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EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 401k Plan overview

Plan NameEL SHADDAI HEALTH CARE, INC. 401(K) PLAN
Plan identification number 001

EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 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.

401k Sponsoring company profile

EL SHADDAI HEALTH CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:EL SHADDAI HEALTH CARE, INC.
Employer identification number (EIN):521777939
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EL SHADDAI HEALTH CARE, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01DR. JOSEPH DEVADOSS2020-02-13
0012018-01-01DR. JOSEPH DEVADOSS2019-02-15
0012017-01-01DR. JOSEPH DEVADOSS2018-02-14
0012016-01-01DR. JOSEPH DEVADOSS2017-03-22
0012015-01-01DR. JOSEPH DEVADOSS2016-03-22
0012014-01-01DR. JOSEPH DEVADOSS2015-03-31
0012013-01-01DR. JOSEPH DEVADOSS2014-04-04
0012012-01-01DR. JOSEPH DEVADOSS2013-05-30
0012011-01-01DR. JOSEPH DEVADOSS
0012009-01-01
0012009-01-01DR. JOSEPH DEVADOSS

Plan Statistics for EL SHADDAI HEALTH CARE, INC. 401(K) PLAN

401k plan membership statisitcs for EL SHADDAI HEALTH CARE, INC. 401(K) PLAN

Measure Date Value
2011: EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0175
Total number of active participants reported on line 7a of the Form 55002011-01-0156
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0156
Number of participants with account balances2011-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0175
Total number of active participants reported on line 7a of the Form 55002009-01-0159
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-018
Total of all active and inactive participants2009-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-0168
Number of participants with account balances2009-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on EL SHADDAI HEALTH CARE, INC. 401(K) PLAN

Measure Date Value
2011 : EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$212,930
Expenses. Total of all expenses incurred2011-12-31$61,368
Benefits paid (including direct rollovers)2011-12-31$60,838
Total plan assets at end of year2011-12-31$949,625
Total plan assets at beginning of year2011-12-31$798,063
Value of fidelity bond covering the plan2011-12-31$44,539
Total contributions received or receivable from participants2011-12-31$158,372
Expenses. Other expenses not covered elsewhere2011-12-31$530
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$49
Net income (gross income less expenses)2011-12-31$151,562
Net plan assets at end of year (total assets less liabilities)2011-12-31$949,625
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$798,063
Assets. Value of participant loans2011-12-31$5,300
Total contributions received or receivable from employer(s)2011-12-31$54,509
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$276,311
Expenses. Total of all expenses incurred2010-12-31$88,546
Benefits paid (including direct rollovers)2010-12-31$88,136
Total plan assets at end of year2010-12-31$798,063
Total plan assets at beginning of year2010-12-31$610,298
Value of fidelity bond covering the plan2010-12-31$44,539
Total contributions received or receivable from participants2010-12-31$159,372
Expenses. Other expenses not covered elsewhere2010-12-31$410
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$60,625
Net income (gross income less expenses)2010-12-31$187,765
Net plan assets at end of year (total assets less liabilities)2010-12-31$798,063
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$610,298
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$56,314
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for EL SHADDAI HEALTH CARE, INC. 401(K) PLAN

2011: EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: EL SHADDAI HEALTH CARE, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-023613
Policy instance 1
Insurance contract or identification numberGA-023613
Number of Individuals Covered37
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,289
Total amount of fees paid to insurance companyUSD $703
Are there contracts with allocated funds for individual policies?No
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-023613
Policy instance 1
Insurance contract or identification numberGA-023613
Number of Individuals Covered39
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,739
Total amount of fees paid to insurance companyUSD $2,121
Are there contracts with allocated funds for individual policies?No
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 $3,739
Insurance broker organization code?3
Amount paid for insurance broker fees2121
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO

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