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CAPSTONE FACILITIES 401(K) PLAN 401k Plan overview

Plan NameCAPSTONE FACILITIES 401(K) PLAN
Plan identification number 001

CAPSTONE FACILITIES 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.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CAPSTONE MANAGEMENT LLC has sponsored the creation of one or more 401k plans.

Company Name:CAPSTONE MANAGEMENT LLC
Employer identification number (EIN):383943640
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAPSTONE FACILITIES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-07-01

Plan Statistics for CAPSTONE FACILITIES 401(K) PLAN

401k plan membership statisitcs for CAPSTONE FACILITIES 401(K) PLAN

Measure Date Value
2022: CAPSTONE FACILITIES 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01261
Total number of active participants reported on line 7a of the Form 55002022-01-01311
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-012
Total of all active and inactive participants2022-01-01313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01313
Number of participants with account balances2022-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CAPSTONE FACILITIES 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01275
Total number of active participants reported on line 7a of the Form 55002021-01-01215
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-018
Total of all active and inactive participants2021-01-01224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01224
Number of participants with account balances2021-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: CAPSTONE FACILITIES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-010
Total number of active participants reported on line 7a of the Form 55002020-07-01218
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0110
Total of all active and inactive participants2020-07-01228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01228
Number of participants with account balances2020-07-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-010

Financial Data on CAPSTONE FACILITIES 401(K) PLAN

Measure Date Value
2022 : CAPSTONE FACILITIES 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$97,357
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$31,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$26,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$152,695
Value of total assets at end of year2022-12-31$322,323
Value of total assets at beginning of year2022-12-31$256,388
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$5,185
Total interest from all sources2022-12-31$0
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$90,000
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$145,450
Participant contributions at end of year2022-12-31$798
Participant contributions at beginning of year2022-12-31$4,678
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$7,113
Other income not declared elsewhere2022-12-31$10
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$65,935
Value of net assets at end of year (total assets less liabilities)2022-12-31$322,323
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$256,388
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$320,942
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$251,225
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$485
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-55,348
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$26,237
Contract administrator fees2022-12-31$5,185
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 name2022-12-31EIDE BAILLY LLP
Accountancy firm EIN2022-12-31450250958
2021 : CAPSTONE FACILITIES 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$152,715
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$14,468
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$10,828
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$132,425
Value of total assets at end of year2021-12-31$256,388
Value of total assets at beginning of year2021-12-31$118,141
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$3,640
Total interest from all sources2021-12-31$0
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$90,000
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$107,922
Participant contributions at end of year2021-12-31$4,678
Participant contributions at beginning of year2021-12-31$1,396
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$24,503
Other income not declared elsewhere2021-12-31$9
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$138,247
Value of net assets at end of year (total assets less liabilities)2021-12-31$256,388
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$118,141
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$251,225
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$114,636
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$2,109
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$20,281
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$10,828
Contract administrator fees2021-12-31$3,640
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 name2021-12-31BERGANKDV, LTD
Accountancy firm EIN2021-12-31411431613
2020 : CAPSTONE FACILITIES 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$118,966
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$105,963
Value of total assets at end of year2020-12-31$118,141
Value of total assets at beginning of year2020-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$825
Total interest from all sources2020-12-31$0
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$90,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$49,486
Participant contributions at end of year2020-12-31$1,396
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$56,477
Other income not declared elsewhere2020-12-31$7
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$118,141
Value of net assets at end of year (total assets less liabilities)2020-12-31$118,141
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$0
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$114,636
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$2,109
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$12,996
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
Contract administrator fees2020-12-31$825
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

Form 5500 Responses for CAPSTONE FACILITIES 401(K) PLAN

2022: CAPSTONE FACILITIES 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulitple 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: CAPSTONE FACILITIES 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulitple 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: CAPSTONE FACILITIES 401(K) PLAN 2020 form 5500 responses
2020-07-01Type of plan entityMulitple employer plan
2020-07-01First time form 5500 has been submittedYes
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number438-80098
Policy instance 1
Insurance contract or identification number438-80098
Number of Individuals Covered54
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?Yes
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 number438-80098
Policy instance 1
Insurance contract or identification number438-80098
Number of Individuals Covered61
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?Yes
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 number438-80098
Policy instance 1
Insurance contract or identification number438-80098
Number of Individuals Covered55
Insurance policy start date2020-07-01
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?Yes
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

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