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GENESIS HEALTHCARE SYSTEM 401(K) PLAN 401k Plan overview

Plan NameGENESIS HEALTHCARE SYSTEM 401(K) PLAN
Plan identification number 003

GENESIS HEALTHCARE SYSTEM 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GENESIS HEALTHCARE SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:GENESIS HEALTHCARE SYSTEM
Employer identification number (EIN):311480941
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about GENESIS HEALTHCARE SYSTEM

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1996-09-20
Company Identification Number: 953587
Legal Registered Office Address: 2951 MAPLE AVE
-
ZANESVILLE
United States of America (USA)
43701

More information about GENESIS HEALTHCARE SYSTEM

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GENESIS HEALTHCARE SYSTEM 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01TERRY WILSON2023-10-13
0032021-01-01TERRY WILSON2022-10-13
0032020-01-01TERRY WILSON2021-10-13
0032019-01-01TERRY WILSON2020-10-14
0032018-01-01TERRY WILSON2019-10-15
0032017-01-01TERRY WILSON TERRY WILSON2018-10-15
0032016-01-01MARTHA NASH
0032015-01-01MARTHA NASH
0032014-01-01MARTHA NASH
0032014-01-01MARTHA NASH
0032013-01-01MARTHA NASH
0032012-01-01MARTHA NASH
0032011-01-01JEFF ROBINSON
0032009-01-01 JEFF ROBINSON2010-10-16
0032009-01-01JEFF ROBINSON

Plan Statistics for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

401k plan membership statisitcs for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

Measure Date Value
2022: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01946
Total number of active participants reported on line 7a of the Form 55002022-01-01856
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-01150
Total of all active and inactive participants2022-01-011,007
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,007
Number of participants with account balances2022-01-011,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01847
Total number of active participants reported on line 7a of the Form 55002021-01-01794
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-01151
Total of all active and inactive participants2021-01-01946
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01946
Number of participants with account balances2021-01-01946
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01766
Total number of active participants reported on line 7a of the Form 55002020-01-01740
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-01106
Total of all active and inactive participants2020-01-01847
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01847
Number of participants with account balances2020-01-01847
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01631
Total number of active participants reported on line 7a of the Form 55002019-01-01683
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0182
Total of all active and inactive participants2019-01-01766
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01766
Number of participants with account balances2019-01-01766
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01541
Total number of active participants reported on line 7a of the Form 55002018-01-01541
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0188
Total of all active and inactive participants2018-01-01631
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01631
Number of participants with account balances2018-01-01631
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01514
Total number of active participants reported on line 7a of the Form 55002017-01-01496
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-0180
Total of all active and inactive participants2017-01-01578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01578
Number of participants with account balances2017-01-01578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01481
Total number of active participants reported on line 7a of the Form 55002016-01-01456
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-0156
Total of all active and inactive participants2016-01-01514
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01514
Number of participants with account balances2016-01-01514
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01400
Total number of active participants reported on line 7a of the Form 55002015-01-01419
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0160
Total of all active and inactive participants2015-01-01481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01481
Number of participants with account balances2015-01-01481
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01338
Total number of active participants reported on line 7a of the Form 55002014-01-01355
Number of retired or separated participants receiving benefits2014-01-012
Number of other retired or separated participants entitled to future benefits2014-01-0143
Total of all active and inactive participants2014-01-01400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01400
Number of participants with account balances2014-01-01400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01289
Total number of active participants reported on line 7a of the Form 55002013-01-01306
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0131
Total of all active and inactive participants2013-01-01338
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01338
Number of participants with account balances2013-01-01338
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01228
Total number of active participants reported on line 7a of the Form 55002012-01-01268
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-0120
Total of all active and inactive participants2012-01-01289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01289
Number of participants with account balances2012-01-01289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01180
Total number of active participants reported on line 7a of the Form 55002011-01-01215
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-0112
Total of all active and inactive participants2011-01-01228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01228
Number of participants with account balances2011-01-01228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01178
Total number of active participants reported on line 7a of the Form 55002009-01-01161
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0117
Total of all active and inactive participants2009-01-01178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01179
Number of participants with account balances2009-01-01179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GENESIS HEALTHCARE SYSTEM 401(K) PLAN

Measure Date Value
2022 : GENESIS HEALTHCARE SYSTEM 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$490,843
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,197,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,083,586
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$3,853,062
Value of total assets at end of year2022-12-31$25,739,289
Value of total assets at beginning of year2022-12-31$26,445,504
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$113,472
Total interest from all sources2022-12-31$419,126
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$2,000,000
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$2,911,121
Participant contributions at end of year2022-12-31$364,635
Participant contributions at beginning of year2022-12-31$230,138
Participant contributions at end of year2022-12-31$98,110
Participant contributions at beginning of year2022-12-31$89,086
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$366,505
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-706,215
Value of net assets at end of year (total assets less liabilities)2022-12-31$25,739,289
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$26,445,504
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$14,259,425
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$15,414,735
Value of interest in pooled separate accounts at end of year2022-12-31$2,223,852
Value of interest in pooled separate accounts at beginning of year2022-12-31$2,027,174
Interest on participant loans2022-12-31$12,834
Interest earned on other investments2022-12-31$406,292
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$8,772,137
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$8,665,112
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-3,538,674
Net investment gain/loss from pooled separate accounts2022-12-31$-242,671
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$575,436
Employer contributions (assets) at end of year2022-12-31$21,130
Employer contributions (assets) at beginning of year2022-12-31$19,259
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,083,586
Contract administrator fees2022-12-31$113,472
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 name2022-12-31REA & ASSOCIATES
Accountancy firm EIN2022-12-31341310124
2021 : GENESIS HEALTHCARE SYSTEM 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$6,006,228
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$945,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$838,900
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,397,977
Value of total assets at end of year2021-12-31$26,445,504
Value of total assets at beginning of year2021-12-31$21,384,311
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$106,135
Total interest from all sources2021-12-31$373,442
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$2,000,000
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$2,607,261
Participant contributions at end of year2021-12-31$230,138
Participant contributions at beginning of year2021-12-31$280,214
Participant contributions at end of year2021-12-31$89,086
Participant contributions at beginning of year2021-12-31$84,171
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$272,289
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$5,061,193
Value of net assets at end of year (total assets less liabilities)2021-12-31$26,445,504
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$21,384,311
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$15,414,735
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$12,106,659
Value of interest in pooled separate accounts at end of year2021-12-31$2,027,174
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,423,210
Interest on participant loans2021-12-31$10,624
Interest earned on other investments2021-12-31$362,818
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$8,665,112
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$7,472,080
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$2,030,872
Net investment gain/loss from pooled separate accounts2021-12-31$203,937
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$518,427
Employer contributions (assets) at end of year2021-12-31$19,259
Employer contributions (assets) at beginning of year2021-12-31$17,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$838,900
Contract administrator fees2021-12-31$106,135
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 name2021-12-31REA & ASSOCIATES
Accountancy firm EIN2021-12-31341310124
2020 : GENESIS HEALTHCARE SYSTEM 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$5,972,637
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$859,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$782,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,064,129
Value of total assets at end of year2020-12-31$21,384,311
Value of total assets at beginning of year2020-12-31$16,271,195
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$77,045
Total interest from all sources2020-12-31$303,668
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$2,000,000
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$2,263,682
Participant contributions at end of year2020-12-31$280,214
Participant contributions at beginning of year2020-12-31$264,689
Participant contributions at end of year2020-12-31$84,171
Participant contributions at beginning of year2020-12-31$80,089
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$351,190
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$5,113,116
Value of net assets at end of year (total assets less liabilities)2020-12-31$21,384,311
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,271,195
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$12,106,659
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$8,939,403
Value of interest in pooled separate accounts at end of year2020-12-31$1,423,210
Value of interest in pooled separate accounts at beginning of year2020-12-31$952,275
Interest on participant loans2020-12-31$13,976
Interest earned on other investments2020-12-31$289,692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$7,472,080
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$6,019,405
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,469,983
Net investment gain/loss from pooled separate accounts2020-12-31$134,857
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$449,257
Employer contributions (assets) at end of year2020-12-31$17,977
Employer contributions (assets) at beginning of year2020-12-31$15,334
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$782,476
Contract administrator fees2020-12-31$77,045
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31REA & ASSOCIATES
Accountancy firm EIN2020-12-31341310124
2019 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,605,302
Total income from all sources (including contributions)2019-12-31$4,605,302
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$610,971
Total of all expenses incurred2019-12-31$610,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$547,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$547,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,373,319
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$2,373,319
Value of total assets at end of year2019-12-31$16,271,195
Value of total assets at end of year2019-12-31$16,271,195
Value of total assets at beginning of year2019-12-31$12,276,864
Value of total assets at beginning of year2019-12-31$12,276,864
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$63,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$63,934
Total interest from all sources2019-12-31$259,583
Total interest from all sources2019-12-31$259,583
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
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$2,000,000
Value of fidelity bond cover2019-12-31$2,000,000
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$1,860,739
Contributions received from participants2019-12-31$1,860,739
Participant contributions at end of year2019-12-31$264,689
Participant contributions at end of year2019-12-31$264,689
Participant contributions at beginning of year2019-12-31$227,286
Participant contributions at beginning of year2019-12-31$227,286
Participant contributions at end of year2019-12-31$80,089
Participant contributions at end of year2019-12-31$80,089
Participant contributions at beginning of year2019-12-31$13,245
Participant contributions at beginning of year2019-12-31$13,245
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$141,384
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$141,384
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$3,994,331
Value of net income/loss2019-12-31$3,994,331
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,271,195
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,271,195
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$12,276,864
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$12,276,864
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 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$8,939,403
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$8,939,403
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,737,328
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$6,737,328
Value of interest in pooled separate accounts at end of year2019-12-31$952,275
Value of interest in pooled separate accounts at end of year2019-12-31$952,275
Value of interest in pooled separate accounts at beginning of year2019-12-31$559,622
Value of interest in pooled separate accounts at beginning of year2019-12-31$559,622
Interest on participant loans2019-12-31$14,004
Interest on participant loans2019-12-31$14,004
Interest earned on other investments2019-12-31$245,579
Interest earned on other investments2019-12-31$245,579
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$6,019,405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$6,019,405
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,679,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,679,589
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,880,179
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,880,179
Net investment gain/loss from pooled separate accounts2019-12-31$92,221
Net investment gain/loss from pooled separate accounts2019-12-31$92,221
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
Contributions received in cash from employer2019-12-31$371,196
Contributions received in cash from employer2019-12-31$371,196
Employer contributions (assets) at end of year2019-12-31$15,334
Employer contributions (assets) at end of year2019-12-31$15,334
Employer contributions (assets) at beginning of year2019-12-31$59,794
Employer contributions (assets) at beginning of year2019-12-31$59,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$547,037
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$547,037
Contract administrator fees2019-12-31$63,934
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
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 name2019-12-31REA & ASSOCIATES
Accountancy firm name2019-12-31REA & ASSOCIATES
Accountancy firm EIN2019-12-31341310124
Accountancy firm EIN2019-12-31341310124
2018 : GENESIS HEALTHCARE SYSTEM 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,283,865
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,180,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,177,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,844,301
Value of total assets at end of year2018-12-31$12,276,864
Value of total assets at beginning of year2018-12-31$12,173,744
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$3,211
Total interest from all sources2018-12-31$219,974
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$2,000,000
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$1,428,528
Participant contributions at end of year2018-12-31$227,286
Participant contributions at beginning of year2018-12-31$123,234
Participant contributions at end of year2018-12-31$13,245
Participant contributions at beginning of year2018-12-31$10,835
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$95,697
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$103,120
Value of net assets at end of year (total assets less liabilities)2018-12-31$12,276,864
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$12,173,744
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$6,737,328
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$6,574,279
Value of interest in pooled separate accounts at end of year2018-12-31$559,622
Value of interest in pooled separate accounts at beginning of year2018-12-31$483,388
Interest on participant loans2018-12-31$8,121
Interest earned on other investments2018-12-31$211,853
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$4,679,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$4,934,569
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-753,329
Net investment gain/loss from pooled separate accounts2018-12-31$-27,081
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$320,076
Employer contributions (assets) at end of year2018-12-31$59,794
Employer contributions (assets) at beginning of year2018-12-31$47,439
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,177,534
Contract administrator fees2018-12-31$3,211
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 name2018-12-31REA & ASSOCIATES
Accountancy firm EIN2018-12-31341310124
2017 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$2,976,610
Total of all expenses incurred2017-12-31$1,058,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,055,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,572,512
Value of total assets at end of year2017-12-31$12,173,744
Value of total assets at beginning of year2017-12-31$10,255,204
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,227
Total interest from all sources2017-12-31$140,813
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$58,655
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$58,655
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$2,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,182,060
Participant contributions at end of year2017-12-31$123,234
Participant contributions at beginning of year2017-12-31$138,383
Participant contributions at end of year2017-12-31$10,835
Participant contributions at beginning of year2017-12-31$9,213
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$116,375
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$1,918,540
Value of net assets at end of year (total assets less liabilities)2017-12-31$12,173,744
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$10,255,204
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$6,574,279
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$5,472,631
Value of interest in pooled separate accounts at end of year2017-12-31$483,388
Value of interest in pooled separate accounts at beginning of year2017-12-31$397,111
Interest on participant loans2017-12-31$5,882
Interest earned on other investments2017-12-31$134,931
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$4,934,569
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$4,196,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,148,317
Net investment gain/loss from pooled separate accounts2017-12-31$56,313
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$274,077
Employer contributions (assets) at end of year2017-12-31$47,439
Employer contributions (assets) at beginning of year2017-12-31$41,728
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,055,843
Contract administrator fees2017-12-31$2,227
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 name2017-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2017-12-31311038077
2016 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$1,991,860
Total of all expenses incurred2016-12-31$454,579
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$452,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,368,748
Value of total assets at end of year2016-12-31$10,255,204
Value of total assets at beginning of year2016-12-31$8,717,923
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,121
Total interest from all sources2016-12-31$121,271
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$50,612
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$50,612
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$2,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,030,933
Participant contributions at end of year2016-12-31$138,383
Participant contributions at beginning of year2016-12-31$120,976
Participant contributions at end of year2016-12-31$9,213
Participant contributions at beginning of year2016-12-31$8,019
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$108,933
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$1,537,281
Value of net assets at end of year (total assets less liabilities)2016-12-31$10,255,204
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$8,717,923
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$5,472,631
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$4,541,427
Value of interest in pooled separate accounts at end of year2016-12-31$397,111
Value of interest in pooled separate accounts at beginning of year2016-12-31$336,575
Interest on participant loans2016-12-31$5,169
Interest earned on other investments2016-12-31$116,102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$4,196,138
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$3,676,549
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$436,468
Net investment gain/loss from pooled separate accounts2016-12-31$14,761
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$228,882
Employer contributions (assets) at end of year2016-12-31$41,728
Employer contributions (assets) at beginning of year2016-12-31$34,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$452,458
Contract administrator fees2016-12-31$2,121
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 name2016-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2016-12-31311038077
2015 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 401k financial data
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$894
Total income from all sources (including contributions)2015-12-31$1,383,011
Total of all expenses incurred2015-12-31$340,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$338,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,169,079
Value of total assets at end of year2015-12-31$8,717,923
Value of total assets at beginning of year2015-12-31$7,675,895
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,715
Total interest from all sources2015-12-31$107,870
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$54,127
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$54,127
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$2,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$886,458
Participant contributions at end of year2015-12-31$120,976
Participant contributions at beginning of year2015-12-31$121,451
Participant contributions at end of year2015-12-31$8,019
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$83,471
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$894
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$1,042,922
Value of net assets at end of year (total assets less liabilities)2015-12-31$8,717,923
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$7,675,001
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$4,541,427
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,915,384
Value of interest in pooled separate accounts at end of year2015-12-31$336,575
Value of interest in pooled separate accounts at beginning of year2015-12-31$321,843
Interest on participant loans2015-12-31$4,870
Interest earned on other investments2015-12-31$103,000
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$3,676,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$3,317,217
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$58,310
Net investment gain/loss from pooled separate accounts2015-12-31$-6,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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$199,150
Employer contributions (assets) at end of year2015-12-31$34,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$338,374
Contract administrator fees2015-12-31$1,715
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 name2015-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2015-12-31311038077
2014 : GENESIS HEALTHCARE SYSTEM 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$894
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$9,906
Total income from all sources (including contributions)2014-12-31$1,308,717
Total of all expenses incurred2014-12-31$774,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$772,592
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$966,460
Value of total assets at end of year2014-12-31$7,675,895
Value of total assets at beginning of year2014-12-31$7,150,424
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,642
Total interest from all sources2014-12-31$96,695
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$38,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$38,634
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$689,164
Participant contributions at end of year2014-12-31$121,451
Participant contributions at beginning of year2014-12-31$125,560
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$109,121
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$894
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$9,906
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$534,483
Value of net assets at end of year (total assets less liabilities)2014-12-31$7,675,001
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$7,140,518
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$3,915,384
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,782,630
Value of interest in pooled separate accounts at end of year2014-12-31$321,843
Value of interest in pooled separate accounts at beginning of year2014-12-31$273,171
Interest on participant loans2014-12-31$5,419
Interest earned on other investments2014-12-31$91,276
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$3,317,217
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$2,969,063
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$196,784
Net investment gain/loss from pooled separate accounts2014-12-31$10,144
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$168,175
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$772,592
Contract administrator fees2014-12-31$1,642
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 name2014-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2014-12-31311038077
2013 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$9,906
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$5,718
Total income from all sources (including contributions)2013-12-31$1,831,448
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$160,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$159,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$902,405
Value of total assets at end of year2013-12-31$7,150,424
Value of total assets at beginning of year2013-12-31$5,475,747
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,888
Total interest from all sources2013-12-31$85,682
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$31,665
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$31,665
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$2,000,000
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$630,115
Participant contributions at end of year2013-12-31$125,560
Participant contributions at beginning of year2013-12-31$95,059
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$135,751
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$9,906
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$5,718
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$1,670,489
Value of net assets at end of year (total assets less liabilities)2013-12-31$7,140,518
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$5,470,029
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,782,630
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,627,460
Value of interest in pooled separate accounts at end of year2013-12-31$273,171
Value of interest in pooled separate accounts at beginning of year2013-12-31$198,646
Interest on participant loans2013-12-31$4,582
Interest earned on other investments2013-12-31$81,100
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$2,969,063
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$2,554,582
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$795,889
Net investment gain/loss from pooled separate accounts2013-12-31$15,807
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$136,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$159,071
Contract administrator fees2013-12-31$1,888
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 name2013-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2013-12-31311038077
2012 : GENESIS HEALTHCARE SYSTEM 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$5,718
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$1,146,438
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$80,049
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$78,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$751,948
Value of total assets at end of year2012-12-31$5,475,747
Value of total assets at beginning of year2012-12-31$4,403,640
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,398
Total interest from all sources2012-12-31$75,602
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$27,825
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$27,825
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$2,000,000
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$464,670
Participant contributions at end of year2012-12-31$95,059
Participant contributions at beginning of year2012-12-31$103,859
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$186,448
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$5,718
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Other income not declared elsewhere2012-12-31$279,837
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$1,066,389
Value of net assets at end of year (total assets less liabilities)2012-12-31$5,470,029
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$4,403,640
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$2,627,460
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,020,748
Value of interest in pooled separate accounts at end of year2012-12-31$198,646
Value of interest in pooled separate accounts at beginning of year2012-12-31$94,079
Interest on participant loans2012-12-31$5,012
Interest earned on other investments2012-12-31$70,590
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$2,554,582
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$2,184,954
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$11,226
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$100,830
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$78,651
Contract administrator fees2012-12-31$1,398
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 name2012-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2012-12-31311038077
2011 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$473,374
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$319,260
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$318,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$448,352
Value of total assets at end of year2011-12-31$4,403,640
Value of total assets at beginning of year2011-12-31$4,249,526
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$641
Total interest from all sources2011-12-31$69,221
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$21,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$21,634
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$2,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$357,832
Participant contributions at end of year2011-12-31$103,859
Participant contributions at beginning of year2011-12-31$87,936
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,044
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$154,114
Value of net assets at end of year (total assets less liabilities)2011-12-31$4,403,640
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,249,526
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,020,748
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,952,533
Value of interest in pooled separate accounts at end of year2011-12-31$94,079
Value of interest in pooled separate accounts at beginning of year2011-12-31$66,750
Interest on participant loans2011-12-31$4,604
Interest earned on other investments2011-12-31$64,617
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$2,184,954
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$2,142,307
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-67,266
Net investment gain/loss from pooled separate accounts2011-12-31$1,433
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$88,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$318,619
Contract administrator fees2011-12-31$641
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2011-12-31311038077
2010 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$929,406
Total loss/gain on sale of assets2010-12-31$17,893
Total of all expenses incurred2010-12-31$252,461
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$251,412
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$637,717
Value of total assets at end of year2010-12-31$4,249,526
Value of total assets at beginning of year2010-12-31$3,572,581
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,049
Total interest from all sources2010-12-31$66,824
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$20,044
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$2,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$321,347
Participant contributions at end of year2010-12-31$87,936
Participant contributions at beginning of year2010-12-31$87,415
Participant contributions at beginning of year2010-12-31$3,120
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$235,630
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$676,945
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,249,526
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,572,581
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,952,533
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,466,115
Value of interest in pooled separate accounts at end of year2010-12-31$66,750
Value of interest in pooled separate accounts at beginning of year2010-12-31$90,531
Interest on participant loans2010-12-31$4,595
Interest earned on other investments2010-12-31$62,229
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$2,142,307
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$1,915,101
Net investment gain/loss from pooled separate accounts2010-12-31$186,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$80,740
Employer contributions (assets) at beginning of year2010-12-31$10,299
Income. Dividends from common stock2010-12-31$20,044
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$251,412
Contract administrator fees2010-12-31$1,049
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$17,893
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN2010-12-31311038077

Form 5500 Responses for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

2022: GENESIS HEALTHCARE SYSTEM 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: GENESIS HEALTHCARE SYSTEM 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: GENESIS HEALTHCARE SYSTEM 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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
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: GENESIS HEALTHCARE SYSTEM 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
2011: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered1007
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered946
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered6
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered847
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered6
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered766
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered6
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered626
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered578
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered6
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number007600
Policy instance 4
Insurance contract or identification number007600
Number of Individuals Covered419
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees290
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SRVCS INS AGENCY INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered419
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $7,001
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
Amount paid for insurance broker fees7001
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PROVIDER
Insurance broker organization code?3
Insurance broker nameUBS FININCIAL SRVCS INS AGENCY INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered8
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered8
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered355
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $6,205
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
Amount paid for insurance broker fees6205
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PROVIDER
Insurance broker organization code?3
Insurance broker nameUBS FININCIAL SRVCS INS AGENCY INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered306
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,673
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
Amount paid for insurance broker fees5673
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PROVIDER
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SRVCS INS AGENCY INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 1
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 3
Insurance contract or identification numberG05581
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 2
Insurance contract or identification number007600
Number of Individuals Covered268
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,881
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
Amount paid for insurance broker fees4881
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PROVIDER
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SRVCS INS AGENCY INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 1
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 3
Insurance contract or identification number007600
Number of Individuals Covered215
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,415
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBETH00OH00K1
Policy instance 3
Insurance contract or identification numberBETH00OH00K1
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG05581
Policy instance 2
Insurance contract or identification numberG05581
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number007600
Policy instance 1
Insurance contract or identification number007600
Number of Individuals Covered166
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,248
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
Amount paid for insurance broker fees4248
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?0
Insurance broker nameUBS FINANCIAL SRVCS INS AGENCY INC

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