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LEGACY LIFECARE 403(B) PLAN 401k Plan overview

Plan NameLEGACY LIFECARE 403(B) PLAN
Plan identification number 001

LEGACY LIFECARE 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CHELSEA JEWISH LIFECARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:CHELSEA JEWISH LIFECARE, INC.
Employer identification number (EIN):510141617
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEGACY LIFECARE 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JENNIFER SANTERRE2023-10-10
0012021-01-01JENNIFER SANTERRE2022-09-20
0012020-01-01JEFFREY LANDA2021-10-13
0012019-01-01JEFFREY LANDA2020-09-11
0012018-01-01DONNA CRESCENZO2019-09-11
0012017-01-01
0012016-01-01

Plan Statistics for LEGACY LIFECARE 403(B) PLAN

401k plan membership statisitcs for LEGACY LIFECARE 403(B) PLAN

Measure Date Value
2022: LEGACY LIFECARE 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,140
Total number of active participants reported on line 7a of the Form 55002022-01-011,330
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01224
Total of all active and inactive participants2022-01-011,554
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,554
Number of participants with account balances2022-01-01606
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-016
2021: LEGACY LIFECARE 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01886
Total number of active participants reported on line 7a of the Form 55002021-01-011,018
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01122
Total of all active and inactive participants2021-01-011,140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-011,140
Number of participants with account balances2021-01-01454
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-013
2020: LEGACY LIFECARE 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01887
Total number of active participants reported on line 7a of the Form 55002020-01-01789
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0196
Total of all active and inactive participants2020-01-01885
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01885
Number of participants with account balances2020-01-01340
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-015
2019: LEGACY LIFECARE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01856
Total number of active participants reported on line 7a of the Form 55002019-01-01688
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0187
Total of all active and inactive participants2019-01-01775
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01775
Number of participants with account balances2019-01-01337
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-013
2018: LEGACY LIFECARE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,125
Total number of active participants reported on line 7a of the Form 55002018-01-01762
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0178
Total of all active and inactive participants2018-01-01840
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01840
Number of participants with account balances2018-01-01320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: LEGACY LIFECARE 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01893
Total number of active participants reported on line 7a of the Form 55002017-01-011,066
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0158
Total of all active and inactive participants2017-01-011,124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-011,124
Number of participants with account balances2017-01-01339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: LEGACY LIFECARE 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01497
Total number of active participants reported on line 7a of the Form 55002016-01-01844
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0149
Total of all active and inactive participants2016-01-01893
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01893
Number of participants with account balances2016-01-01330
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-018

Financial Data on LEGACY LIFECARE 403(B) PLAN

Measure Date Value
2022 : LEGACY LIFECARE 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$4,972,370
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,395,787
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,099,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$962,070
Expenses. Certain deemed distributions of participant loans2022-12-31$12,357
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,180,180
Value of total assets at end of year2022-12-31$27,744,988
Value of total assets at beginning of year2022-12-31$25,268,007
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$125,175
Total interest from all sources2022-12-31$66,376
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$940,866
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$940,866
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$1,931,028
Participant contributions at end of year2022-12-31$684,431
Participant contributions at beginning of year2022-12-31$504,828
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$172,718
Administrative expenses (other) incurred2022-12-31$125,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,495,389
Value of net assets at end of year (total assets less liabilities)2022-12-31$27,744,988
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$25,268,007
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$22,727,172
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$21,282,129
Interest on participant loans2022-12-31$28,478
Interest earned on other investments2022-12-31$37,898
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$4,333,385
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$3,481,050
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,583,209
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$76,434
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$962,070
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 : LEGACY LIFECARE 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$6,642,566
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,059,801
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$895,836
Expenses. Certain deemed distributions of participant loans2021-12-31$27,020
Value of total corrective distributions2021-12-31$7,755
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,041,368
Value of total assets at end of year2021-12-31$25,268,007
Value of total assets at beginning of year2021-12-31$19,685,242
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$129,190
Total interest from all sources2021-12-31$20,798
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$1,127,236
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$1,127,236
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
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$1,515,411
Participant contributions at end of year2021-12-31$504,828
Participant contributions at beginning of year2021-12-31$383,560
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$2,367,703
Administrative expenses (other) incurred2021-12-31$129,190
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$5,582,765
Value of net assets at end of year (total assets less liabilities)2021-12-31$25,268,007
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$19,685,242
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$21,282,129
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$16,074,096
Interest on participant loans2021-12-31$20,798
Interest earned on other investments2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$3,481,050
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,227,586
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,453,164
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$158,254
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$895,836
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 : LEGACY LIFECARE 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,738,835
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$706,875
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$614,424
Expenses. Certain deemed distributions of participant loans2020-12-31$5,328
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,452,520
Value of total assets at end of year2020-12-31$19,685,242
Value of total assets at beginning of year2020-12-31$16,653,282
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$87,123
Total interest from all sources2020-12-31$63,501
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$507,568
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$507,568
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,265,227
Participant contributions at end of year2020-12-31$383,560
Participant contributions at beginning of year2020-12-31$426,611
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$115,324
Administrative expenses (other) incurred2020-12-31$87,123
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$3,031,960
Value of net assets at end of year (total assets less liabilities)2020-12-31$19,685,242
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,653,282
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$16,074,096
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$13,362,543
Interest on participant loans2020-12-31$22,939
Interest earned on other investments2020-12-31$40,562
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,227,586
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,864,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,715,246
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$71,969
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$614,424
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 : LEGACY LIFECARE 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,951,230
Total income from all sources (including contributions)2019-12-31$3,951,230
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,355,435
Total of all expenses incurred2019-12-31$1,355,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,325,406
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,325,406
Expenses. Certain deemed distributions of participant loans2019-12-31$8,954
Expenses. Certain deemed distributions of participant loans2019-12-31$8,954
Value of total corrective distributions2019-12-31$4,989
Value of total corrective distributions2019-12-31$4,989
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,280,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,280,659
Value of total assets at end of year2019-12-31$16,653,282
Value of total assets at end of year2019-12-31$16,653,282
Value of total assets at beginning of year2019-12-31$14,057,487
Value of total assets at beginning of year2019-12-31$14,057,487
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$16,086
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$16,086
Total interest from all sources2019-12-31$77,220
Total interest from all sources2019-12-31$77,220
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$743,105
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$743,105
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
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$743,105
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$743,105
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$500,000
Value of fidelity bond cover2019-12-31$500,000
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
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$1,209,025
Contributions received from participants2019-12-31$1,209,025
Participant contributions at end of year2019-12-31$426,611
Participant contributions at end of year2019-12-31$426,611
Participant contributions at beginning of year2019-12-31$411,951
Participant contributions at beginning of year2019-12-31$411,951
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$1,247
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$1,247
Administrative expenses (other) incurred2019-12-31$16,086
Administrative expenses (other) incurred2019-12-31$16,086
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$2,595,795
Value of net income/loss2019-12-31$2,595,795
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,653,282
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,653,282
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$14,057,487
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$14,057,487
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$13,362,543
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$13,362,543
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$11,226,608
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$11,226,608
Interest on participant loans2019-12-31$22,131
Interest on participant loans2019-12-31$22,131
Interest earned on other investments2019-12-31$55,089
Interest earned on other investments2019-12-31$55,089
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,864,128
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,864,128
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,418,928
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,418,928
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,850,246
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,850,246
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 contributions2019-12-31No
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$70,387
Contributions received in cash from employer2019-12-31$70,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,325,406
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,325,406
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 name2019-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm name2019-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2019-12-31410746749
Accountancy firm EIN2019-12-31410746749
2018 : LEGACY LIFECARE 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$525,583
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,634,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,595,870
Expenses. Certain deemed distributions of participant loans2018-12-31$25,386
Value of total corrective distributions2018-12-31$10,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,266,628
Value of total assets at end of year2018-12-31$14,057,487
Value of total assets at beginning of year2018-12-31$15,166,565
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,925
Total interest from all sources2018-12-31$60,919
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$796,432
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$796,432
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
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$1,146,740
Participant contributions at end of year2018-12-31$411,951
Participant contributions at beginning of year2018-12-31$372,242
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$18,173
Administrative expenses (other) incurred2018-12-31$2,925
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-1,109,078
Value of net assets at end of year (total assets less liabilities)2018-12-31$14,057,487
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$15,166,565
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$11,226,608
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$11,468,973
Interest on participant loans2018-12-31$18,851
Interest earned on other investments2018-12-31$42,068
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$2,418,928
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$3,325,350
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,598,396
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$101,715
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,595,870
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 : LEGACY LIFECARE 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
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$3,443,557
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$751,969
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$724,760
Expenses. Certain deemed distributions of participant loans2017-12-31$12,795
Value of total corrective distributions2017-12-31$11,989
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,691,047
Value of total assets at end of year2017-12-31$15,166,565
Value of total assets at beginning of year2017-12-31$12,474,977
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,425
Total interest from all sources2017-12-31$56,557
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$406,125
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$406,125
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
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$1,233,224
Participant contributions at end of year2017-12-31$372,242
Participant contributions at beginning of year2017-12-31$359,371
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$15,894
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$169,782
Administrative expenses (other) incurred2017-12-31$2,425
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$2,691,588
Value of net assets at end of year (total assets less liabilities)2017-12-31$15,166,565
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$12,474,977
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$11,468,973
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$9,572,465
Interest on participant loans2017-12-31$14,244
Interest earned on other investments2017-12-31$42,313
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$3,325,350
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$2,520,605
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,289,828
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$288,041
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$6,642
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$724,760
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 : LEGACY LIFECARE 403(B) 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$9,163,631
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$445,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$431,153
Expenses. Certain deemed distributions of participant loans2016-12-31$4,932
Value of total corrective distributions2016-12-31$3,273
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$8,613,127
Value of total assets at end of year2016-12-31$12,474,977
Value of total assets at beginning of year2016-12-31$3,756,599
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$5,895
Total interest from all sources2016-12-31$41,087
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$2,865
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$2,865
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
Contributions received from participants2016-12-31$1,255,989
Participant contributions at end of year2016-12-31$359,371
Participant contributions at beginning of year2016-12-31$96,628
Participant contributions at end of year2016-12-31$15,894
Participant contributions at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$6,863,167
Administrative expenses (other) incurred2016-12-31$5,895
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$8,718,378
Value of net assets at end of year (total assets less liabilities)2016-12-31$12,474,977
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,756,599
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$9,572,465
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,942,199
Interest on participant loans2016-12-31$8,137
Interest earned on other investments2016-12-31$32,950
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$2,520,605
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$687,025
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$506,552
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 contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$493,971
Employer contributions (assets) at end of year2016-12-31$6,642
Employer contributions (assets) at beginning of year2016-12-31$30,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$431,153
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

Form 5500 Responses for LEGACY LIFECARE 403(B) PLAN

2022: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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: LEGACY LIFECARE 403(B) 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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered603
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 2
Insurance contract or identification number613953
Number of Individuals Covered16
Insurance policy start date2022-12-19
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF7064
Policy instance 3
Insurance contract or identification numberVF7064
Number of Individuals Covered5
Insurance policy start date2022-12-19
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF7065
Policy instance 4
Insurance contract or identification numberVF7065
Number of Individuals Covered11
Insurance policy start date2022-12-19
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered454
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered340
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $8
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered337
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $52,983
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $52,933
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered320
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,063
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $10,063
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664058
Policy instance 1
Insurance contract or identification number664058
Number of Individuals Covered339
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $57,130
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $44,343
Insurance broker organization code?3
Insurance broker nameMSI FINANCIAL SERVICES, INC.

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