401k Plan data: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR plan

TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR
Plan identification number	002

TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR Benefits

401k Plan Type	Defined 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. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

CHILDREN'S HARBOR, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHILDREN'S HARBOR, INC.

Employer identification number (EIN): 570892070

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about CHILDREN'S HARBOR, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1996-05-15

Company Identification Number: N96000002706

Legal Registered Office Address: 19425 SW 58TH MANOR

PEMBROKE PINES

33332

More information about CHILDREN'S HARBOR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01
002 2016-01-01 MYRLE GRATE MYRLE GRATE 2017-07-17
002 2015-01-01 MYRLE GRATE MYRLE GRATE 2016-08-22
002 2014-01-01 MYRLE GRATE MYRLE GRATE 2015-07-16
002 2013-01-01 JAMES A. RAY JAMES A. RAY 2014-10-03
002 2012-01-01 JAMES A. RAY JAMES A. RAY 2013-07-24
002 2011-01-01 JAMES A. RAY JAMES A. RAY 2012-07-23
002 2009-01-01 JAMES A. RAY JAMES A. RAY 2010-10-05

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01
002	2016-01-01	MYRLE GRATE	MYRLE GRATE	2017-07-17
002	2015-01-01	MYRLE GRATE	MYRLE GRATE	2016-08-22
002	2014-01-01	MYRLE GRATE	MYRLE GRATE	2015-07-16
002	2013-01-01	JAMES A. RAY	JAMES A. RAY	2014-10-03
002	2012-01-01	JAMES A. RAY	JAMES A. RAY	2013-07-24
002	2011-01-01	JAMES A. RAY	JAMES A. RAY	2012-07-23
002	2009-01-01	JAMES A. RAY	JAMES A. RAY	2010-10-05

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR

Measure Date Value
2016: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2016 401k membership
Total participants, beginning-of-year 2016-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 4
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 3
Total of all active and inactive participants 2016-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 7
Number of participants with account balances 2016-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2015 401k membership
Total participants, beginning-of-year 2015-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 8
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 3
Total of all active and inactive participants 2015-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2014 401k membership
Total participants, beginning-of-year 2014-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 8
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 11
Number of participants with account balances 2014-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2013 401k membership
Total participants, beginning-of-year 2013-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 8
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 4
Total of all active and inactive participants 2013-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 12
Number of participants with account balances 2013-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2012 401k membership
Total participants, beginning-of-year 2012-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 4
Total of all active and inactive participants 2012-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 12
Number of participants with account balances 2012-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2011 401k membership
Total participants, beginning-of-year 2011-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 13
Number of participants with account balances 2011-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2009 401k membership
Total participants, beginning-of-year 2009-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 6
Total of all active and inactive participants 2009-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 15
Number of participants with account balances 2009-01-01 15

Measure	Date	Value
2016: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2016 401k membership
Total participants, beginning-of-year	2016-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	4
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	3
Total of all active and inactive participants	2016-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	7
Number of participants with account balances	2016-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2015 401k membership
Total participants, beginning-of-year	2015-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	8
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	3
Total of all active and inactive participants	2015-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2014 401k membership
Total participants, beginning-of-year	2014-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	8
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	11
Number of participants with account balances	2014-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2013 401k membership
Total participants, beginning-of-year	2013-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	4
Total of all active and inactive participants	2013-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	12
Number of participants with account balances	2013-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2012 401k membership
Total participants, beginning-of-year	2012-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	4
Total of all active and inactive participants	2012-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	12
Number of participants with account balances	2012-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2011 401k membership
Total participants, beginning-of-year	2011-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	13
Number of participants with account balances	2011-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2009 401k membership
Total participants, beginning-of-year	2009-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	6
Total of all active and inactive participants	2009-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	15
Number of participants with account balances	2009-01-01	15

Financial Data on TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR

Measure	Date	Value
2016 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2016 401k financial data
Total income from all sources	2016-12-31	$6,751
Expenses. Total of all expenses incurred	2016-12-31	$55
Total plan assets at end of year	2016-12-31	$81,887
Total plan assets at beginning of year	2016-12-31	$75,191
Other income received	2016-12-31	$6,751
Net income (gross income less expenses)	2016-12-31	$6,696
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$81,887
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$75,191
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$55
2015 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2015 401k financial data
Total income from all sources	2015-12-31	$-238
Expenses. Total of all expenses incurred	2015-12-31	$56
Total plan assets at end of year	2015-12-31	$75,191
Total plan assets at beginning of year	2015-12-31	$75,485
Other income received	2015-12-31	$-238
Net income (gross income less expenses)	2015-12-31	$-294
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$75,191
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$75,485
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$56
2014 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2014 401k financial data
Total income from all sources	2014-12-31	$3,867
Expenses. Total of all expenses incurred	2014-12-31	$69
Total plan assets at end of year	2014-12-31	$75,485
Total plan assets at beginning of year	2014-12-31	$71,687
Other income received	2014-12-31	$3,867
Net income (gross income less expenses)	2014-12-31	$3,798
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$75,485
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$71,687
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$69
2013 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2013 401k financial data
Total income from all sources	2013-12-31	$8,380
Expenses. Total of all expenses incurred	2013-12-31	$79
Total plan assets at end of year	2013-12-31	$71,687
Total plan assets at beginning of year	2013-12-31	$63,386
Other income received	2013-12-31	$8,380
Net income (gross income less expenses)	2013-12-31	$8,301
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$71,687
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$63,386
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$79
2012 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2012 401k financial data
Total income from all sources	2012-12-31	$4,877
Expenses. Total of all expenses incurred	2012-12-31	$3,888
Benefits paid (including direct rollovers)	2012-12-31	$3,799
Total plan assets at end of year	2012-12-31	$63,386
Total plan assets at beginning of year	2012-12-31	$62,397
Other income received	2012-12-31	$4,877
Net income (gross income less expenses)	2012-12-31	$989
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$63,386
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$62,397
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$89
2011 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2011 401k financial data
Total income from all sources	2011-12-31	$216
Expenses. Total of all expenses incurred	2011-12-31	$12,400
Benefits paid (including direct rollovers)	2011-12-31	$12,292
Total plan assets at end of year	2011-12-31	$62,397
Total plan assets at beginning of year	2011-12-31	$74,581
Other income received	2011-12-31	$216
Net income (gross income less expenses)	2011-12-31	$-12,184
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$62,397
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$74,581
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$108
2010 : TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2010 401k financial data
Total income from all sources	2010-12-31	$23,796
Expenses. Total of all expenses incurred	2010-12-31	$62,832
Benefits paid (including direct rollovers)	2010-12-31	$62,678
Total plan assets at end of year	2010-12-31	$74,581
Total plan assets at beginning of year	2010-12-31	$113,617
Total contributions received or receivable from participants	2010-12-31	$17,148
Other income received	2010-12-31	$6,648
Net income (gross income less expenses)	2010-12-31	$-39,036
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$74,581
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$113,617
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$154

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR

2016: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: TAX DEFERRED ANNUITY PLAN OF CHILDREN'S HARBOR 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	11
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	11
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	12
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	12
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	13
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $45
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

054061-D

Policy instance

Insurance contract or identification number	054061-D
Number of Individuals Covered	14
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of fees paid to insurance company	USD $103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CHILDREN'S HARBOR, INC.
Employer identification number (EIN):	570892070
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1996-05-15
Company Identification Number:	N96000002706
Legal Registered Office Address:	19425 SW 58TH MANOR PEMBROKE PINES 33332