401k Plan data: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN plan

COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 401k Plan overview

Plan Name	COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN
Plan identification number	001

COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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

COUNTRYVIEW GROUP HOME, LLC has sponsored the creation of one or more 401k plans.

Company Name: COUNTRYVIEW GROUP HOME, LLC

Employer identification number (EIN): 392014448

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2021-01-01 ORIT YELIN
001 2020-01-01
001 2019-01-01
001 2018-01-01 ORIT YELIN
001 2017-01-01 ORIT YELIN
001 2016-01-01 ORIT YELIN
001 2015-01-01 ORIT YELIN
001 2014-01-01
001 2013-01-01
001 2012-01-01 ORIT YELIN 2013-10-15 ORIT YELIN 2013-10-15
001 2011-01-01 ZVIA SHAER 2012-10-09 ZVIA SHAER 2012-10-09
001 2010-01-01 ZVIA SHAER 2011-10-14 ZVIA SHAER 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01
001	2021-01-01	ORIT YELIN
001	2020-01-01
001	2019-01-01
001	2018-01-01	ORIT YELIN
001	2017-01-01	ORIT YELIN
001	2016-01-01	ORIT YELIN
001	2015-01-01	ORIT YELIN
001	2014-01-01
001	2013-01-01
001	2012-01-01	ORIT YELIN	2013-10-15	ORIT YELIN	2013-10-15
001	2011-01-01	ZVIA SHAER	2012-10-09	ZVIA SHAER	2012-10-09
001	2010-01-01	ZVIA SHAER	2011-10-14	ZVIA SHAER	2011-10-14

Financial Data on COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN

Measure	Date	Value
2021 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-15	$0
Total plan liabilities at end of year	2021-12-15	$0
Total plan liabilities at beginning of year	2021-12-15	$0
Total income from all sources	2021-12-15	$35,198
Expenses. Total of all expenses incurred	2021-12-15	$2,739,646
Benefits paid (including direct rollovers)	2021-12-15	$2,723,735
Total plan assets at end of year	2021-12-15	$0
Total plan assets at beginning of year	2021-12-15	$2,704,448
Value of fidelity bond covering the plan	2021-12-15	$150,000
Total contributions received or receivable from participants	2021-12-15	$0
Expenses. Other expenses not covered elsewhere	2021-12-15	$0
Contributions received from other sources (not participants or employers)	2021-12-15	$0
Other income received	2021-12-15	$35,198
Noncash contributions received	2021-12-15	$0
Net income (gross income less expenses)	2021-12-15	$-2,704,448
Net plan assets at end of year (total assets less liabilities)	2021-12-15	$0
Net plan assets at beginning of year (total assets less liabilities)	2021-12-15	$2,704,448
Assets. Value of participant loans	2021-12-15	$0
Total contributions received or receivable from employer(s)	2021-12-15	$0
Value of certain deemed distributions of participant loans	2021-12-15	$5,567
Value of corrective distributions	2021-12-15	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-15	$10,344
2020 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 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	$215,365
Expenses. Total of all expenses incurred	2020-12-31	$66,041
Benefits paid (including direct rollovers)	2020-12-31	$52,619
Total plan assets at end of year	2020-12-31	$2,704,448
Total plan assets at beginning of year	2020-12-31	$2,555,124
Value of fidelity bond covering the plan	2020-12-31	$150,000
Total contributions received or receivable from participants	2020-12-31	$24,531
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	$185,621
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$149,324
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$2,704,448
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$2,555,124
Assets. Value of participant loans	2020-12-31	$27,202
Total contributions received or receivable from employer(s)	2020-12-31	$5,213
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	$13,422
2019 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$418,886
Expenses. Total of all expenses incurred	2019-12-31	$42,306
Benefits paid (including direct rollovers)	2019-12-31	$30,186
Total plan assets at end of year	2019-12-31	$2,555,124
Total plan assets at beginning of year	2019-12-31	$2,178,544
Value of fidelity bond covering the plan	2019-12-31	$150,000
Total contributions received or receivable from participants	2019-12-31	$54,569
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$350,230
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$376,580
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$2,555,124
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$2,178,544
Assets. Value of participant loans	2019-12-31	$11,161
Total contributions received or receivable from employer(s)	2019-12-31	$14,087
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$12,120
2018 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$64,989
Expenses. Total of all expenses incurred	2018-12-31	$97,297
Benefits paid (including direct rollovers)	2018-12-31	$78,212
Total plan assets at end of year	2018-12-31	$2,178,544
Total plan assets at beginning of year	2018-12-31	$2,210,852
Value of fidelity bond covering the plan	2018-12-31	$150,000
Total contributions received or receivable from participants	2018-12-31	$70,982
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-97,049
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-32,308
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$2,178,544
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$2,210,852
Assets. Value of participant loans	2018-12-31	$9,491
Total contributions received or receivable from employer(s)	2018-12-31	$91,056
Value of certain deemed distributions of participant loans	2018-12-31	$1,538
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$17,547
2017 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$457,345
Expenses. Total of all expenses incurred	2017-12-31	$51,011
Benefits paid (including direct rollovers)	2017-12-31	$40,153
Total plan assets at end of year	2017-12-31	$2,210,852
Total plan assets at beginning of year	2017-12-31	$1,804,518
Value of fidelity bond covering the plan	2017-12-31	$150,000
Total contributions received or receivable from participants	2017-12-31	$105,524
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$2,677
Other income received	2017-12-31	$250,210
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$406,334
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$2,210,852
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,804,518
Assets. Value of participant loans	2017-12-31	$17,306
Total contributions received or receivable from employer(s)	2017-12-31	$98,934
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$10,858
2016 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$314,520
Expenses. Total of all expenses incurred	2016-12-31	$56,635
Benefits paid (including direct rollovers)	2016-12-31	$48,318
Total plan assets at end of year	2016-12-31	$1,804,518
Total plan assets at beginning of year	2016-12-31	$1,546,633
Value of fidelity bond covering the plan	2016-12-31	$150,000
Total contributions received or receivable from participants	2016-12-31	$107,691
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$94,030
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$257,885
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,804,518
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,546,633
Assets. Value of participant loans	2016-12-31	$10,481
Total contributions received or receivable from employer(s)	2016-12-31	$112,799
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$8,317
2015 : COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$106,819
Expenses. Total of all expenses incurred	2015-12-31	$23,952
Benefits paid (including direct rollovers)	2015-12-31	$22,951
Total plan assets at end of year	2015-12-31	$1,546,633
Total plan assets at beginning of year	2015-12-31	$1,463,766
Value of fidelity bond covering the plan	2015-12-31	$150,000
Total contributions received or receivable from participants	2015-12-31	$69,233
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$29,977
Other income received	2015-12-31	$-20,712
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$82,867
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,546,633
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,463,766
Assets. Value of participant loans	2015-12-31	$25,951
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2015-12-31	$0
Total contributions received or receivable from employer(s)	2015-12-31	$28,321
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$1,001
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0

Form 5500 Responses for COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN

2021: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 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 – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COUNTRYVIEW GROUP HOME, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	GA-063609
Policy instance	1

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Company Name:	COUNTRYVIEW GROUP HOME, LLC
Employer identification number (EIN):	392014448
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities