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SKAALEN NURSING & REHAB CENTER VISION PLAN 401k Plan overview

Plan NameSKAALEN NURSING & REHAB CENTER VISION PLAN
Plan identification number 511

SKAALEN NURSING & REHAB CENTER VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision

401k Sponsoring company profile

SKAALEN NURSING AND REHABILITATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name:SKAALEN NURSING AND REHABILITATION CENTER, INC.
Employer identification number (EIN):391104331
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SKAALEN NURSING & REHAB CENTER VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112021-07-01
5112020-07-01
5112019-07-01
5112018-07-01
5112017-07-01DEBRA PUNDT DEBRA PUNDT2019-02-18
5112016-07-01DEBRA PUNDT DEBRA PUNDT2018-02-27
5112015-07-01DEBRA PUNDT DEBRA PUNDT2017-03-21
5112014-07-01DEBRA PUNDT DEBRA PUNDT2016-03-30
5112013-07-01DEBRA PUNDT DEBRA PUNDT2015-03-09

Plan Statistics for SKAALEN NURSING & REHAB CENTER VISION PLAN

401k plan membership statisitcs for SKAALEN NURSING & REHAB CENTER VISION PLAN

Measure Date Value
2021: SKAALEN NURSING & REHAB CENTER VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-0154
Total number of active participants reported on line 7a of the Form 55002021-07-010
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-010
2020: SKAALEN NURSING & REHAB CENTER VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-0166
Total number of active participants reported on line 7a of the Form 55002020-07-0154
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-0154
2019: SKAALEN NURSING & REHAB CENTER VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-0162
Total number of active participants reported on line 7a of the Form 55002019-07-0166
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-0166
2018: SKAALEN NURSING & REHAB CENTER VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-0155
Total number of active participants reported on line 7a of the Form 55002018-07-0162
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-0162
2017: SKAALEN NURSING & REHAB CENTER VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-0156
Total number of active participants reported on line 7a of the Form 55002017-07-0155
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-0155
2016: SKAALEN NURSING & REHAB CENTER VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0157
Total number of active participants reported on line 7a of the Form 55002016-07-0156
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0156
2015: SKAALEN NURSING & REHAB CENTER VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0167
Total number of active participants reported on line 7a of the Form 55002015-07-0157
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0157
2014: SKAALEN NURSING & REHAB CENTER VISION PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0166
Total number of active participants reported on line 7a of the Form 55002014-07-0167
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0167
2013: SKAALEN NURSING & REHAB CENTER VISION PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-010
Total number of active participants reported on line 7a of the Form 55002013-07-0166
Total of all active and inactive participants2013-07-0166

Financial Data on SKAALEN NURSING & REHAB CENTER VISION PLAN

Measure Date Value
2022 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30No
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net assets at end of year (total assets less liabilities)2022-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Did the plan have assets held for investment2022-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30Yes
2021 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Was this plan covered by a fidelity bond2021-06-30No
If this is an individual account plan, was there a blackout period2021-06-30No
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net assets at end of year (total assets less liabilities)2021-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Did the plan have assets held for investment2021-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
2020 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Was this plan covered by a fidelity bond2020-06-30No
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net assets at end of year (total assets less liabilities)2020-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Did the plan have assets held for investment2020-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
2019 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Was this plan covered by a fidelity bond2019-06-30No
If this is an individual account plan, was there a blackout period2019-06-30No
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net assets at end of year (total assets less liabilities)2019-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Did the plan have assets held for investment2019-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
2018 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Was this plan covered by a fidelity bond2018-06-30No
If this is an individual account plan, was there a blackout period2018-06-30No
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net assets at end of year (total assets less liabilities)2018-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Did the plan have assets held for investment2018-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
2017 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Was this plan covered by a fidelity bond2017-06-30No
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net assets at end of year (total assets less liabilities)2017-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Did the plan have assets held for investment2017-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
2016 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Was this plan covered by a fidelity bond2016-06-30No
If this is an individual account plan, was there a blackout period2016-06-30No
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net assets at end of year (total assets less liabilities)2016-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Did the plan have assets held for investment2016-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
2015 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2015 401k financial data
Total income from all sources2015-06-30$0
Total plan assets at end of year2015-06-30$0
Total plan assets at beginning of year2015-06-30$0
Net plan assets at end of year (total assets less liabilities)2015-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$0
2014 : SKAALEN NURSING & REHAB CENTER VISION PLAN 2014 401k financial data
Total income from all sources2014-06-30$0
Total plan assets at end of year2014-06-30$0
Total plan assets at beginning of year2014-06-30$0
Net plan assets at end of year (total assets less liabilities)2014-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$0

Form 5500 Responses for SKAALEN NURSING & REHAB CENTER VISION PLAN

2021: SKAALEN NURSING & REHAB CENTER VISION PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01This submission is the final filingYes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: SKAALEN NURSING & REHAB CENTER VISION PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: SKAALEN NURSING & REHAB CENTER VISION PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: SKAALEN NURSING & REHAB CENTER VISION PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: SKAALEN NURSING & REHAB CENTER VISION PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: SKAALEN NURSING & REHAB CENTER VISION PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: SKAALEN NURSING & REHAB CENTER VISION PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: SKAALEN NURSING & REHAB CENTER VISION PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: SKAALEN NURSING & REHAB CENTER VISION PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01First time form 5500 has been submittedYes
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number165950
Policy instance 1
Insurance contract or identification number165950
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $1,069
Total amount of fees paid to insurance companyUSD $303
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $762
Insurance broker organization code?3
Amount paid for insurance broker fees303
Additional information about fees paid to insurance brokerADMINISTRATION
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number165950
Policy instance 1
Insurance contract or identification number165950
Number of Individuals Covered66
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,083
Total amount of fees paid to insurance companyUSD $362
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $721
Insurance broker organization code?3
Amount paid for insurance broker fees362
Additional information about fees paid to insurance brokerADMINISTRATION
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number165950
Policy instance 1
Insurance contract or identification number165950
Number of Individuals Covered66
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,563
Total amount of fees paid to insurance companyUSD $413
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $730
Insurance broker organization code?3
Amount paid for insurance broker fees413
Additional information about fees paid to insurance brokerADMINISTRATION
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40688 00000
Policy instance 1
Insurance contract or identification number40688 00000
Number of Individuals Covered62
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $607
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $607
Insurance broker organization code?3
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40688 00000
Policy instance 1
Insurance contract or identification number40688 00000
Number of Individuals Covered55
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $549
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40688 00000
Policy instance 1
Insurance contract or identification number40688 00000
Number of Individuals Covered57
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $660
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $660
Insurance broker organization code?3
Insurance broker nameTRICOR INSURANCE AGENCY
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40688 00000
Policy instance 1
Insurance contract or identification number40688 00000
Number of Individuals Covered67
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $658
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $658
Insurance broker organization code?3
Insurance broker nameTRICOR INSURANCE AGENCY
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40688 00000
Policy instance 1
Insurance contract or identification number40688 00000
Number of Individuals Covered66
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $713
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $713
Insurance broker organization code?3
Insurance broker nameTRICOR INSURANCE AGENCY

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