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| Plan Name | FAIRFAX NURSING CENTER, INC. |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FAIRFAX NURSING CENTER, INC. |
| Employer identification number (EIN): | 540736885 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about FAIRFAX NURSING CENTER, INC.
| Jurisdiction of Incorporation: | Virginia Secretary of State |
| Incorporation Date: | 1963-07-29 |
| Company Identification Number: | 0097467 |
| Legal Registered Office Address: |
10701 MAIN ST 4320 FOREST HILL DR FAIRFAX United States of America (USA) 22030 |
More information about FAIRFAX NURSING CENTER, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-01-01 | JONATHAN MUNSAYAC | |||
| 501 | 2016-01-01 | JONATHAN MUNSAYAC | |||
| 501 | 2015-01-01 | JONATHAN MUNSAYAC |
| Measure | Date | Value |
|---|---|---|
| 2017: FAIRFAX NURSING CENTER, INC. 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 238 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 275 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 275 |
| 2016: FAIRFAX NURSING CENTER, INC. 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 238 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 238 |
| 2015: FAIRFAX NURSING CENTER, INC. 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 232 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 232 |
| 2017: FAIRFAX NURSING CENTER, INC. 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FAIRFAX NURSING CENTER, INC. 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FAIRFAX NURSING CENTER, INC. 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 12632 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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