broker organization code?	7

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FR2S

Policy instance

Insurance contract or identification number	GAP-CP-FR2S
Number of Individuals Covered	97
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $5
Insurance broker organization code?	7

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-FR2S

Policy instance

Insurance contract or identification number	GAP-CP-FR2S
Number of Individuals Covered	193
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $3
Insurance broker organization code?	7

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

063-84428

Policy instance

Insurance contract or identification number	063-84428
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $2
Amount paid for insurance broker fees	0
Insurance broker organization code?	7
Insurance broker name	LPL FINANCIAL, LLC

Potentially related plans

PROVIDENT HOMES CORP. 401K PLAN [EIN = 810657017]

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See full terms and conditions

Company Name:	PROVIDENT HOME HEALTHCARE, LLC
Employer identification number (EIN):	270832417
NAIC Classification:	621610
NAIC Description:	Home Health Care Services