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SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 401k Plan overview

Plan NameSAMARITAN BETHANY INC. 403B RETIREMENT PLAN
Plan identification number 001

SAMARITAN BETHANY INC. 403B RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • 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(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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • 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.

401k Sponsoring company profile

SAMARITAN BETHANY INC has sponsored the creation of one or more 401k plans.

Company Name:SAMARITAN BETHANY INC
Employer identification number (EIN):411373420
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAMARITAN BETHANY INC. 403B RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01BRANDON MILLER BRANDON MILLER2018-10-05
0012016-01-01BRANDON MILLER
0012015-01-01BRANDON MILLER
0012014-01-01BRANDON MILLER
0012013-01-01BRANDON MILLER
0012012-01-01BRANDON MILLER
0012011-01-01BRANDON MILLER
0012009-01-01BRANDON MILLER

Plan Statistics for SAMARITAN BETHANY INC. 403B RETIREMENT PLAN

401k plan membership statisitcs for SAMARITAN BETHANY INC. 403B RETIREMENT PLAN

Measure Date Value
2022: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01357
Total number of active participants reported on line 7a of the Form 55002022-01-01139
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-01175
Total of all active and inactive participants2022-01-01316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01316
Number of participants with account balances2022-01-01262
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-019
2021: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01411
Total number of active participants reported on line 7a of the Form 55002021-01-01165
Number of retired or separated participants receiving benefits2021-01-016
Number of other retired or separated participants entitled to future benefits2021-01-01179
Total of all active and inactive participants2021-01-01350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01350
Number of participants with account balances2021-01-01283
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-019
2020: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01409
Total number of active participants reported on line 7a of the Form 55002020-01-01214
Number of retired or separated participants receiving benefits2020-01-016
Number of other retired or separated participants entitled to future benefits2020-01-01179
Total of all active and inactive participants2020-01-01399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01399
Number of participants with account balances2020-01-01298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-016
2019: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01415
Total number of active participants reported on line 7a of the Form 55002019-01-01252
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-01166
Total of all active and inactive participants2019-01-01421
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01421
Number of participants with account balances2019-01-01300
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01400
Total number of active participants reported on line 7a of the Form 55002018-01-01236
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01170
Total of all active and inactive participants2018-01-01406
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01406
Number of participants with account balances2018-01-01303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01394
Total number of active participants reported on line 7a of the Form 55002017-01-01215
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01164
Total of all active and inactive participants2017-01-01379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01379
Number of participants with account balances2017-01-01290
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01547
Total number of active participants reported on line 7a of the Form 55002016-01-01148
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-01157
Total of all active and inactive participants2016-01-01305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01305
Number of participants with account balances2016-01-01293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01502
Total number of active participants reported on line 7a of the Form 55002015-01-01343
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-01204
Total of all active and inactive participants2015-01-01547
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01547
Number of participants with account balances2015-01-01288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01501
Total number of active participants reported on line 7a of the Form 55002014-01-01384
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-01118
Total of all active and inactive participants2014-01-01502
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01502
Number of participants with account balances2014-01-01262
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01520
Total number of active participants reported on line 7a of the Form 55002013-01-01398
Number of other retired or separated participants entitled to future benefits2013-01-01103
Total of all active and inactive participants2013-01-01501
Total participants2013-01-01501
Number of participants with account balances2013-01-01238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01452
Total number of active participants reported on line 7a of the Form 55002012-01-01424
Number of other retired or separated participants entitled to future benefits2012-01-0196
Total of all active and inactive participants2012-01-01520
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01520
Number of participants with account balances2012-01-01232
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01150
Total number of active participants reported on line 7a of the Form 55002011-01-01401
Number of other retired or separated participants entitled to future benefits2011-01-0151
Total of all active and inactive participants2011-01-01452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01452
Number of participants with account balances2011-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01361
Total number of active participants reported on line 7a of the Form 55002009-01-01339
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0133
Total of all active and inactive participants2009-01-01372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01372
Number of participants with account balances2009-01-01146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SAMARITAN BETHANY INC. 403B RETIREMENT PLAN

Measure Date Value
2022 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$17,518
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$9,277
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$4,084
Total income from all sources (including contributions)2022-12-31$-226,099
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$377,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$329,086
Value of total corrective distributions2022-12-31$1,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$510,052
Value of total assets at end of year2022-12-31$5,438,735
Value of total assets at beginning of year2022-12-31$6,019,284
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$46,548
Total interest from all sources2022-12-31$28,601
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$75,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$75,544
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
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$278,653
Participant contributions at end of year2022-12-31$72,382
Participant contributions at beginning of year2022-12-31$78,774
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$750
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$764
Liabilities. Value of operating payables at end of year2022-12-31$7,266
Liabilities. Value of operating payables at beginning of year2022-12-31$1,670
Total non interest bearing cash at end of year2022-12-31$10,464
Total non interest bearing cash at beginning of year2022-12-31$7,879
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
Income. Non cash contributions2022-12-31$5,414
Value of net income/loss2022-12-31$-603,260
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,429,458
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,015,200
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
Investment advisory and management fees2022-12-31$33,902
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,669,793
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,172,978
Value of interest in pooled separate accounts at end of year2022-12-31$264,224
Value of interest in pooled separate accounts at beginning of year2022-12-31$325,366
Interest on participant loans2022-12-31$4,429
Interest earned on other investments2022-12-31$24,172
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,420,713
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,433,523
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-785,969
Net investment gain or loss from common/collective trusts2022-12-31$-54,327
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$225,985
Employer contributions (assets) at end of year2022-12-31$409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$329,086
Contract administrator fees2022-12-31$12,646
Liabilities. Value of benefit claims payable at end of year2022-12-31$2,011
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$2,414
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 plan2022-12-31Disclaimer
Accountancy firm name2022-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-12-31410746749
2021 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$171,925
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$4,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,678
Total income from all sources (including contributions)2021-12-31$1,057,336
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$527,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$494,494
Expenses. Certain deemed distributions of participant loans2021-12-31$9,169
Value of total corrective distributions2021-12-31$1,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$478,086
Value of total assets at end of year2021-12-31$6,019,284
Value of total assets at beginning of year2021-12-31$5,317,083
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$21,875
Total interest from all sources2021-12-31$30,549
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$71,193
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$71,193
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$267,837
Participant contributions at end of year2021-12-31$78,774
Participant contributions at beginning of year2021-12-31$105,239
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$764
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$1,300
Liabilities. Value of operating payables at end of year2021-12-31$1,670
Liabilities. Value of operating payables at beginning of year2021-12-31$2,055
Total non interest bearing cash at end of year2021-12-31$7,879
Total non interest bearing cash at beginning of year2021-12-31$0
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$529,870
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,015,200
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$5,313,405
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
Investment advisory and management fees2021-12-31$9,362
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,172,978
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,491,041
Value of interest in pooled separate accounts at end of year2021-12-31$325,366
Value of interest in pooled separate accounts at beginning of year2021-12-31$297,346
Interest on participant loans2021-12-31$5,353
Interest earned on other investments2021-12-31$25,196
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,433,523
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,420,091
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$435,698
Net investment gain/loss from pooled separate accounts2021-12-31$41,810
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$210,249
Employer contributions (assets) at beginning of year2021-12-31$2,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$494,494
Contract administrator fees2021-12-31$12,513
Liabilities. Value of benefit claims payable at end of year2021-12-31$2,414
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,623
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 plan2021-12-31Disclaimer
Accountancy firm name2021-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2021-12-31410746749
2020 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets to this plan2020-12-31$51,266
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,678
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$7,278
Total income from all sources (including contributions)2020-12-31$1,025,987
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$223,327
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$201,843
Value of total corrective distributions2020-12-31$1,623
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$507,526
Value of total assets at end of year2020-12-31$5,317,083
Value of total assets at beginning of year2020-12-31$4,466,757
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$19,861
Total interest from all sources2020-12-31$31,532
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$54,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$54,525
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
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$296,306
Participant contributions at end of year2020-12-31$105,239
Participant contributions at beginning of year2020-12-31$105,874
Participant contributions at beginning of year2020-12-31$295
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$1,300
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$818
Liabilities. Value of operating payables at end of year2020-12-31$2,055
Liabilities. Value of operating payables at beginning of year2020-12-31$4,246
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$8,535
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$802,660
Value of net assets at end of year (total assets less liabilities)2020-12-31$5,313,405
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,459,479
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
Investment advisory and management fees2020-12-31$8,816
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,491,041
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,840,331
Value of interest in pooled separate accounts at end of year2020-12-31$297,346
Value of interest in pooled separate accounts at beginning of year2020-12-31$314,271
Interest on participant loans2020-12-31$5,904
Interest earned on other investments2020-12-31$25,628
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,420,091
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,196,633
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$395,906
Net investment gain/loss from pooled separate accounts2020-12-31$36,498
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$211,220
Employer contributions (assets) at end of year2020-12-31$2,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$201,843
Contract administrator fees2020-12-31$11,045
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,623
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$3,032
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 plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-12-31410746749
2019 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$52,271
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$7,278
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,007
Total income from all sources (including contributions)2019-12-31$1,131,471
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$290,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$269,672
Value of total corrective distributions2019-12-31$1,774
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$533,691
Value of total assets at end of year2019-12-31$4,466,757
Value of total assets at beginning of year2019-12-31$3,569,138
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$18,948
Total interest from all sources2019-12-31$28,443
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$62,114
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$62,114
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$311,651
Participant contributions at end of year2019-12-31$105,874
Participant contributions at beginning of year2019-12-31$58,465
Participant contributions at end of year2019-12-31$295
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$1,105
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$818
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$554
Liabilities. Value of operating payables at end of year2019-12-31$4,246
Liabilities. Value of operating payables at beginning of year2019-12-31$1,749
Total non interest bearing cash at end of year2019-12-31$8,535
Total non interest bearing cash at beginning of year2019-12-31$18,684
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$841,077
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,459,479
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,566,131
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
Investment advisory and management fees2019-12-31$8,525
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,840,331
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,150,020
Value of interest in pooled separate accounts at end of year2019-12-31$314,271
Value of interest in pooled separate accounts at beginning of year2019-12-31$275,518
Income. Interest from loans (other than to participants)2019-12-31$3,970
Interest earned on other investments2019-12-31$24,473
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,196,633
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,065,897
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$454,044
Net investment gain/loss from pooled separate accounts2019-12-31$53,179
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$220,935
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$269,672
Contract administrator fees2019-12-31$10,423
Liabilities. Value of benefit claims payable at end of year2019-12-31$3,032
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,258
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2019-12-31410746749
2018 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$39,795
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,007
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,781
Total income from all sources (including contributions)2018-12-31$346,999
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$103,207
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$79,826
Expenses. Certain deemed distributions of participant loans2018-12-31$4,688
Value of total corrective distributions2018-12-31$1,258
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$491,223
Value of total assets at end of year2018-12-31$3,569,138
Value of total assets at beginning of year2018-12-31$3,286,325
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$17,435
Total interest from all sources2018-12-31$23,513
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$49,639
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$49,639
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$279,555
Participant contributions at end of year2018-12-31$58,465
Participant contributions at beginning of year2018-12-31$62,493
Participant contributions at beginning of year2018-12-31$492
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$1,629
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$554
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$28
Liabilities. Value of operating payables at end of year2018-12-31$1,749
Liabilities. Value of operating payables at beginning of year2018-12-31$1,749
Total non interest bearing cash at end of year2018-12-31$18,684
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$243,792
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,566,131
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,282,544
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
Investment advisory and management fees2018-12-31$8,249
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,150,020
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$1,957,057
Value of interest in pooled separate accounts at end of year2018-12-31$275,518
Value of interest in pooled separate accounts at beginning of year2018-12-31$323,657
Interest on participant loans2018-12-31$3,141
Interest earned on other investments2018-12-31$20,372
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$16,648
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$16,648
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,065,897
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$925,838
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-201,694
Net investment gain/loss from pooled separate accounts2018-12-31$-15,682
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 contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$210,039
Employer contributions (assets) at beginning of year2018-12-31$112
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$79,826
Contract administrator fees2018-12-31$9,186
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,258
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$2,032
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 name2018-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2018-12-31410746749
2017 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$807,022
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,781
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$708,285
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$206,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$190,884
Value of total corrective distributions2017-12-31$2,032
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$405,418
Value of total assets at end of year2017-12-31$3,286,325
Value of total assets at beginning of year2017-12-31$1,974,113
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$13,960
Total interest from all sources2017-12-31$18,340
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$36,234
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$36,234
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
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$230,271
Participant contributions at end of year2017-12-31$62,493
Participant contributions at end of year2017-12-31$492
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$28
Liabilities. Value of operating payables at end of year2017-12-31$1,749
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$501,409
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,282,544
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,974,113
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
Investment advisory and management fees2017-12-31$1,749
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$1,957,057
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,205,528
Value of interest in pooled separate accounts at end of year2017-12-31$323,657
Interest on participant loans2017-12-31$1,601
Interest earned on other investments2017-12-31$17,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$16,648
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$-347
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$925,838
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$768,585
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$170,922
Net investment gain/loss from pooled separate accounts2017-12-31$77,371
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 contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$175,147
Employer contributions (assets) at end of year2017-12-31$112
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$190,884
Contract administrator fees2017-12-31$12,211
Liabilities. Value of benefit claims payable at end of year2017-12-31$2,032
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 name2017-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2017-12-31410746749
2016 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$310,564
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$34,094
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$34,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$199,575
Value of total assets at end of year2016-12-31$1,974,113
Value of total assets at beginning of year2016-12-31$1,697,643
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$0
Total interest from all sources2016-12-31$15,390
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$276,470
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,974,113
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,697,643
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$1,205,528
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,020,812
Interest earned on other investments2016-12-31$15,390
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$768,585
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$669,482
Net investment gain/loss from pooled separate accounts2016-12-31$95,599
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$199,575
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$7,349
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$34,094
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 name2016-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2016-12-31410746749
2015 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
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$0
Total income from all sources (including contributions)2015-12-31$182,885
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$124,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$124,984
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$192,680
Value of total assets at end of year2015-12-31$1,697,643
Value of total assets at beginning of year2015-12-31$1,639,742
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$0
Total interest from all sources2015-12-31$14,017
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$57,901
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,697,643
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,639,742
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$1,020,812
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,019,992
Interest earned on other investments2015-12-31$14,017
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$669,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$619,750
Net investment gain/loss from pooled separate accounts2015-12-31$-23,812
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
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$192,680
Employer contributions (assets) at end of year2015-12-31$7,349
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$124,984
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 name2015-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2015-12-31410746749
2014 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$349,532
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$73,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$73,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$284,403
Value of total assets at end of year2014-12-31$1,639,742
Value of total assets at beginning of year2014-12-31$1,363,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$13,064
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$85,980
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$276,512
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,639,742
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,363,230
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$1,019,992
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$803,984
Interest earned on other investments2014-12-31$13,064
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$619,750
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$550,659
Net investment gain/loss from pooled separate accounts2014-12-31$52,065
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$198,423
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$8,587
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$73,020
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 name2014-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2014-12-31410746749
2013 : SAMARITAN BETHANY INC. 403B RETIREMENT 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$341,630
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$104,465
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$104,465
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$188,060
Value of total assets at end of year2013-12-31$1,363,230
Value of total assets at beginning of year2013-12-31$1,126,065
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$0
Total interest from all sources2013-12-31$11,658
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
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
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$237,165
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,363,230
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,126,065
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 pooled separate accounts at end of year2013-12-31$803,984
Value of interest in pooled separate accounts at beginning of year2013-12-31$615,809
Interest earned on other investments2013-12-31$11,658
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$550,659
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$510,256
Net investment gain/loss from pooled separate accounts2013-12-31$141,912
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$188,060
Employer contributions (assets) at end of year2013-12-31$8,587
Employer contributions (assets) at beginning of year2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$104,465
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 name2013-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2013-12-31410746749
2012 : SAMARITAN BETHANY INC. 403B RETIREMENT 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$0
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$255,053
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$55,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$55,533
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$181,062
Value of total assets at end of year2012-12-31$1,126,065
Value of total assets at beginning of year2012-12-31$926,545
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$0
Total interest from all sources2012-12-31$11,486
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
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
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$0
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$199,520
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,126,065
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$926,545
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 pooled separate accounts at end of year2012-12-31$615,809
Value of interest in pooled separate accounts at beginning of year2012-12-31$448,257
Interest earned on other investments2012-12-31$11,486
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$510,256
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$402,021
Net investment gain/loss from pooled separate accounts2012-12-31$62,505
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$181,062
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$76,267
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$55,533
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 name2012-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2012-12-31410746749
2011 : SAMARITAN BETHANY INC. 403B RETIREMENT 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$199,984
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$81,504
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$81,504
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$196,950
Value of total assets at end of year2011-12-31$926,545
Value of total assets at beginning of year2011-12-31$808,065
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$11,055
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
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
Participant contributions at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$423
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$118,480
Value of net assets at end of year (total assets less liabilities)2011-12-31$926,545
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$808,065
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 beginning of year2011-12-31$418,903
Value of interest in pooled separate accounts at end of year2011-12-31$448,257
Interest earned on other investments2011-12-31$11,055
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$402,021
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$329,093
Net investment gain/loss from pooled separate accounts2011-12-31$-8,021
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$196,527
Employer contributions (assets) at end of year2011-12-31$76,267
Employer contributions (assets) at beginning of year2011-12-31$60,069
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$81,504
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 name2011-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2011-12-31410746749
2010 : SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$229,081
Total of all expenses incurred2010-12-31$77,019
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$77,019
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$166,512
Value of total assets at end of year2010-12-31$754,362
Value of total assets at beginning of year2010-12-31$602,300
Total interest from all sources2010-12-31$10,456
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$500,000
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
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$2,134
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$152,062
Value of net assets at end of year (total assets less liabilities)2010-12-31$754,362
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$602,300
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$418,903
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$323,810
Interest on participant loans2010-12-31$0
Interest earned on other investments2010-12-31$10,456
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$329,093
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$271,042
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$52,113
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$166,512
Employer contributions (assets) at end of year2010-12-31$6,366
Employer contributions (assets) at beginning of year2010-12-31$5,314
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$77,019
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
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 name2010-12-31LARSONALLEN LLP
Accountancy firm EIN2010-12-31410746749

Form 5500 Responses for SAMARITAN BETHANY INC. 403B RETIREMENT PLAN

2022: SAMARITAN BETHANY INC. 403B RETIREMENT 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: SAMARITAN BETHANY INC. 403B RETIREMENT 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: SAMARITAN BETHANY INC. 403B RETIREMENT 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: SAMARITAN BETHANY INC. 403B RETIREMENT 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: SAMARITAN BETHANY INC. 403B RETIREMENT 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: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
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: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SAMARITAN BETHANY INC. 403B RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SAMARITAN BETHANY INC. 403B RETIREMENT 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 benefit arrangement – InsuranceYes
2012: SAMARITAN BETHANY INC. 403B RETIREMENT 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 benefit arrangement – InsuranceYes
2011: SAMARITAN BETHANY INC. 403B RETIREMENT 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 benefit arrangement – InsuranceYes
2009: SAMARITAN BETHANY INC. 403B RETIREMENT 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59182
Policy instance 2
Insurance contract or identification number59182
Number of Individuals Covered173
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $65
Total amount of fees paid to insurance companyUSD $0
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 Administration1
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
Commission paid to Insurance BrokerUSD $65
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63940
Policy instance 1
Insurance contract or identification numberGA-63940
Number of Individuals Covered31
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59182
Policy instance 2
Insurance contract or identification number59182
Number of Individuals Covered180
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $85
Total amount of fees paid to insurance companyUSD $0
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 Administration1
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
Commission paid to Insurance BrokerUSD $85
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63940
Policy instance 1
Insurance contract or identification numberGA-63940
Number of Individuals Covered34
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59182
Policy instance 2
Insurance contract or identification number59182
Number of Individuals Covered210
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $99
Total amount of fees paid to insurance companyUSD $0
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 Administration1
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
Commission paid to Insurance BrokerUSD $99
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63940
Policy instance 1
Insurance contract or identification numberGA-63940
Number of Individuals Covered43
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59182
Policy instance 2
Insurance contract or identification number59182
Number of Individuals Covered215
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $103
Total amount of fees paid to insurance companyUSD $0
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 Administration1
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
Commission paid to Insurance BrokerUSD $103
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63940
Policy instance 1
Insurance contract or identification numberGA-63940
Number of Individuals Covered41
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59182
Policy instance 2
Insurance contract or identification number59182
Number of Individuals Covered236
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?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 Administration1
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 RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-63940
Policy instance 1
Insurance contract or identification numberGA-63940
Number of Individuals Covered40
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?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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