401k Plan data: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST plan

PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 401k Plan overview

Plan Name	PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST
Plan identification number	001

PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

PRIME CARE RESOURCE, INC. has sponsored the creation of one or more 401k plans.

Company Name: PRIME CARE RESOURCE, INC.

Employer identification number (EIN): 363941174

NAIC Classification: 541800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 CORAZON MONZON 2023-07-13
001 2021-01-01 CORAZON MONZON 2022-05-10
001 2020-01-01
001 2018-01-01 CORAZON MONZON 2019-10-15
001 2017-01-01 CORAZON MONZON 2018-10-12
001 2016-01-01 CORAZON MONZON 2017-10-12
001 2016-01-01 CORAZON MONZON 2018-01-04
001 2015-01-01 CORAZON MONZON 2016-10-13
001 2014-01-01 CORAZON MONZON 2015-10-13
001 2013-01-01 CORAZON MONZON 2014-09-23
001 2012-01-01 CORAZON MONZON 2013-11-21
001 2011-01-01 CORAZON MONZON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	CORAZON MONZON	2023-07-13
001	2021-01-01	CORAZON MONZON	2022-05-10
001	2020-01-01
001	2018-01-01	CORAZON MONZON	2019-10-15
001	2017-01-01	CORAZON MONZON	2018-10-12
001	2016-01-01	CORAZON MONZON	2017-10-12
001	2016-01-01	CORAZON MONZON	2018-01-04
001	2015-01-01	CORAZON MONZON	2016-10-13
001	2014-01-01	CORAZON MONZON	2015-10-13
001	2013-01-01	CORAZON MONZON	2014-09-23
001	2012-01-01	CORAZON MONZON	2013-11-21
001	2011-01-01	CORAZON MONZON

Plan Statistics for PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST

401k plan membership statisitcs for PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST

Measure Date Value
2020: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 21
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 2
Total of all active and inactive participants 2020-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 23
Number of participants with account balances 2020-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2011: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 13
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 9
Total of all active and inactive participants 2011-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 22
Number of participants with account balances 2011-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2020: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	21
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	2
Total of all active and inactive participants	2020-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	23
Number of participants with account balances	2020-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2011: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	13
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	9
Total of all active and inactive participants	2011-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	22
Number of participants with account balances	2011-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST

Measure	Date	Value
2020 : PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$150,130
Expenses. Total of all expenses incurred	2020-12-31	$46,171
Benefits paid (including direct rollovers)	2020-12-31	$45,000
Total plan assets at end of year	2020-12-31	$1,118,882
Total plan assets at beginning of year	2020-12-31	$1,014,923
Value of fidelity bond covering the plan	2020-12-31	$0
Total contributions received or receivable from participants	2020-12-31	$55,396
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$83,120
Net income (gross income less expenses)	2020-12-31	$103,959
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,118,882
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,014,923
Assets. Value of participant loans	2020-12-31	$471
Total contributions received or receivable from employer(s)	2020-12-31	$11,614
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$1,171
2011 : PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$92,496
Expenses. Total of all expenses incurred	2011-12-31	$100
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$701,887
Total plan assets at beginning of year	2011-12-31	$609,491
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$95,168
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-19,793
Net income (gross income less expenses)	2011-12-31	$92,396
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$701,887
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$609,491
Assets. Value of participant loans	2011-12-31	$1,311
Total contributions received or receivable from employer(s)	2011-12-31	$17,121
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$100

Form 5500 Responses for PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST

2020: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2011: PRIME CARE RESOURCE, INC. 401(K) PLAN & TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

939372

Policy instance

Insurance contract or identification number	939372
Number of Individuals Covered	21
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,006
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PRIME CARE RESOURCE, INC.
Employer identification number (EIN):	363941174
NAIC Classification:	541800