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BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 401k Plan overview

Plan NameBARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Plan identification number 002

BARTZ-ALTADONNA COMMUNITY HEALTH CENTER Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BARTZ-ALTADONNA COMMUNITY HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name:BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Employer identification number (EIN):273261289
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01JO ELLEN VASQUEZ2021-08-26

Plan Statistics for BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

401k plan membership statisitcs for BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

Measure Date Value
2022: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2022 401k membership
Total participants, beginning-of-year2022-01-01142
Total number of active participants reported on line 7a of the Form 55002022-01-01136
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-011
Total of all active and inactive participants2022-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01138
Number of participants with account balances2022-01-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-014
2021: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2021 401k membership
Total participants, beginning-of-year2021-01-01135
Total number of active participants reported on line 7a of the Form 55002021-01-01136
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-015
Total of all active and inactive participants2021-01-01142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01142
Number of participants with account balances2021-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010

Financial Data on BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

Measure Date Value
2022 : BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$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$664,531
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$276,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$269,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$926,752
Value of total assets at end of year2022-12-31$2,022,867
Value of total assets at beginning of year2022-12-31$1,634,345
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$6,691
Total interest from all sources2022-12-31$3,390
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$374,682
Participant contributions at end of year2022-12-31$66,739
Participant contributions at beginning of year2022-12-31$70,076
Participant contributions at end of year2022-12-31$11,133
Participant contributions at beginning of year2022-12-31$7,109
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$260,828
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$121
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$107
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$388,522
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,022,867
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,634,345
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,891,777
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,463,944
Value of interest in pooled separate accounts at end of year2022-12-31$33,560
Value of interest in pooled separate accounts at beginning of year2022-12-31$87,668
Interest on participant loans2022-12-31$3,390
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-266,100
Net investment gain/loss from pooled separate accounts2022-12-31$489
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$291,242
Employer contributions (assets) at end of year2022-12-31$19,537
Employer contributions (assets) at beginning of year2022-12-31$5,441
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$269,318
Contract administrator fees2022-12-31$6,691
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31VASQUEZ AND COMPANY LLP
Accountancy firm EIN2022-12-31330700332
2021 : BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$761,055
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$135,639
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$130,845
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$623,743
Value of total assets at end of year2021-12-31$1,634,345
Value of total assets at beginning of year2021-12-31$1,008,929
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$4,794
Total interest from all sources2021-12-31$3,124
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$277,140
Participant contributions at end of year2021-12-31$70,076
Participant contributions at beginning of year2021-12-31$56,777
Participant contributions at end of year2021-12-31$7,109
Participant contributions at beginning of year2021-12-31$7,005
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$149,888
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$107
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$77
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$625,416
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,634,345
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,008,929
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,463,944
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$887,404
Value of interest in pooled separate accounts at end of year2021-12-31$87,668
Value of interest in pooled separate accounts at beginning of year2021-12-31$52,195
Interest on participant loans2021-12-31$3,124
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$133,512
Net investment gain/loss from pooled separate accounts2021-12-31$676
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$196,715
Employer contributions (assets) at end of year2021-12-31$5,441
Employer contributions (assets) at beginning of year2021-12-31$5,471
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$130,845
Contract administrator fees2021-12-31$4,794
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31VASQUEZ AND COMPANY LLC
Accountancy firm EIN2021-12-31330700332

Form 5500 Responses for BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

2022: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-LI1E
Policy instance 1
Insurance contract or identification numberGAP-B2-LI1E
Number of Individuals Covered68
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $263
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-LI1E
Policy instance 1
Insurance contract or identification numberGAP-B2-LI1E
Number of Individuals Covered142
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $358
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $358
Insurance broker organization code?3

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