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HAVEN HEALTH 401(K) PLAN 401k Plan overview

Plan NameHAVEN HEALTH 401(K) PLAN
Plan identification number 001

HAVEN HEALTH 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PALM CONSULTING has sponsored the creation of one or more 401k plans.

Company Name:PALM CONSULTING
Employer identification number (EIN):274544408
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAVEN HEALTH 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MELODY KEENAN2023-08-01
0012021-01-01MELODY KEENAN2022-10-04
0012020-01-01MELODY KEENAN2021-10-13
0012020-01-01MELODY KEENAN2022-04-12
0012019-01-01MELODY KEENAN2020-12-09
0012019-01-01MELODY KEENAN2020-10-09
0012018-01-01MELODY KEENAN2019-12-19
0012018-01-01MELODY KEENAN2019-10-11
0012017-01-01
0012017-01-01
0012016-01-01
0012015-01-01MELODY KEENAN
0012015-01-01MELODY KEENAN
0012014-01-01MELODY KEENAN
0012013-01-01CONNIE NEWMAN
0012012-01-01CONNIE NEWMAN
0012011-01-01MELODY KEENAN2012-10-11

Plan Statistics for HAVEN HEALTH 401(K) PLAN

401k plan membership statisitcs for HAVEN HEALTH 401(K) PLAN

Measure Date Value
2022: HAVEN HEALTH 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01204
Total number of active participants reported on line 7a of the Form 55002022-01-01146
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0139
Total of all active and inactive participants2022-01-01185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01185
Number of participants with account balances2022-01-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-015
2021: HAVEN HEALTH 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01208
Total number of active participants reported on line 7a of the Form 55002021-01-01163
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0137
Total of all active and inactive participants2021-01-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01200
Number of participants with account balances2021-01-0189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: HAVEN HEALTH 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01235
Total number of active participants reported on line 7a of the Form 55002020-01-01154
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0152
Total of all active and inactive participants2020-01-01206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01206
Number of participants with account balances2020-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-012
2019: HAVEN HEALTH 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01301
Total number of active participants reported on line 7a of the Form 55002019-01-01177
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0156
Total of all active and inactive participants2019-01-01233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01233
Number of participants with account balances2019-01-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0112
2018: HAVEN HEALTH 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01299
Total number of active participants reported on line 7a of the Form 55002018-01-01251
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0147
Total of all active and inactive participants2018-01-01298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01298
Number of participants with account balances2018-01-01116
2017: HAVEN HEALTH 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01265
Total number of active participants reported on line 7a of the Form 55002017-01-01255
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0139
Total of all active and inactive participants2017-01-01294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01294
Number of participants with account balances2017-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0110
2016: HAVEN HEALTH 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01252
Total number of active participants reported on line 7a of the Form 55002016-01-01254
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0130
Total of all active and inactive participants2016-01-01284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01284
Number of participants with account balances2016-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-013
2015: HAVEN HEALTH 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01175
Total number of active participants reported on line 7a of the Form 55002015-01-01252
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0118
Total of all active and inactive participants2015-01-01270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01270
Number of participants with account balances2015-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: HAVEN HEALTH 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01167
Total number of active participants reported on line 7a of the Form 55002014-01-01140
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0118
Total of all active and inactive participants2014-01-01158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01158
Number of participants with account balances2014-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-014
2013: HAVEN HEALTH 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01150
Total number of active participants reported on line 7a of the Form 55002013-01-01127
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0122
Total of all active and inactive participants2013-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01149
Number of participants with account balances2013-01-0189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0112
2012: HAVEN HEALTH 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01130
Total number of active participants reported on line 7a of the Form 55002012-01-01129
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-018
Total of all active and inactive participants2012-01-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01137
Number of participants with account balances2012-01-0182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012

Financial Data on HAVEN HEALTH 401(K) PLAN

Measure Date Value
2022 : HAVEN HEALTH 401(K) PLAN 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$0
Total income from all sources (including contributions)2022-12-31$-384,142
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$230,910
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$198,500
Value of total corrective distributions2022-12-31$5,608
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$333,381
Value of total assets at end of year2022-12-31$3,682,517
Value of total assets at beginning of year2022-12-31$4,297,569
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$26,802
Total interest from all sources2022-12-31$3,698
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
Administrative expenses professional fees incurred2022-12-31$8,422
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$266,146
Participant contributions at end of year2022-12-31$58,388
Participant contributions at beginning of year2022-12-31$82,238
Participant contributions at end of year2022-12-31$606
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$67,235
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-615,052
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,682,517
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,297,569
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$3,622,385
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,208,126
Interest on participant loans2022-12-31$3,698
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,138
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$7,205
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$7,205
Net investment gain/loss from pooled separate accounts2022-12-31$-721,239
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$198,500
Contract administrator fees2022-12-31$18,380
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 name2022-12-31HEDMAN PARTNERS LLP
Accountancy firm EIN2022-12-31854036357
2021 : HAVEN HEALTH 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$815,545
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$365,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$336,881
Value of total corrective distributions2021-12-31$4,832
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$255,480
Value of total assets at end of year2021-12-31$4,297,569
Value of total assets at beginning of year2021-12-31$3,847,544
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$23,807
Total interest from all sources2021-12-31$6,039
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$254,108
Participant contributions at end of year2021-12-31$82,238
Participant contributions at beginning of year2021-12-31$140,619
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$1,372
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$450,025
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,297,569
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,847,544
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,208,126
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,706,361
Interest on participant loans2021-12-31$6,039
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$7,205
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$564
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$564
Net investment gain/loss from pooled separate accounts2021-12-31$554,026
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 contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$336,881
Contract administrator fees2021-12-31$23,807
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 name2021-12-31HEDMAN PARTNERS LLP
Accountancy firm EIN2021-12-31854036357
2020 : HAVEN HEALTH 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$741,504
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$261,175
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$241,793
Value of total corrective distributions2020-12-31$17,710
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$252,293
Value of total assets at end of year2020-12-31$3,847,544
Value of total assets at beginning of year2020-12-31$3,367,215
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,672
Total interest from all sources2020-12-31$8,350
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$625
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$235,221
Participant contributions at end of year2020-12-31$140,619
Participant contributions at beginning of year2020-12-31$205,455
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$743
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$17,072
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$480,329
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,847,544
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,367,215
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,706,361
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,160,945
Interest on participant loans2020-12-31$8,331
Interest earned on other investments2020-12-31$19
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$564
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$72
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$72
Net investment gain/loss from pooled separate accounts2020-12-31$480,861
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Employer contributions (assets) at end of year2020-12-31$0
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$241,793
Contract administrator fees2020-12-31$1,047
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31MAYER HOFFMAN MCCANN
Accountancy firm EIN2020-12-31431947695
2019 : HAVEN HEALTH 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,794
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$9,794
Total income from all sources (including contributions)2019-12-31$893,034
Total income from all sources (including contributions)2019-12-31$893,034
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$222,233
Total of all expenses incurred2019-12-31$222,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$197,010
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$197,010
Value of total corrective distributions2019-12-31$9,952
Value of total corrective distributions2019-12-31$9,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$325,205
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$325,205
Value of total assets at end of year2019-12-31$3,367,215
Value of total assets at end of year2019-12-31$3,367,215
Value of total assets at beginning of year2019-12-31$2,706,208
Value of total assets at beginning of year2019-12-31$2,706,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$15,271
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$15,271
Total interest from all sources2019-12-31$11,096
Total interest from all sources2019-12-31$11,096
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$224,603
Contributions received from participants2019-12-31$224,603
Participant contributions at end of year2019-12-31$205,455
Participant contributions at end of year2019-12-31$205,455
Participant contributions at beginning of year2019-12-31$224,278
Participant contributions at beginning of year2019-12-31$224,278
Participant contributions at end of year2019-12-31$743
Participant contributions at end of year2019-12-31$743
Participant contributions at beginning of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$100,602
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$100,602
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$9,794
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$9,794
Administrative expenses (other) incurred2019-12-31$13,869
Administrative expenses (other) incurred2019-12-31$13,869
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$670,801
Value of net income/loss2019-12-31$670,801
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,367,215
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,367,215
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,696,414
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,696,414
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,160,945
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,160,945
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,468,245
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,468,245
Interest on participant loans2019-12-31$11,096
Interest on participant loans2019-12-31$11,096
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$72
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$72
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$7,890
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$7,890
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$7,890
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$7,890
Net investment gain/loss from pooled separate accounts2019-12-31$556,733
Net investment gain/loss from pooled separate accounts2019-12-31$556,733
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$5,795
Employer contributions (assets) at beginning of year2019-12-31$5,795
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$197,010
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$197,010
Contract administrator fees2019-12-31$1,402
Contract administrator fees2019-12-31$1,402
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MAYER HOFFMAN MCCANN
Accountancy firm name2019-12-31MAYER HOFFMAN MCCANN
Accountancy firm EIN2019-12-31431947695
Accountancy firm EIN2019-12-31431947695
2018 : HAVEN HEALTH 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$9,794
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$9,794
Total income from all sources (including contributions)2018-12-31$409,754
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$127,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$101,759
Value of total corrective distributions2018-12-31$15,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$567,988
Value of total assets at end of year2018-12-31$2,706,208
Value of total assets at beginning of year2018-12-31$2,423,692
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$10,444
Total interest from all sources2018-12-31$13,412
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$240,153
Participant contributions at end of year2018-12-31$224,278
Participant contributions at beginning of year2018-12-31$274,307
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$327,648
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$9,794
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$9,794
Administrative expenses (other) incurred2018-12-31$9,522
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$282,516
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,696,414
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,413,898
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 registered invesment companies (eg mutual funds) at end of year2018-12-31$2,468,245
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,128,182
Interest on participant loans2018-12-31$13,412
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$7,890
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$15,408
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$15,408
Net investment gain/loss from pooled separate accounts2018-12-31$-171,646
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$187
Employer contributions (assets) at end of year2018-12-31$5,795
Employer contributions (assets) at beginning of year2018-12-31$5,795
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$101,759
Contract administrator fees2018-12-31$922
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 name2018-12-31MAYER HOFFMAN MCCANN
Accountancy firm EIN2018-12-31431947695
2017 : HAVEN HEALTH 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$9,794
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$9,794
Total income from all sources (including contributions)2017-12-31$562,869
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$99,827
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$88,979
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$242,130
Value of total assets at end of year2017-12-31$2,423,692
Value of total assets at beginning of year2017-12-31$1,960,650
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$10,848
Total interest from all sources2017-12-31$13,768
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$385,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$227,642
Participant contributions at end of year2017-12-31$274,307
Participant contributions at beginning of year2017-12-31$239,707
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$4,684
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$109
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$9,794
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$9,794
Administrative expenses (other) incurred2017-12-31$9,896
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$463,042
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,413,898
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,950,856
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$2,128,182
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,694,425
Interest on participant loans2017-12-31$13,768
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$15,408
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$20,614
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$20,614
Net investment gain/loss from pooled separate accounts2017-12-31$306,971
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$9,804
Employer contributions (assets) at end of year2017-12-31$5,795
Employer contributions (assets) at beginning of year2017-12-31$5,795
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$88,979
Contract administrator fees2017-12-31$952
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 name2017-12-31MAYER HOFFMAN MCCANN PC
Accountancy firm EIN2017-12-31431947695
2016 : HAVEN HEALTH 401(K) PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$9,794
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$8,586
Total income from all sources (including contributions)2016-12-31$400,292
Total of all expenses incurred2016-12-31$300,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$287,974
Value of total corrective distributions2016-12-31$7,208
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$275,284
Value of total assets at end of year2016-12-31$1,960,650
Value of total assets at beginning of year2016-12-31$1,859,749
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$5,417
Total interest from all sources2016-12-31$9,317
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$375,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$231,233
Participant contributions at end of year2016-12-31$239,707
Participant contributions at beginning of year2016-12-31$124,083
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$921
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$109
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$9,794
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$2,586
Administrative expenses (other) incurred2016-12-31$4,705
Liabilities. Value of operating payables at beginning of year2016-12-31$6,000
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$99,693
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,950,856
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,851,163
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$1,694,425
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,709,578
Interest on participant loans2016-12-31$9,208
Interest earned on other investments2016-12-31$109
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$20,614
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$23,237
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$23,237
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$115,691
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$43,130
Employer contributions (assets) at end of year2016-12-31$5,795
Employer contributions (assets) at beginning of year2016-12-31$2,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$287,974
Contract administrator fees2016-12-31$712
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 name2016-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2016-12-31431947695
2015 : HAVEN HEALTH 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$6,000
Total income from all sources (including contributions)2015-12-31$288,188
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$499,302
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$503,684
Value of total corrective distributions2015-12-31$-117
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$305,081
Value of total assets at end of year2015-12-31$1,856,896
Value of total assets at beginning of year2015-12-31$2,074,010
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$-4,265
Total interest from all sources2015-12-31$5,872
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$221,408
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$193,290
Participant contributions at end of year2015-12-31$124,082
Participant contributions at beginning of year2015-12-31$162,263
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$1,112
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$73,361
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$2,586
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Liabilities. Value of operating payables at end of year2015-12-31$0
Liabilities. Value of operating payables at beginning of year2015-12-31$6,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-211,114
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,856,896
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,068,010
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,709,578
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,890,999
Interest on participant loans2015-12-31$5,872
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$23,236
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$19,119
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$19,119
Net investment gain/loss from pooled separate accounts2015-12-31$-22,765
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$38,430
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$517
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$503,684
Contract administrator fees2015-12-31$-4,265
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 name2015-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2015-12-31431947695
2014 : HAVEN HEALTH 401(K) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$6,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$9,363
Total income from all sources (including contributions)2014-12-31$285,246
Total of all expenses incurred2014-12-31$431,312
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$421,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$177,894
Value of total assets at end of year2014-12-31$2,074,010
Value of total assets at beginning of year2014-12-31$2,223,439
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$9,778
Total interest from all sources2014-12-31$5,387
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$221,408
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$150,544
Participant contributions at end of year2014-12-31$162,263
Participant contributions at beginning of year2014-12-31$99,318
Participant contributions at end of year2014-12-31$1,112
Liabilities. Value of operating payables at end of year2014-12-31$6,000
Liabilities. Value of operating payables at beginning of year2014-12-31$9,363
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-146,066
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,068,010
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,214,076
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,890,999
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,097,206
Interest on participant loans2014-12-31$5,387
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$19,119
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$26,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$26,915
Net investment gain/loss from pooled separate accounts2014-12-31$101,965
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$27,350
Employer contributions (assets) at end of year2014-12-31$517
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$421,534
Contract administrator fees2014-12-31$9,778
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 name2014-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2014-12-31431947695
2013 : HAVEN HEALTH 401(K) PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$9,363
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$10,518
Total income from all sources (including contributions)2013-12-31$492,628
Total of all expenses incurred2013-12-31$70,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$49,750
Value of total corrective distributions2013-12-31$1,125
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$236,510
Value of total assets at end of year2013-12-31$2,223,439
Value of total assets at beginning of year2013-12-31$1,802,033
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$19,192
Total interest from all sources2013-12-31$3,487
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$8,000
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$179,152
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$174,804
Participant contributions at end of year2013-12-31$99,318
Participant contributions at beginning of year2013-12-31$68,853
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$20,531
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$10,518
Administrative expenses (other) incurred2013-12-31$52
Liabilities. Value of operating payables at end of year2013-12-31$9,363
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$422,561
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,214,076
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,791,515
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
Investment advisory and management fees2013-12-31$652
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,097,206
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,682,470
Interest on participant loans2013-12-31$3,487
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$26,915
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$21,883
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$21,883
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$252,631
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$61,706
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$8,296
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$49,750
Contract administrator fees2013-12-31$10,488
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 name2013-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2013-12-31431947695
2012 : HAVEN HEALTH 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$10,518
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$523,408
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$82,850
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$45,776
Value of total corrective distributions2012-12-31$35,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$370,741
Value of total assets at end of year2012-12-31$1,802,033
Value of total assets at beginning of year2012-12-31$1,350,957
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,610
Total interest from all sources2012-12-31$3,118
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$150,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$228,584
Participant contributions at end of year2012-12-31$68,853
Participant contributions at beginning of year2012-12-31$83,301
Participant contributions at end of year2012-12-31$20,531
Participant contributions at beginning of year2012-12-31$33,112
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$10,518
Administrative expenses (other) incurred2012-12-31$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$440,558
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,791,515
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,350,957
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$1,682,470
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,211,532
Interest on participant loans2012-12-31$3,118
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$21,883
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$13,848
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$13,848
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
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 contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$142,157
Employer contributions (assets) at end of year2012-12-31$8,296
Employer contributions (assets) at beginning of year2012-12-31$9,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$45,776
Contract administrator fees2012-12-31$1,588
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 name2012-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2012-12-31431947695

Form 5500 Responses for HAVEN HEALTH 401(K) PLAN

2022: HAVEN HEALTH 401(K) PLAN 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: HAVEN HEALTH 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HAVEN HEALTH 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HAVEN HEALTH 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HAVEN HEALTH 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HAVEN HEALTH 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HAVEN HEALTH 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HAVEN HEALTH 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HAVEN HEALTH 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HAVEN HEALTH 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HAVEN HEALTH 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered101
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,846
Total amount of fees paid to insurance companyUSD $1,897
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,846
Insurance broker organization code?3
Amount paid for insurance broker fees1897
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered89
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,535
Total amount of fees paid to insurance companyUSD $2,037
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,535
Insurance broker organization code?3
Amount paid for insurance broker fees2037
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered106
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $12,521
Total amount of fees paid to insurance companyUSD $1,646
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,521
Insurance broker organization code?3
Amount paid for insurance broker fees1646
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered177
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,409
Total amount of fees paid to insurance companyUSD $1,534
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,409
Insurance broker organization code?3
Amount paid for insurance broker fees1534
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered116
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,997
Total amount of fees paid to insurance companyUSD $10,912
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,997
Insurance broker organization code?3
Amount paid for insurance broker fees9679
Additional information about fees paid to insurance brokerTHIRD PARTY ADMIN SERVICES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered117
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,501
Total amount of fees paid to insurance companyUSD $10,874
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10874
Additional information about fees paid to insurance brokerTHIRD PARTY ADMIN SERVICES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $7,501
Insurance broker nameNPB FINANCIAL GROUP
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered93
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,704
Total amount of fees paid to insurance companyUSD $910
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,704
Insurance broker organization code?4
Amount paid for insurance broker fees910
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE, SUBSCRIPTIONS, WEBINARS
Insurance broker nameQBI, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered87
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,134
Total amount of fees paid to insurance companyUSD $1,134
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,134
Insurance broker organization code?4
Amount paid for insurance broker fees1134
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE, SUBSCRIPTIONS, WEBINARS
Insurance broker nameSTRATEGIC PENSION SERVICES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered89
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,536
Total amount of fees paid to insurance companyUSD $1,014
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,536
Insurance broker organization code?3
Amount paid for insurance broker fees1014
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE, SUBSCRIPTIONS, WEBINARS
Insurance broker nameSTRATEGIC PENSION SERVICES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number103686
Policy instance 1
Insurance contract or identification number103686
Number of Individuals Covered82
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,099
Total amount of fees paid to insurance companyUSD $5,580
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,099
Insurance broker organization code?3
Amount paid for insurance broker fees5580
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE, SUBSCRIPTIONS WEBINARS
Insurance broker nameSTRATEGIC PENSION SERVICES, INC.

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