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ASSURANCE HEALTH LLC 401K 401k Plan overview

Plan NameASSURANCE HEALTH LLC 401K
Plan identification number 001

ASSURANCE HEALTH LLC 401K Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ASSURANCE HEALTH SYSTEM, LLC has sponsored the creation of one or more 401k plans.

Company Name:ASSURANCE HEALTH SYSTEM, LLC
Employer identification number (EIN):463598233
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSURANCE HEALTH LLC 401K

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
0012019-01-01
0012018-01-01
0012017-01-01KYLE SMALL KYLE SMALL2018-10-12
0012017-01-01
0012016-01-01KRISTEN KEMP2017-09-27 KRISTEN KEMP2017-09-27
0012016-01-01KRISTEN KEMP2017-11-17 KRISTEN KEMP2017-11-17
0012015-01-01ROBERT DEVRIES2017-02-02

Plan Statistics for ASSURANCE HEALTH LLC 401K

401k plan membership statisitcs for ASSURANCE HEALTH LLC 401K

Measure Date Value
2022: ASSURANCE HEALTH LLC 401K 2022 401k membership
Total participants, beginning-of-year2022-01-01389
Total number of active participants reported on line 7a of the Form 55002022-01-01368
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0122
Total of all active and inactive participants2022-01-01390
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01390
Number of participants with account balances2022-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ASSURANCE HEALTH LLC 401K 2021 401k membership
Total participants, beginning-of-year2021-01-01332
Total number of active participants reported on line 7a of the Form 55002021-01-01359
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0124
Total of all active and inactive participants2021-01-01383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01383
Number of participants with account balances2021-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-017
2020: ASSURANCE HEALTH LLC 401K 2020 401k membership
Total participants, beginning-of-year2020-01-01313
Total number of active participants reported on line 7a of the Form 55002020-01-01306
Number of retired or separated participants receiving benefits2020-01-0126
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01332
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01332
Number of participants with account balances2020-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ASSURANCE HEALTH LLC 401K 2019 401k membership
Total participants, beginning-of-year2019-01-01302
Total number of active participants reported on line 7a of the Form 55002019-01-01290
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0124
Total of all active and inactive participants2019-01-01314
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01314
Number of participants with account balances2019-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: ASSURANCE HEALTH LLC 401K 2018 401k membership
Total participants, beginning-of-year2018-01-01274
Total number of active participants reported on line 7a of the Form 55002018-01-01261
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0119
Total of all active and inactive participants2018-01-01280
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01280
Number of participants with account balances2018-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: ASSURANCE HEALTH LLC 401K 2017 401k membership
Total participants, beginning-of-year2017-01-01266
Total number of active participants reported on line 7a of the Form 55002017-01-01239
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0110
Total of all active and inactive participants2017-01-01249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01249
Number of participants with account balances2017-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on ASSURANCE HEALTH LLC 401K

Measure Date Value
2022 : ASSURANCE HEALTH LLC 401K 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$63,871
Total of all expenses incurred2022-12-31$232,902
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$218,013
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$200,994
Value of total assets at end of year2022-12-31$647,424
Value of total assets at beginning of year2022-12-31$816,455
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$14,889
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$2,623
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
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$200,994
Participant contributions at end of year2022-12-31$7,551
Participant contributions at beginning of year2022-12-31$7,915
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-169,031
Value of net assets at end of year (total assets less liabilities)2022-12-31$647,424
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$816,455
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$634,707
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$805,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$5,166
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$3,271
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-137,123
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 contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$218,013
Contract administrator fees2022-12-31$12,266
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31KATZ, SAPPER & MILLER LLP
Accountancy firm EIN2022-12-31351090346
2021 : ASSURANCE HEALTH LLC 401K 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$327,090
Total of all expenses incurred2021-12-31$101,011
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$96,617
Value of total corrective distributions2021-12-31$2,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$241,146
Value of total assets at end of year2021-12-31$816,455
Value of total assets at beginning of year2021-12-31$590,376
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,153
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$2,153
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$144,457
Participant contributions at end of year2021-12-31$7,915
Participant contributions at beginning of year2021-12-31$4,211
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$96,689
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$226,079
Value of net assets at end of year (total assets less liabilities)2021-12-31$816,455
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$590,376
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$805,269
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$582,839
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$3,271
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,326
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$85,944
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 contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$96,617
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31ALERDING CPA GROUP
Accountancy firm EIN2021-12-31352043580
2020 : ASSURANCE HEALTH LLC 401K 2020 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$172,025
Total of all expenses incurred2020-12-31$77,201
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$77,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$97,896
Value of total assets at end of year2020-12-31$590,376
Value of total assets at beginning of year2020-12-31$495,552
Total interest from all sources2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
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$87,208
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Participant contributions at end of year2020-12-31$4,211
Participant contributions at beginning of year2020-12-31$2,276
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$10,688
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$94,824
Value of net assets at end of year (total assets less liabilities)2020-12-31$590,376
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$495,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$582,839
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$490,241
Interest on participant loans2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,326
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$3,035
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$74,129
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$77,201
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 name2020-12-31ALERDING CPA GROUP
Accountancy firm EIN2020-12-31352043580
2019 : ASSURANCE HEALTH LLC 401K 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,253
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,253
Total income from all sources (including contributions)2019-12-31$181,147
Total income from all sources (including contributions)2019-12-31$181,147
Total of all expenses incurred2019-12-31$45,410
Total of all expenses incurred2019-12-31$45,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$37,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$37,961
Expenses. Certain deemed distributions of participant loans2019-12-31$908
Expenses. Certain deemed distributions of participant loans2019-12-31$908
Value of total corrective distributions2019-12-31$6,541
Value of total corrective distributions2019-12-31$6,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$102,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$102,452
Value of total assets at end of year2019-12-31$495,552
Value of total assets at end of year2019-12-31$495,552
Value of total assets at beginning of year2019-12-31$362,068
Value of total assets at beginning of year2019-12-31$362,068
Total interest from all sources2019-12-31$322
Total interest from all sources2019-12-31$322
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000
Value of fidelity bond cover2019-12-31$1,000
If this is an individual account plan, was there a blackout period2019-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$102,452
Contributions received from participants2019-12-31$102,452
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$4,232
Participant contributions at beginning of year2019-12-31$4,232
Participant contributions at end of year2019-12-31$2,276
Participant contributions at end of year2019-12-31$2,276
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$2,253
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$2,253
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
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$135,737
Value of net income/loss2019-12-31$135,737
Value of net assets at end of year (total assets less liabilities)2019-12-31$495,552
Value of net assets at end of year (total assets less liabilities)2019-12-31$495,552
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$359,815
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$359,815
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$490,241
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$490,241
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$355,216
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$355,216
Interest on participant loans2019-12-31$183
Interest on participant loans2019-12-31$183
Interest earned on other investments2019-12-31$139
Interest earned on other investments2019-12-31$139
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,035
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,035
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,620
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,620
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$78,373
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$78,373
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
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 contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$37,961
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$37,961
Did the plan have assets held for investment2019-12-31Yes
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
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
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
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ALERDING CPA GROUP
Accountancy firm name2019-12-31ALERDING CPA GROUP
Accountancy firm EIN2019-12-31352043580
Accountancy firm EIN2019-12-31352043580
2018 : ASSURANCE HEALTH LLC 401K 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,253
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$179
Total income from all sources (including contributions)2018-12-31$284,854
Total of all expenses incurred2018-12-31$222,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$213,753
Expenses. Certain deemed distributions of participant loans2018-12-31$1,179
Value of total corrective distributions2018-12-31$7,131
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$317,334
Value of total assets at end of year2018-12-31$362,068
Value of total assets at beginning of year2018-12-31$297,203
Total interest from all sources2018-12-31$784
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$142,652
Participant contributions at end of year2018-12-31$4,232
Participant contributions at beginning of year2018-12-31$20,499
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$174,682
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$2,253
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$179
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$62,791
Value of net assets at end of year (total assets less liabilities)2018-12-31$359,815
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$297,024
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$355,216
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$274,250
Interest on participant loans2018-12-31$784
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$2,620
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$2,454
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-33,264
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$213,753
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 name2018-12-31ALERDING CPA GROUP
Accountancy firm EIN2018-12-31352043580
2017 : ASSURANCE HEALTH LLC 401K 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$179
Total income from all sources (including contributions)2017-12-31$175,957
Total of all expenses incurred2017-12-31$37,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$37,164
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$147,819
Value of total assets at end of year2017-12-31$297,203
Value of total assets at beginning of year2017-12-31$158,231
Total interest from all sources2017-12-31$418
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$147,819
Participant contributions at end of year2017-12-31$20,499
Participant contributions at beginning of year2017-12-31$3,693
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$179
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$138,793
Value of net assets at end of year (total assets less liabilities)2017-12-31$297,024
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$158,231
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$274,250
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$143,012
Interest on participant loans2017-12-31$418
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$2,454
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$11,526
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$27,720
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 contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$37,164
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 name2017-12-31ALERDING CPA GROUP
Accountancy firm EIN2017-12-31352043580

Form 5500 Responses for ASSURANCE HEALTH LLC 401K

2022: ASSURANCE HEALTH LLC 401K 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: ASSURANCE HEALTH LLC 401K 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: ASSURANCE HEALTH LLC 401K 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 - TrustYes
2019: ASSURANCE HEALTH LLC 401K 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
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 - TrustYes
2018: ASSURANCE HEALTH LLC 401K 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 - TrustYes
2017: ASSURANCE HEALTH LLC 401K 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 - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered4
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $27
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $27
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered4
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $25
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $25
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $24
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $24
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered5
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $21
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered5
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number363-80874
Policy instance 1
Insurance contract or identification number363-80874
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $25
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameFIFTH THIRD SECURITIES INC

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