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CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 401k Plan overview

Plan NameCHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN
Plan identification number 001

CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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)(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.
  • Code section 408 accounts and annuities - See Limited Pension Plan Reporting instructions for pension plan utilizing individual Code section 408 retirement accounts or annuities as the funding vehicle for providing benefits.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

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

Company Name:CHARLOTTE BEHAVIORAL HEALTH CARE, INC.
Employer identification number (EIN):591234922
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Additional information about CHARLOTTE BEHAVIORAL HEALTH CARE, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1968-07-15
Company Identification Number: 714950
Legal Registered Office Address: 1700 EDUCATION AVE

PUNTA GORDA

33950

More information about CHARLOTTE BEHAVIORAL HEALTH CARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01VICTORIA SCANLON2023-10-09
0012021-01-01VICTORIA SCANLON2022-10-06
0012020-01-01VICTORIA SCANLON2021-10-14
0012020-01-01DEREK ROGERS2022-06-17
0012019-01-01VICTORIA SCANLON2020-10-15
0012019-01-01DEREK ROGERS2022-06-17
0012018-01-01VICTORIA SCANLON2019-10-14
0012018-01-01DEREK ROGERS2022-06-17
0012017-01-01JENNIFER BORTOLINI VICTORIA SCANLON2018-10-15
0012017-01-01VICTORIA SCANLON2019-08-27
0012016-01-01LORI CHEEZEM VICTORIA SCANLON2017-07-25
0012015-01-01
0012014-01-01JAY GLYNN
0012013-01-01JAY GLYNN
0012012-01-01JAY GLYNN
0012011-01-01JAY GLYNN
0012010-01-01JAY GLYNN
0012009-01-01JAY GLYNN

Plan Statistics for CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN

401k plan membership statisitcs for CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN

Measure Date Value
2022: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01465
Total number of active participants reported on line 7a of the Form 55002022-01-01218
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01332
Total of all active and inactive participants2022-01-01550
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01550
Number of participants with account balances2022-01-01531
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0138
2021: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01400
Total number of active participants reported on line 7a of the Form 55002021-01-01213
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01251
Total of all active and inactive participants2021-01-01464
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01464
Number of participants with account balances2021-01-01454
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0142
2020: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01337
Total number of active participants reported on line 7a of the Form 55002020-01-01258
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01154
Total of all active and inactive participants2020-01-01412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01412
Number of participants with account balances2020-01-01398
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0148
2019: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01338
Total number of active participants reported on line 7a of the Form 55002019-01-01299
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01114
Total of all active and inactive participants2019-01-01413
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01413
Number of participants with account balances2019-01-01398
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0134
2018: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01328
Total number of active participants reported on line 7a of the Form 55002018-01-01230
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0175
Total of all active and inactive participants2018-01-01305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01305
Number of participants with account balances2018-01-01301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0112
2017: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01317
Total number of active participants reported on line 7a of the Form 55002017-01-01218
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01143
Total of all active and inactive participants2017-01-01361
Total participants2017-01-01361
Number of participants with account balances2017-01-01328
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0112
2016: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2016 401k membership
Total number of active participants reported on line 7a of the Form 55002016-01-01145
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-01104
Total of all active and inactive participants2016-01-01252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01252
Number of participants with account balances2016-01-01252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0111
2015: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01227
Total number of active participants reported on line 7a of the Form 55002015-01-01131
Number of other retired or separated participants entitled to future benefits2015-01-0194
Total of all active and inactive participants2015-01-01225
Total participants2015-01-01225
Number of participants with account balances2015-01-01225
2014: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01202
Total number of active participants reported on line 7a of the Form 55002014-01-01125
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-01102
Total of all active and inactive participants2014-01-01227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01227
Number of participants with account balances2014-01-01227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01198
Total number of active participants reported on line 7a of the Form 55002013-01-01110
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0192
Total of all active and inactive participants2013-01-01202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01202
Number of participants with account balances2013-01-01202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01215
Total number of active participants reported on line 7a of the Form 55002012-01-01129
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0169
Total of all active and inactive participants2012-01-01198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01198
Number of participants with account balances2012-01-01198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01212
Total number of active participants reported on line 7a of the Form 55002011-01-01118
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0197
Total of all active and inactive participants2011-01-01215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01215
Number of participants with account balances2011-01-01215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01209
Total number of active participants reported on line 7a of the Form 55002010-01-01135
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0177
Total of all active and inactive participants2010-01-01212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01212
Number of participants with account balances2010-01-01212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01189
Total number of active participants reported on line 7a of the Form 55002009-01-01134
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0175
Total of all active and inactive participants2009-01-01209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01209
Number of participants with account balances2009-01-01209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN

Measure Date Value
2022 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2022 401k financial data
Total transfer of assets to this plan2022-12-31$21,594
Total income from all sources (including contributions)2022-12-31$-318,383
Total of all expenses incurred2022-12-31$588,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$579,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$975,385
Value of total assets at end of year2022-12-31$8,582,959
Value of total assets at beginning of year2022-12-31$9,468,568
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$9,010
Total interest from all sources2022-12-31$36,934
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$208,152
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$208,152
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$750,000
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$299,255
Participant contributions at end of year2022-12-31$133,310
Participant contributions at beginning of year2022-12-31$152,375
Participant contributions at end of year2022-12-31$9,542
Participant contributions at beginning of year2022-12-31$9,554
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$0
Administrative expenses (other) incurred2022-12-31$9,010
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-907,203
Value of net assets at end of year (total assets less liabilities)2022-12-31$8,582,959
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$9,468,568
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$7,084,990
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$7,898,216
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$4,178
Interest earned on other investments2022-12-31$32,756
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,522
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,163,611
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,221,517
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,538,854
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$676,130
Employer contributions (assets) at end of year2022-12-31$189,984
Employer contributions (assets) at beginning of year2022-12-31$186,906
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$579,810
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2022-12-31590548468
2021 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2021 401k financial data
Total transfer of assets to this plan2021-12-31$23,382
Total income from all sources (including contributions)2021-12-31$1,945,430
Total of all expenses incurred2021-12-31$576,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$565,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$986,645
Value of total assets at end of year2021-12-31$9,468,568
Value of total assets at beginning of year2021-12-31$8,076,328
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$10,751
Total interest from all sources2021-12-31$40,462
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$294,124
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$294,124
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$750,000
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$298,552
Participant contributions at end of year2021-12-31$152,375
Participant contributions at beginning of year2021-12-31$78,139
Participant contributions at end of year2021-12-31$9,554
Participant contributions at beginning of year2021-12-31$9,355
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$73,253
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$10,751
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$1,368,858
Value of net assets at end of year (total assets less liabilities)2021-12-31$9,468,568
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,076,328
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
Investment advisory and management fees2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$7,898,216
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,467,315
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$5,294
Interest earned on other investments2021-12-31$35,168
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$4,318
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$4,318
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,221,517
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,348,756
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$624,199
Net investment gain/loss from pooled separate accounts2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$614,840
Employer contributions (assets) at end of year2021-12-31$186,906
Employer contributions (assets) at beginning of year2021-12-31$168,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$565,821
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2021-12-31590548468
2020 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2020 401k financial data
Total transfer of assets to this plan2020-12-31$93,561
Total income from all sources (including contributions)2020-12-31$1,826,718
Total of all expenses incurred2020-12-31$830,497
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$830,356
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$898,183
Value of total assets at end of year2020-12-31$8,029,143
Value of total assets at beginning of year2020-12-31$6,939,361
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$141
Total interest from all sources2020-12-31$6,506
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$141,568
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$141,568
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$311,465
Participant contributions at end of year2020-12-31$157,503
Participant contributions at beginning of year2020-12-31$173,491
Participant contributions at end of year2020-12-31$15,867
Participant contributions at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$36,169
Administrative expenses (other) incurred2020-12-31$141
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$996,221
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,029,143
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,939,361
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$5,731,611
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$4,821,595
Value of interest in pooled separate accounts at end of year2020-12-31$656,340
Value of interest in pooled separate accounts at beginning of year2020-12-31$600,673
Interest on participant loans2020-12-31$6,439
Interest earned on other investments2020-12-31$36,245
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$6,436
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$6,436
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$6,436
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$67
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,348,756
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,337,166
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$786,268
Net investment gain/loss from pooled separate accounts2020-12-31$99,592
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$586,718
Employer contributions (assets) at end of year2020-12-31$112,630
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$830,356
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 name2020-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2020-12-31590548468
2019 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2019 401k financial data
Total transfer of assets to this plan2019-12-31$132,086
Total transfer of assets to this plan2019-12-31$132,086
Total income from all sources (including contributions)2019-12-31$1,875,180
Total income from all sources (including contributions)2019-12-31$1,875,180
Total of all expenses incurred2019-12-31$988,940
Total of all expenses incurred2019-12-31$988,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$988,797
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$988,797
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$891,759
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$891,759
Value of total assets at end of year2019-12-31$6,939,361
Value of total assets at end of year2019-12-31$6,939,361
Value of total assets at beginning of year2019-12-31$5,921,035
Value of total assets at beginning of year2019-12-31$5,921,035
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$143
Total interest from all sources2019-12-31$7,788
Total interest from all sources2019-12-31$7,788
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$131,650
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$131,650
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$301,043
Contributions received from participants2019-12-31$301,043
Participant contributions at end of year2019-12-31$173,491
Participant contributions at end of year2019-12-31$173,491
Participant contributions at beginning of year2019-12-31$181,063
Participant contributions at beginning of year2019-12-31$181,063
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$21,028
Participant contributions at beginning of year2019-12-31$21,028
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,091
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,091
Other income not declared elsewhere2019-12-31$37,853
Other income not declared elsewhere2019-12-31$37,853
Administrative expenses (other) incurred2019-12-31$143
Administrative expenses (other) incurred2019-12-31$143
Total non interest bearing cash at beginning of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party 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$886,240
Value of net income/loss2019-12-31$886,240
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,939,361
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,939,361
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,921,035
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,921,035
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$4,821,595
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,821,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,518,131
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,518,131
Value of interest in pooled separate accounts at end of year2019-12-31$600,673
Value of interest in pooled separate accounts at end of year2019-12-31$600,673
Value of interest in pooled separate accounts at beginning of year2019-12-31$594,670
Value of interest in pooled separate accounts at beginning of year2019-12-31$594,670
Interest on participant loans2019-12-31$7,748
Interest on participant loans2019-12-31$7,748
Interest earned on other investments2019-12-31$37,864
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$6,436
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$6,436
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$12,441
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$12,441
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$12,441
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$12,441
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$40
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$40
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,337,166
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,337,166
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,572,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,572,909
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$807,080
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$807,080
Net investment gain/loss from pooled separate accounts2019-12-31$130,700
Net investment gain/loss from pooled separate accounts2019-12-31$130,700
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$587,625
Contributions received in cash from employer2019-12-31$587,625
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$20,793
Employer contributions (assets) at beginning of year2019-12-31$20,793
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$988,797
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$988,797
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 name2019-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm name2019-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2019-12-31590548468
Accountancy firm EIN2019-12-31590548468
2018 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2018 401k financial data
Total transfer of assets to this plan2018-12-31$162,816
Total income from all sources (including contributions)2018-12-31$641,706
Total of all expenses incurred2018-12-31$760,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$752,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$836,141
Value of total assets at end of year2018-12-31$5,921,035
Value of total assets at beginning of year2018-12-31$5,877,465
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$8,498
Total interest from all sources2018-12-31$7,116
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$45,856
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$45,856
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$298,869
Participant contributions at end of year2018-12-31$181,063
Participant contributions at beginning of year2018-12-31$175,696
Participant contributions at end of year2018-12-31$21,028
Participant contributions at beginning of year2018-12-31$11,146
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$1,398
Other income not declared elsewhere2018-12-31$1,134
Administrative expenses (other) incurred2018-12-31$8,498
Total non interest bearing cash at end of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-119,246
Value of net assets at end of year (total assets less liabilities)2018-12-31$5,921,035
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,877,465
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$3,518,131
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,948,677
Value of interest in pooled separate accounts at end of year2018-12-31$594,670
Value of interest in pooled separate accounts at beginning of year2018-12-31$875,000
Interest on participant loans2018-12-31$7,082
Interest earned on other investments2018-12-31$51,428
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$12,441
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$20,523
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$20,523
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$34
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,572,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,825,514
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-248,541
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 contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$535,874
Employer contributions (assets) at end of year2018-12-31$20,793
Employer contributions (assets) at beginning of year2018-12-31$20,909
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$752,454
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 name2018-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2018-12-31590548468
2017 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$0
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$671,221
Total transfer of assets from this plan2017-12-31$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
Expenses. Interest paid2017-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,291,128
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$475,807
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$472,405
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Value of total corrective distributions2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$809,121
Value of total assets at end of year2017-12-31$5,841,473
Value of total assets at beginning of year2017-12-31$4,354,931
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$3,402
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$64,572
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$67,821
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$67,821
Assets. Real estate other than employer real property at end of year2017-12-31$0
Assets. Real estate other than employer real property at beginning of year2017-12-31$0
Administrative expenses professional fees incurred2017-12-31$1,501
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
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 period2017-12-31Yes
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$274,260
Participant contributions at end of year2017-12-31$175,696
Participant contributions at beginning of year2017-12-31$191,754
Participant contributions at end of year2017-12-31$56
Participant contributions at beginning of year2017-12-31$0
Assets. Other investments not covered elsewhere at end of year2017-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$38,882
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Assets. Loans (other than to participants) at end of year2017-12-31$0
Assets. Loans (other than to participants) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$0
Liabilities. Value of operating payables at end of year2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$815,321
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,841,473
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,354,931
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
Assets. partnership/joint venture interests at end of year2017-12-31$0
Assets. partnership/joint venture interests at beginning of year2017-12-31$0
Investment advisory and management fees2017-12-31$1,901
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,938,052
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$1,051,213
Value of interest in pooled separate accounts at beginning of year2017-12-31$1,307,382
Interest on participant loans2017-12-31$344
Income. Interest from loans (other than to participants)2017-12-31$0
Interest earned on other investments2017-12-31$0
Income. Interest from US Government securities2017-12-31$0
Income. Interest from corporate debt instruments2017-12-31$0
Value of interest in master investment trust accounts at end of year2017-12-31$0
Value of interest in master investment trust accounts at beginning of year2017-12-31$0
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$22,784
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$25,395
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$25,395
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$64,228
Assets. Value of investments in 103.12 investment entities at end of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,649,451
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$2,812,748
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$21,622
Asset value of US Government securities at end of year2017-12-31$0
Asset value of US Government securities at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$349,614
Net investment gain/loss from pooled separate accounts2017-12-31$0
Net investment gain or loss from common/collective trusts2017-12-31$0
Net gain/loss from 103.12 investment entities2017-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Assets. Value of employer real property at end of year2017-12-31$0
Assets. Value of employer real property at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$495,979
Employer contributions (assets) at end of year2017-12-31$4,221
Employer contributions (assets) at beginning of year2017-12-31$17,652
Income. Dividends from preferred stock2017-12-31$0
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$450,783
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$0
Contract administrator fees2017-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$0
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
Aggregate proceeds on sale of assets2017-12-31$0
Aggregate carrying amount (costs) on sale of assets2017-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
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 name2017-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2017-12-31590548468
2016 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$0
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$0
Total transfer of assets from this plan2016-12-31$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
Expenses. Interest paid2016-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022016-12-31$0
Total income from all sources (including contributions)2016-12-31$669,474
Total loss/gain on sale of assets2016-12-31$80,408
Total of all expenses incurred2016-12-31$813,776
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$812,747
Expenses. Certain deemed distributions of participant loans2016-12-31$0
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$507,010
Value of total assets at end of year2016-12-31$4,354,931
Value of total assets at beginning of year2016-12-31$4,499,233
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,029
Total interest from all sources2016-12-31$82,056
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
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$0
Assets. Real estate other than employer real property at end of year2016-12-31$0
Assets. Real estate other than employer real property at beginning of year2016-12-31$0
Administrative expenses professional fees incurred2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$0
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$0
Participant contributions at end of year2016-12-31$191,754
Participant contributions at beginning of year2016-12-31$136,056
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Assets. Other investments not covered elsewhere at end of year2016-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$65,000
Assets. Loans (other than to participants) at end of year2016-12-31$0
Assets. Loans (other than to participants) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Other income not declared elsewhere2016-12-31$0
Administrative expenses (other) incurred2016-12-31$0
Liabilities. Value of operating payables at end of year2016-12-31$0
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$0
Value of net income/loss2016-12-31$-144,302
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,354,931
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$4,499,233
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
Assets. partnership/joint venture interests at end of year2016-12-31$0
Assets. partnership/joint venture interests at beginning of year2016-12-31$0
Investment advisory and management fees2016-12-31$369
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$0
Value of interest in pooled separate accounts at end of year2016-12-31$1,307,382
Value of interest in pooled separate accounts at beginning of year2016-12-31$1,609,165
Interest on participant loans2016-12-31$5,937
Income. Interest from loans (other than to participants)2016-12-31$0
Interest earned on other investments2016-12-31$3,542
Income. Interest from US Government securities2016-12-31$0
Income. Interest from corporate debt instruments2016-12-31$0
Value of interest in master investment trust accounts at end of year2016-12-31$0
Value of interest in master investment trust accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$25,395
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$7,484
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$7,484
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$72,577
Assets. Value of investments in 103.12 investment entities at end of year2016-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$2,812,748
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$2,665,282
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Asset value of US Government securities at end of year2016-12-31$0
Asset value of US Government securities at beginning of year2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$0
Net investment gain or loss from common/collective trusts2016-12-31$0
Net gain/loss from 103.12 investment entities2016-12-31$0
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 contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Assets. Value of employer real property at end of year2016-12-31$0
Assets. Value of employer real property at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$507,010
Employer contributions (assets) at end of year2016-12-31$17,652
Employer contributions (assets) at beginning of year2016-12-31$16,246
Income. Dividends from preferred stock2016-12-31$0
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$812,747
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$0
Contract administrator fees2016-12-31$660
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$0
Liabilities. Value of benefit claims payable at end of year2016-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$0
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
Aggregate proceeds on sale of assets2016-12-31$80,408
Aggregate carrying amount (costs) on sale of assets2016-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2016-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
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 name2016-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2016-12-31590548468
2015 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$589,734
Total of all expenses incurred2015-12-31$340,325
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$339,411
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$554,680
Value of total assets at end of year2015-12-31$4,499,233
Value of total assets at beginning of year2015-12-31$4,249,824
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$914
Total interest from all sources2015-12-31$4,564
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$0
Participant contributions at end of year2015-12-31$136,056
Participant contributions at beginning of year2015-12-31$112,111
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$65,000
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$65,000
Other income not declared elsewhere2015-12-31$69,046
Administrative expenses (other) incurred2015-12-31$914
Total non interest bearing cash at end of year2015-12-31$7,484
Total non interest bearing cash at beginning of year2015-12-31$6,243
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$249,409
Value of net assets at end of year (total assets less liabilities)2015-12-31$4,499,233
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$4,249,824
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$1,609,165
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,540,862
Interest on participant loans2015-12-31$4,564
Income. Interest from loans (other than to participants)2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$2,665,282
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$2,579,569
Net investment gain/loss from pooled separate accounts2015-12-31$-38,556
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$489,680
Employer contributions (assets) at end of year2015-12-31$16,246
Employer contributions (assets) at beginning of year2015-12-31$11,039
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$339,411
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2015-12-31590548468
2014 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$625,796
Total of all expenses incurred2014-12-31$513,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$512,860
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$471,603
Value of total assets at end of year2014-12-31$4,249,824
Value of total assets at beginning of year2014-12-31$4,137,802
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$914
Total interest from all sources2014-12-31$4,026
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Participant contributions at end of year2014-12-31$112,111
Participant contributions at beginning of year2014-12-31$107,493
Administrative expenses (other) incurred2014-12-31$914
Total non interest bearing cash at end of year2014-12-31$6,243
Total non interest bearing cash at beginning of year2014-12-31$5,320
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$112,022
Value of net assets at end of year (total assets less liabilities)2014-12-31$4,249,824
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$4,137,802
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$1,540,862
Value of interest in pooled separate accounts at beginning of year2014-12-31$1,495,859
Interest on participant loans2014-12-31$4,026
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$2,579,569
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$2,519,747
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$68,987
Net investment gain/loss from pooled separate accounts2014-12-31$81,180
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$471,603
Employer contributions (assets) at end of year2014-12-31$11,039
Employer contributions (assets) at beginning of year2014-12-31$9,383
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$512,860
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2014-12-31590548468
2013 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2013 401k financial data
Total transfer of assets to this plan2013-12-31$0
Total transfer of assets from this plan2013-12-31$0
Expenses. Interest paid2013-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-12-31$0
Total income from all sources (including contributions)2013-12-31$731,485
Total of all expenses incurred2013-12-31$306,893
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$305,955
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$443,882
Value of total assets at end of year2013-12-31$4,137,802
Value of total assets at beginning of year2013-12-31$3,713,210
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$938
Total interest from all sources2013-12-31$4,168
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$0
Participant contributions at end of year2013-12-31$107,493
Participant contributions at beginning of year2013-12-31$127,214
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Administrative expenses (other) incurred2013-12-31$938
Total non interest bearing cash at end of year2013-12-31$5,320
Total non interest bearing cash at beginning of year2013-12-31$24,754
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$424,592
Value of net assets at end of year (total assets less liabilities)2013-12-31$4,137,802
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$3,713,210
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$0
Value of interest in pooled separate accounts at end of year2013-12-31$1,495,859
Value of interest in pooled separate accounts at beginning of year2013-12-31$1,152,844
Interest on participant loans2013-12-31$4,168
Interest earned on other investments2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$2,519,747
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$2,400,279
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$66,858
Net investment gain/loss from pooled separate accounts2013-12-31$216,577
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$443,882
Employer contributions (assets) at end of year2013-12-31$9,383
Employer contributions (assets) at beginning of year2013-12-31$8,119
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$305,955
Contract administrator fees2013-12-31$0
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2013-12-31590548468
2012 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$639,162
Total of all expenses incurred2012-12-31$259,791
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$259,090
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$447,679
Value of total assets at end of year2012-12-31$3,713,210
Value of total assets at beginning of year2012-12-31$3,333,839
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$701
Total interest from all sources2012-12-31$123,400
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Participant contributions at end of year2012-12-31$127,214
Participant contributions at beginning of year2012-12-31$87,074
Total non interest bearing cash at end of year2012-12-31$24,754
Total non interest bearing cash at beginning of year2012-12-31$12,669
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$379,371
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,713,210
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,333,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in pooled separate accounts at end of year2012-12-31$1,152,844
Value of interest in pooled separate accounts at beginning of year2012-12-31$920,359
Interest on participant loans2012-12-31$4,524
Interest earned on other investments2012-12-31$118,876
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$2,400,279
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$2,306,976
Net investment gain/loss from pooled separate accounts2012-12-31$68,083
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$447,679
Employer contributions (assets) at end of year2012-12-31$8,119
Employer contributions (assets) at beginning of year2012-12-31$6,761
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$259,090
Contract administrator fees2012-12-31$701
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2012-12-31590548468
2011 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Expenses. Interest paid2011-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022011-12-31$0
Total income from all sources (including contributions)2011-12-31$530,460
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$410,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$410,038
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Value of total corrective distributions2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$456,618
Value of total assets at end of year2011-12-31$3,333,839
Value of total assets at beginning of year2011-12-31$3,213,881
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$464
Total income from rents2011-12-31$0
Total interest from all sources2011-12-31$4,373
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$-4,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$-4,736
Administrative expenses professional fees incurred2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$0
Participant contributions at end of year2011-12-31$87,074
Participant contributions at beginning of year2011-12-31$99,149
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$464
Total non interest bearing cash at end of year2011-12-31$12,669
Total non interest bearing cash at beginning of year2011-12-31$51,433
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Income. Non cash contributions2011-12-31$0
Value of net income/loss2011-12-31$119,958
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,333,839
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,213,881
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$0
Value of interest in pooled separate accounts at end of year2011-12-31$920,359
Value of interest in pooled separate accounts at beginning of year2011-12-31$893,417
Interest on participant loans2011-12-31$4,373
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$0
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$2,306,976
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$2,163,676
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$74,205
Net investment gain or loss from common/collective trusts2011-12-31$0
Net gain/loss from 103.12 investment entities2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$456,618
Employer contributions (assets) at end of year2011-12-31$6,761
Employer contributions (assets) at beginning of year2011-12-31$6,206
Income. Dividends from preferred stock2011-12-31$0
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$410,038
Contract administrator fees2011-12-31$0
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$0
Aggregate carrying amount (costs) on sale of assets2011-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2011-12-31590548468
2010 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$3,300
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$655,576
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$415,027
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$414,862
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$465,326
Value of total assets at end of year2010-12-31$3,213,881
Value of total assets at beginning of year2010-12-31$2,976,632
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$165
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$4,191
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$74,258
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$74,258
Administrative expenses professional fees incurred2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$0
Participant contributions at end of year2010-12-31$99,149
Participant contributions at beginning of year2010-12-31$62,853
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$3,300
Administrative expenses (other) incurred2010-12-31$165
Total non interest bearing cash at end of year2010-12-31$51,433
Total non interest bearing cash at beginning of year2010-12-31$57,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$240,549
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,213,881
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,973,332
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$0
Value of interest in pooled separate accounts at end of year2010-12-31$893,417
Value of interest in pooled separate accounts at beginning of year2010-12-31$767,101
Interest on participant loans2010-12-31$4,191
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$0
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$2,163,676
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$2,072,660
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$111,801
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$465,326
Employer contributions (assets) at end of year2010-12-31$6,206
Employer contributions (assets) at beginning of year2010-12-31$16,189
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$414,862
Contract administrator fees2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31PURVIS, GRAY & COMPANY, LLP
Accountancy firm EIN2010-12-31590548468
2009 : CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN

2022: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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
2015: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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
2011-01-01Plan benefit arrangement - TrustYes
2010: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT 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
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 2
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $85
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85
Insurance broker organization code?7
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered120
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 2
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $50
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50
Insurance broker organization code?7
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered130
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $43
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43
Insurance broker organization code?3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 2
Insurance contract or identification number42026
Number of Individuals Covered141
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $72
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $47
Insurance broker organization code?3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 1
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 3
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 2
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13
Insurance broker organization code?7
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered148
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $227
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $201
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 1
Insurance contract or identification numberGAP-B2-JW3B
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9
Insurance broker organization code?7
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 2
Insurance contract or identification number42026
Number of Individuals Covered171
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $281
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-JW3B
Policy instance 2
Insurance contract or identification numberGAP-B2-JW3B
Number of Individuals Covered191
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $20
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?Yes
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
Commission paid to Insurance BrokerUSD $20
Insurance broker organization code?7
Insurance broker nameFSC SECURITIES CORP.
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered191
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $66
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 Administration1
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
Commission paid to Insurance BrokerUSD $52
Insurance broker organization code?3
Insurance broker namePONTIUS, AMANDA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered231
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,836
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $5,270
Insurance broker organization code?3
Insurance broker nameHUDSON, ALLISON
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered230
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,401
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $5,767
Insurance broker organization code?3
Insurance broker nameHELGAGER, DAVID B
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered207
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,694
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $4,240
Insurance broker organization code?3
Insurance broker nameHELGAGER, DAVID B
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered201
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,084
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $3,723
Insurance broker organization code?3
Insurance broker nameHUDAK, GREGG A
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered207
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,607
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number42026
Policy instance 1
Insurance contract or identification number42026
Number of Individuals Covered212
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,632
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Commission paid to Insurance BrokerUSD $3,625
Insurance broker organization code?3
Insurance broker nameHELGAGER, DAVID

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