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HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 401k Plan overview

Plan NameHOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN
Plan identification number 001

HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

HOLLY HALL has sponsored the creation of one or more 401k plans.

Company Name:HOLLY HALL
Employer identification number (EIN):741157354
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-12-01
0012020-12-01
0012019-12-01
0012018-12-01
0012017-12-01
0012016-12-01CHRISTIAN DOMINGUEZ
0012015-12-01CHRISTIAN DOMINGUEZ
0012014-12-01CHRISTIAN DOMINGUEZ
0012013-12-01DIANE PARMER
0012013-01-01RAMONA WILLIAMS2014-05-14
0012012-12-01DIANE PARMER
0012012-01-01RAMONA WILLIAMS2013-04-16
0012011-12-01RAMONA WILLIAMS
0012011-01-01RAMONA WILLIAMS2012-04-26
0012010-12-01RAMONA WILLIAMS
0012010-04-01TINA COPENHAGEN2011-05-17
0012009-12-01TINA COPENHAGEN
0012009-12-01TINA COPENHAGEN
0012009-12-01TINA COPENHAGEN
0012009-12-01TINA COPENHAGEN
0012008-12-01

Plan Statistics for HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN

401k plan membership statisitcs for HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN

Measure Date Value
2022: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2022 401k membership
Market value of plan assets2022-11-304,419,704
Acturial value of plan assets2022-11-304,097,972
Funding target for retired participants and beneficiaries receiving payment2022-11-302,365,337
Number of terminated vested participants2022-11-3014
Fundng target for terminated vested participants2022-11-30818,957
Active participant vested funding target2022-11-30471,763
Number of active participants2022-11-3010
Total funding liabilities for active participants2022-11-30473,293
Total participant count2022-11-3074
Total funding target for all participants2022-11-303,657,587
Balance at beginning of prior year after applicable adjustments2022-11-300
Prefunding balance at beginning of prior year after applicable adjustments2022-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2022-11-300
Prefunding balanced used to offset prior years funding requirement2022-11-300
Amount remaining of carryover balance2022-11-300
Amount remaining of prefunding balance2022-11-300
Present value of excess contributions2022-11-30224,619
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2022-11-30237,175
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2022-11-300
Reductions in caryover balances due to elections or deemed elections2022-11-300
Reductions in prefunding balances due to elections or deemed elections2022-11-300
Balance of carryovers at beginning of current year2022-11-300
Balance of prefunding at beginning of current year2022-11-300
Total employer contributions2022-11-300
Total employee contributions2022-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2022-11-300
Contributions made to avoid restrictions adjusted to valuation date2022-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2022-11-300
Unpaid minimum required contributions for all prior years2022-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2022-11-300
Remaining amount of unpaid minimum required contributions2022-11-300
Minimum required contributions for current year target normal cost2022-11-303,000
Net shortfall amortization installment of oustanding balance2022-11-300
Waiver amortization installment2022-11-300
Total funding amount beforereflecting carryover/prefunding balances2022-11-300
Carryover balance elected to use to offset funding requirement2022-11-300
Prefunding balance elected to use to offset funding requirement2022-11-300
Additional cash requirement2022-11-300
Contributions allocatedtoward minimum required contributions for current year2022-11-300
Unpaid minimum required contributions for current year2022-11-300
Unpaid minimum required contributions for all years2022-11-300
2021: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-0174
Total number of active participants reported on line 7a of the Form 55002021-12-019
Number of retired or separated participants receiving benefits2021-12-0148
Number of other retired or separated participants entitled to future benefits2021-12-0113
Total of all active and inactive participants2021-12-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-12-010
Total participants2021-12-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-12-010
Market value of plan assets2021-11-303,923,135
Acturial value of plan assets2021-11-303,706,952
Funding target for retired participants and beneficiaries receiving payment2021-11-302,153,865
Number of terminated vested participants2021-11-3018
Fundng target for terminated vested participants2021-11-301,031,484
Active participant vested funding target2021-11-30487,765
Number of active participants2021-11-3012
Total funding liabilities for active participants2021-11-30489,610
Total participant count2021-11-3077
Total funding target for all participants2021-11-303,674,959
Balance at beginning of prior year after applicable adjustments2021-11-300
Prefunding balance at beginning of prior year after applicable adjustments2021-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2021-11-300
Prefunding balanced used to offset prior years funding requirement2021-11-300
Amount remaining of carryover balance2021-11-300
Amount remaining of prefunding balance2021-11-300
Present value of excess contributions2021-11-30291,910
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2021-11-30307,586
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2021-11-300
Reductions in caryover balances due to elections or deemed elections2021-11-300
Reductions in prefunding balances due to elections or deemed elections2021-11-300
Balance of carryovers at beginning of current year2021-11-300
Balance of prefunding at beginning of current year2021-11-300
Total employer contributions2021-11-30244,320
Total employee contributions2021-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2021-11-300
Contributions made to avoid restrictions adjusted to valuation date2021-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2021-11-30224,619
Liquidity shortfalls end of Q12021-11-300
Liquidity shortfalls end of Q22021-11-300
Liquidity shortfalls end of Q32021-11-300
Liquidity shortfalls end of Q42021-11-300
Unpaid minimum required contributions for all prior years2021-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2021-11-300
Remaining amount of unpaid minimum required contributions2021-11-300
Minimum required contributions for current year target normal cost2021-11-303,000
Net shortfall amortization installment of oustanding balance2021-11-300
Waiver amortization installment2021-11-300
Total funding amount beforereflecting carryover/prefunding balances2021-11-300
Carryover balance elected to use to offset funding requirement2021-11-300
Prefunding balance elected to use to offset funding requirement2021-11-300
Additional cash requirement2021-11-300
Contributions allocatedtoward minimum required contributions for current year2021-11-30224,619
Unpaid minimum required contributions for current year2021-11-300
Unpaid minimum required contributions for all years2021-11-300
2020: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-0177
Total number of active participants reported on line 7a of the Form 55002020-12-0110
Number of retired or separated participants receiving benefits2020-12-0150
Number of other retired or separated participants entitled to future benefits2020-12-0114
Total of all active and inactive participants2020-12-0174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-12-010
Total participants2020-12-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-12-010
Market value of plan assets2020-11-303,362,062
Acturial value of plan assets2020-11-303,264,244
Funding target for retired participants and beneficiaries receiving payment2020-11-302,186,897
Number of terminated vested participants2020-11-3020
Fundng target for terminated vested participants2020-11-301,095,184
Active participant vested funding target2020-11-30469,415
Number of active participants2020-11-3012
Total funding liabilities for active participants2020-11-30471,681
Total participant count2020-11-3079
Total funding target for all participants2020-11-303,753,762
Balance at beginning of prior year after applicable adjustments2020-11-300
Prefunding balance at beginning of prior year after applicable adjustments2020-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2020-11-300
Prefunding balanced used to offset prior years funding requirement2020-11-300
Amount remaining of carryover balance2020-11-300
Amount remaining of prefunding balance2020-11-300
Present value of excess contributions2020-11-3047
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2020-11-3050
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2020-11-300
Reductions in caryover balances due to elections or deemed elections2020-11-300
Reductions in prefunding balances due to elections or deemed elections2020-11-300
Balance of carryovers at beginning of current year2020-11-300
Balance of prefunding at beginning of current year2020-11-300
Total employer contributions2020-11-30437,440
Total employee contributions2020-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2020-11-300
Contributions made to avoid restrictions adjusted to valuation date2020-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2020-11-30408,788
Liquidity shortfalls end of Q12020-11-300
Liquidity shortfalls end of Q22020-11-300
Liquidity shortfalls end of Q32020-11-300
Liquidity shortfalls end of Q42020-11-300
Unpaid minimum required contributions for all prior years2020-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2020-11-300
Remaining amount of unpaid minimum required contributions2020-11-300
Minimum required contributions for current year target normal cost2020-11-303,000
Net shortfall amortization installment of oustanding balance2020-11-30489,518
Waiver amortization installment2020-11-300
Total funding amount beforereflecting carryover/prefunding balances2020-11-30116,878
Additional cash requirement2020-11-30116,878
Contributions allocatedtoward minimum required contributions for current year2020-11-30408,788
Unpaid minimum required contributions for current year2020-11-300
Unpaid minimum required contributions for all years2020-11-300
2019: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-0179
Total number of active participants reported on line 7a of the Form 55002019-12-0112
Number of retired or separated participants receiving benefits2019-12-0146
Number of other retired or separated participants entitled to future benefits2019-12-0118
Total of all active and inactive participants2019-12-0176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-12-011
Total participants2019-12-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-12-010
Market value of plan assets2019-11-303,310,121
Acturial value of plan assets2019-11-303,370,589
Funding target for retired participants and beneficiaries receiving payment2019-11-302,175,720
Number of terminated vested participants2019-11-3027
Fundng target for terminated vested participants2019-11-301,060,714
Active participant vested funding target2019-11-30450,930
Number of active participants2019-11-3013
Total funding liabilities for active participants2019-11-30453,847
Total participant count2019-11-3087
Total funding target for all participants2019-11-303,690,281
Balance at beginning of prior year after applicable adjustments2019-11-300
Prefunding balance at beginning of prior year after applicable adjustments2019-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2019-11-300
Prefunding balanced used to offset prior years funding requirement2019-11-300
Amount remaining of carryover balance2019-11-300
Amount remaining of prefunding balance2019-11-300
Present value of excess contributions2019-11-307,053
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-11-307,461
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2019-11-300
Reductions in caryover balances due to elections or deemed elections2019-11-300
Reductions in prefunding balances due to elections or deemed elections2019-11-300
Balance of carryovers at beginning of current year2019-11-300
Balance of prefunding at beginning of current year2019-11-300
Total employer contributions2019-11-3059,350
Total employee contributions2019-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2019-11-300
Contributions made to avoid restrictions adjusted to valuation date2019-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-11-3056,047
Liquidity shortfalls end of Q12019-11-300
Liquidity shortfalls end of Q22019-11-300
Liquidity shortfalls end of Q32019-11-300
Liquidity shortfalls end of Q42019-11-300
Unpaid minimum required contributions for all prior years2019-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-11-300
Remaining amount of unpaid minimum required contributions2019-11-300
Minimum required contributions for current year target normal cost2019-11-3056,000
Net shortfall amortization installment of oustanding balance2019-11-30319,692
Waiver amortization installment2019-11-300
Total funding amount beforereflecting carryover/prefunding balances2019-11-3056,000
Carryover balance elected to use to offset funding requirement2019-11-300
Prefunding balance elected to use to offset funding requirement2019-11-300
Additional cash requirement2019-11-3056,000
Contributions allocatedtoward minimum required contributions for current year2019-11-3056,047
Unpaid minimum required contributions for current year2019-11-300
Unpaid minimum required contributions for all years2019-11-300
2018: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-0187
Total number of active participants reported on line 7a of the Form 55002018-12-0112
Number of retired or separated participants receiving benefits2018-12-0146
Number of other retired or separated participants entitled to future benefits2018-12-0120
Total of all active and inactive participants2018-12-0178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-12-011
Total participants2018-12-0179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-12-010
Market value of plan assets2018-11-303,544,748
Acturial value of plan assets2018-11-303,528,797
Funding target for retired participants and beneficiaries receiving payment2018-11-302,255,639
Number of terminated vested participants2018-11-3027
Fundng target for terminated vested participants2018-11-30883,682
Active participant vested funding target2018-11-30590,492
Number of active participants2018-11-3016
Total funding liabilities for active participants2018-11-30591,931
Total participant count2018-11-3091
Total funding target for all participants2018-11-303,731,252
Balance at beginning of prior year after applicable adjustments2018-11-300
Prefunding balance at beginning of prior year after applicable adjustments2018-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2018-11-300
Prefunding balanced used to offset prior years funding requirement2018-11-300
Amount remaining of carryover balance2018-11-300
Amount remaining of prefunding balance2018-11-300
Present value of excess contributions2018-11-300
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-11-300
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-11-300
Reductions in caryover balances due to elections or deemed elections2018-11-300
Reductions in prefunding balances due to elections or deemed elections2018-11-300
Balance of carryovers at beginning of current year2018-11-300
Balance of prefunding at beginning of current year2018-11-300
Total employer contributions2018-11-3044,668
Total employee contributions2018-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2018-11-300
Contributions made to avoid restrictions adjusted to valuation date2018-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-11-3043,633
Liquidity shortfalls end of Q12018-11-300
Liquidity shortfalls end of Q22018-11-300
Liquidity shortfalls end of Q32018-11-300
Liquidity shortfalls end of Q42018-11-300
Unpaid minimum required contributions for all prior years2018-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-11-300
Remaining amount of unpaid minimum required contributions2018-11-300
Minimum required contributions for current year target normal cost2018-11-3017,000
Net shortfall amortization installment of oustanding balance2018-11-30202,455
Waiver amortization installment2018-11-300
Total funding amount beforereflecting carryover/prefunding balances2018-11-3036,580
Additional cash requirement2018-11-3036,580
Contributions allocatedtoward minimum required contributions for current year2018-11-3043,633
Unpaid minimum required contributions for current year2018-11-300
Unpaid minimum required contributions for all years2018-11-300
2017: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-0191
Total number of active participants reported on line 7a of the Form 55002017-12-0113
Number of retired or separated participants receiving benefits2017-12-0146
Number of other retired or separated participants entitled to future benefits2017-12-0127
Total of all active and inactive participants2017-12-0186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-12-011
Total participants2017-12-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-12-010
Market value of plan assets2017-11-303,474,120
Acturial value of plan assets2017-11-303,647,794
Funding target for retired participants and beneficiaries receiving payment2017-11-302,165,047
Number of terminated vested participants2017-11-3028
Fundng target for terminated vested participants2017-11-30879,546
Active participant vested funding target2017-11-30675,394
Number of active participants2017-11-3020
Total funding liabilities for active participants2017-11-30677,447
Total participant count2017-11-3096
Total funding target for all participants2017-11-303,722,040
Balance at beginning of prior year after applicable adjustments2017-11-300
Prefunding balance at beginning of prior year after applicable adjustments2017-11-300
Carryover balanced portion elected for use to offset prior years funding requirement2017-11-300
Prefunding balanced used to offset prior years funding requirement2017-11-300
Amount remaining of carryover balance2017-11-300
Amount remaining of prefunding balance2017-11-300
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2017-11-300
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2017-11-300
Reductions in caryover balances due to elections or deemed elections2017-11-300
Reductions in prefunding balances due to elections or deemed elections2017-11-300
Balance of carryovers at beginning of current year2017-11-300
Balance of prefunding at beginning of current year2017-11-300
Total employer contributions2017-11-3094,775
Total employee contributions2017-11-300
Contributions allocated toward unpaid minimum require contributions from prior years2017-11-300
Contributions made to avoid restrictions adjusted to valuation date2017-11-300
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2017-11-3089,336
Liquidity shortfalls end of Q12017-11-300
Liquidity shortfalls end of Q22017-11-300
Liquidity shortfalls end of Q32017-11-300
Liquidity shortfalls end of Q42017-11-300
Unpaid minimum required contributions for all prior years2017-11-300
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2017-11-300
Remaining amount of unpaid minimum required contributions2017-11-300
Minimum required contributions for current year target normal cost2017-11-306,000
Net shortfall amortization installment of oustanding balance2017-11-3074,246
Waiver amortization installment2017-11-300
Total funding amount beforereflecting carryover/prefunding balances2017-11-3089,336
Carryover balance elected to use to offset funding requirement2017-11-300
Prefunding balance elected to use to offset funding requirement2017-11-300
Additional cash requirement2017-11-3089,336
Contributions allocatedtoward minimum required contributions for current year2017-11-3089,336
Unpaid minimum required contributions for current year2017-11-300
Unpaid minimum required contributions for all years2017-11-300
2016: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-0196
Total number of active participants reported on line 7a of the Form 55002016-12-0116
Number of retired or separated participants receiving benefits2016-12-0147
Number of other retired or separated participants entitled to future benefits2016-12-0127
Total of all active and inactive participants2016-12-0190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-12-011
Total participants2016-12-0191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-12-010
2015: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-01100
Total number of active participants reported on line 7a of the Form 55002015-12-0120
Number of retired or separated participants receiving benefits2015-12-0146
Number of other retired or separated participants entitled to future benefits2015-12-0128
Total of all active and inactive participants2015-12-0194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-12-012
Total participants2015-12-0196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-12-010
2014: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-01102
Total number of active participants reported on line 7a of the Form 55002014-12-0121
Number of retired or separated participants receiving benefits2014-12-0147
Number of other retired or separated participants entitled to future benefits2014-12-0129
Total of all active and inactive participants2014-12-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-12-013
Total participants2014-12-01100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-12-010
2013: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-12-01105
Total number of active participants reported on line 7a of the Form 55002013-12-0122
Number of retired or separated participants receiving benefits2013-12-0148
Number of other retired or separated participants entitled to future benefits2013-12-0130
Total of all active and inactive participants2013-12-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-12-012
Total participants2013-12-01102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-12-010
2012: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-12-01109
Total number of active participants reported on line 7a of the Form 55002012-12-0118
Number of retired or separated participants receiving benefits2012-12-0148
Number of other retired or separated participants entitled to future benefits2012-12-0137
Total of all active and inactive participants2012-12-01103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-12-012
Total participants2012-12-01105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-12-010
2011: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-12-01113
Total number of active participants reported on line 7a of the Form 55002011-12-0122
Number of retired or separated participants receiving benefits2011-12-0148
Number of other retired or separated participants entitled to future benefits2011-12-0137
Total of all active and inactive participants2011-12-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-12-012
Total participants2011-12-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-12-010
2010: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-12-01117
Total number of active participants reported on line 7a of the Form 55002010-12-0125
Number of retired or separated participants receiving benefits2010-12-0146
Number of other retired or separated participants entitled to future benefits2010-12-0140
Total of all active and inactive participants2010-12-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-12-012
Total participants2010-12-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-12-010
2009: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-12-01120
Total number of active participants reported on line 7a of the Form 55002009-12-0126
Number of retired or separated participants receiving benefits2009-12-0149
Number of other retired or separated participants entitled to future benefits2009-12-0141
Total of all active and inactive participants2009-12-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-12-011
Total participants2009-12-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-12-010

Financial Data on HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN

Measure Date Value
2022 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2022 401k financial data
Total plan liabilities at end of year2022-11-30$0
Total plan liabilities at beginning of year2022-11-30$4
Total income from all sources2022-11-30$-176,701
Expenses. Total of all expenses incurred2022-11-30$283,892
Benefits paid (including direct rollovers)2022-11-30$280,682
Total plan assets at end of year2022-11-30$3,966,252
Total plan assets at beginning of year2022-11-30$4,426,849
Value of fidelity bond covering the plan2022-11-30$1,000,000
Expenses. Other expenses not covered elsewhere2022-11-30$3,210
Other income received2022-11-30$-176,701
Net income (gross income less expenses)2022-11-30$-460,593
Net plan assets at end of year (total assets less liabilities)2022-11-30$3,966,252
Net plan assets at beginning of year (total assets less liabilities)2022-11-30$4,426,845
Assets. Value of assets in partnership/joint-venture interests2022-11-30$68,094
Total contributions received or receivable from employer(s)2022-11-30$0
2021 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2021 401k financial data
Total plan liabilities at end of year2021-11-30$4
Total plan liabilities at beginning of year2021-11-30$0
Total income from all sources2021-11-30$836,958
Expenses. Total of all expenses incurred2021-11-30$340,968
Benefits paid (including direct rollovers)2021-11-30$337,493
Total plan assets at end of year2021-11-30$4,426,849
Total plan assets at beginning of year2021-11-30$3,930,855
Value of fidelity bond covering the plan2021-11-30$1,000,000
Expenses. Other expenses not covered elsewhere2021-11-30$3,475
Other income received2021-11-30$592,638
Net income (gross income less expenses)2021-11-30$495,990
Net plan assets at end of year (total assets less liabilities)2021-11-30$4,426,845
Net plan assets at beginning of year (total assets less liabilities)2021-11-30$3,930,855
Assets. Value of assets in partnership/joint-venture interests2021-11-30$35,590
Total contributions received or receivable from employer(s)2021-11-30$244,320
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-11-30$0
2020 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2020 401k financial data
Total plan liabilities at end of year2020-11-30$0
Total plan liabilities at beginning of year2020-11-30$40,011
Total income from all sources2020-11-30$846,334
Expenses. Total of all expenses incurred2020-11-30$278,370
Benefits paid (including direct rollovers)2020-11-30$274,895
Total plan assets at end of year2020-11-30$3,930,855
Total plan assets at beginning of year2020-11-30$3,402,902
Value of fidelity bond covering the plan2020-11-30$1,000,000
Expenses. Other expenses not covered elsewhere2020-11-30$3,475
Other income received2020-11-30$408,894
Net income (gross income less expenses)2020-11-30$567,964
Net plan assets at end of year (total assets less liabilities)2020-11-30$3,930,855
Net plan assets at beginning of year (total assets less liabilities)2020-11-30$3,362,891
Assets. Value of assets in partnership/joint-venture interests2020-11-30$24,809
Total contributions received or receivable from employer(s)2020-11-30$437,440
2019 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2019 401k financial data
Total plan liabilities at end of year2019-11-30$40,011
Total plan liabilities at beginning of year2019-11-30$34,450
Total income from all sources2019-11-30$464,866
Expenses. Total of all expenses incurred2019-11-30$412,096
Benefits paid (including direct rollovers)2019-11-30$408,397
Total plan assets at end of year2019-11-30$3,402,902
Total plan assets at beginning of year2019-11-30$3,344,571
Value of fidelity bond covering the plan2019-11-30$1,000,000
Expenses. Other expenses not covered elsewhere2019-11-30$3,699
Other income received2019-11-30$405,516
Net income (gross income less expenses)2019-11-30$52,770
Net plan assets at end of year (total assets less liabilities)2019-11-30$3,362,891
Net plan assets at beginning of year (total assets less liabilities)2019-11-30$3,310,121
Assets. Value of assets in partnership/joint-venture interests2019-11-30$33,986
Total contributions received or receivable from employer(s)2019-11-30$59,350
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-11-30$0
2018 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2018 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-11-30$0
2017 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2017 401k financial data
Total plan liabilities at end of year2017-11-30$0
Total plan liabilities at beginning of year2017-11-30$0
Total income from all sources2017-11-30$420,718
Expenses. Total of all expenses incurred2017-11-30$349,003
Benefits paid (including direct rollovers)2017-11-30$331,470
Total plan assets at end of year2017-11-30$3,545,991
Total plan assets at beginning of year2017-11-30$3,474,276
Value of fidelity bond covering the plan2017-11-30$1,000,000
Expenses. Other expenses not covered elsewhere2017-11-30$5,733
Other income received2017-11-30$325,943
Net income (gross income less expenses)2017-11-30$71,715
Net plan assets at end of year (total assets less liabilities)2017-11-30$3,545,991
Net plan assets at beginning of year (total assets less liabilities)2017-11-30$3,474,276
Assets. Value of assets in partnership/joint-venture interests2017-11-30$37,060
Total contributions received or receivable from employer(s)2017-11-30$94,775
Expenses. Administrative service providers (salaries,fees and commissions)2017-11-30$11,800
2016 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-11-30$18,797
Total unrealized appreciation/depreciation of assets2016-11-30$18,797
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-30$0
Total income from all sources (including contributions)2016-11-30$143,459
Total loss/gain on sale of assets2016-11-30$114
Total of all expenses incurred2016-11-30$283,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-11-30$283,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-11-30$68,081
Value of total assets at end of year2016-11-30$3,474,276
Value of total assets at beginning of year2016-11-30$3,613,977
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-11-30$0
Total interest from all sources2016-11-30$22,021
Total dividends received (eg from common stock, registered investment company shares)2016-11-30$31,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-11-30$147
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-11-30$87,504
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-11-30$87,040
Was this plan covered by a fidelity bond2016-11-30Yes
Value of fidelity bond cover2016-11-30$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-11-30$0
Were there any nonexempt tranactions with any party-in-interest2016-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-11-30$9,102
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-11-30$9,751
Total non interest bearing cash at end of year2016-11-30$22,527
Total non interest bearing cash at beginning of year2016-11-30$22,194
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Value of net income/loss2016-11-30$-139,701
Value of net assets at end of year (total assets less liabilities)2016-11-30$3,474,276
Value of net assets at beginning of year (total assets less liabilities)2016-11-30$3,613,977
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-11-30No
Were any leases to which the plan was party in default or uncollectible2016-11-30No
Assets. partnership/joint venture interests at end of year2016-11-30$29,835
Assets. partnership/joint venture interests at beginning of year2016-11-30$17,129
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-11-30$1,576,834
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-11-30$1,572,638
Income. Interest from corporate debt instruments2016-11-30$22,021
Expenses. Payments to insurance carriers foe the provision of benefits2016-11-30$5,127
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-11-30$2,710
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-11-30Yes
Was there a failure to transmit to the plan any participant contributions2016-11-30No
Has the plan failed to provide any benefit when due under the plan2016-11-30No
Contributions received in cash from employer2016-11-30$68,081
Employer contributions (assets) at end of year2016-11-30$18,335
Employer contributions (assets) at beginning of year2016-11-30$29,848
Income. Dividends from preferred stock2016-11-30$3,558
Income. Dividends from common stock2016-11-30$28,031
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-11-30$278,033
Asset. Corporate debt instrument debt (other) at end of year2016-11-30$445,913
Asset. Corporate debt instrument debt (other) at beginning of year2016-11-30$577,254
Assets. Corporate common stocks other than exployer securities at end of year2016-11-30$1,284,226
Assets. Corporate common stocks other than exployer securities at beginning of year2016-11-30$1,298,123
Did the plan have assets held for investment2016-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-11-30No
Aggregate proceeds on sale of assets2016-11-30$397,878
Aggregate carrying amount (costs) on sale of assets2016-11-30$397,764
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-11-30Yes
Opinion of an independent qualified public accountant for this plan2016-11-30Disclaimer
Accountancy firm name2016-11-30BLAZEK & VETTERLING LLP
Accountancy firm EIN2016-11-30760269860
2015 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-11-30$-9,969
Total unrealized appreciation/depreciation of assets2015-11-30$-9,969
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-11-30$0
Total income from all sources (including contributions)2015-11-30$133,730
Total loss/gain on sale of assets2015-11-30$2,637
Total of all expenses incurred2015-11-30$286,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-11-30$286,435
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-11-30$81,689
Value of total assets at end of year2015-11-30$3,613,977
Value of total assets at beginning of year2015-11-30$3,766,682
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-11-30$0
Total interest from all sources2015-11-30$24,377
Total dividends received (eg from common stock, registered investment company shares)2015-11-30$34,996
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-11-30$161
Assets. Corporate prefeered stocks other than exployer securities at end of year2015-11-30$87,040
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-11-30$114,487
Was this plan covered by a fidelity bond2015-11-30Yes
Value of fidelity bond cover2015-11-30$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-11-30$0
Were there any nonexempt tranactions with any party-in-interest2015-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-11-30$9,751
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-11-30$7,201
Total non interest bearing cash at end of year2015-11-30$22,194
Total non interest bearing cash at beginning of year2015-11-30$23,224
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-11-30No
Value of net income/loss2015-11-30$-152,705
Value of net assets at end of year (total assets less liabilities)2015-11-30$3,613,977
Value of net assets at beginning of year (total assets less liabilities)2015-11-30$3,766,682
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-11-30No
Were any leases to which the plan was party in default or uncollectible2015-11-30No
Assets. partnership/joint venture interests at end of year2015-11-30$17,129
Assets. partnership/joint venture interests at beginning of year2015-11-30$25,090
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-11-30$1,572,638
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-11-30$1,623,450
Income. Interest from corporate debt instruments2015-11-30$24,377
Expenses. Payments to insurance carriers foe the provision of benefits2015-11-30$5,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-11-30Yes
Was there a failure to transmit to the plan any participant contributions2015-11-30No
Has the plan failed to provide any benefit when due under the plan2015-11-30No
Contributions received in cash from employer2015-11-30$81,689
Employer contributions (assets) at end of year2015-11-30$29,848
Employer contributions (assets) at beginning of year2015-11-30$173,545
Income. Dividends from preferred stock2015-11-30$4,543
Income. Dividends from common stock2015-11-30$30,292
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-11-30$280,575
Asset. Corporate debt instrument debt (other) at end of year2015-11-30$577,254
Asset. Corporate debt instrument debt (other) at beginning of year2015-11-30$436,330
Assets. Corporate common stocks other than exployer securities at end of year2015-11-30$1,298,123
Assets. Corporate common stocks other than exployer securities at beginning of year2015-11-30$1,363,355
Did the plan have assets held for investment2015-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-11-30No
Aggregate proceeds on sale of assets2015-11-30$475,237
Aggregate carrying amount (costs) on sale of assets2015-11-30$472,600
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-11-30Yes
Opinion of an independent qualified public accountant for this plan2015-11-30Disclaimer
Accountancy firm name2015-11-30BLAZEK & VETTERLING LLP
Accountancy firm EIN2015-11-30760269860
2014 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-11-30$154,999
Total unrealized appreciation/depreciation of assets2014-11-30$154,999
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-11-30$0
Total income from all sources (including contributions)2014-11-30$444,801
Total loss/gain on sale of assets2014-11-30$293
Total of all expenses incurred2014-11-30$374,601
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-11-30$374,601
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-11-30$229,577
Value of total assets at end of year2014-11-30$3,766,682
Value of total assets at beginning of year2014-11-30$3,696,482
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-11-30$0
Total interest from all sources2014-11-30$22,042
Total dividends received (eg from common stock, registered investment company shares)2014-11-30$37,890
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-11-30$176
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-11-30$114,487
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-11-30$101,387
Was this plan covered by a fidelity bond2014-11-30Yes
Value of fidelity bond cover2014-11-30$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-11-30$0
Were there any nonexempt tranactions with any party-in-interest2014-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-11-30$7,201
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-11-30$36,963
Total non interest bearing cash at end of year2014-11-30$23,224
Total non interest bearing cash at beginning of year2014-11-30$22,821
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-11-30No
Value of net income/loss2014-11-30$70,200
Value of net assets at end of year (total assets less liabilities)2014-11-30$3,766,682
Value of net assets at beginning of year (total assets less liabilities)2014-11-30$3,696,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-11-30No
Were any leases to which the plan was party in default or uncollectible2014-11-30No
Assets. partnership/joint venture interests at end of year2014-11-30$25,090
Assets. partnership/joint venture interests at beginning of year2014-11-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-11-30$1,623,450
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-11-30$1,575,851
Income. Interest from US Government securities2014-11-30$22,042
Expenses. Payments to insurance carriers foe the provision of benefits2014-11-30$4,141
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-11-30Yes
Was there a failure to transmit to the plan any participant contributions2014-11-30No
Has the plan failed to provide any benefit when due under the plan2014-11-30No
Contributions received in cash from employer2014-11-30$229,577
Employer contributions (assets) at end of year2014-11-30$173,545
Employer contributions (assets) at beginning of year2014-11-30$24,368
Income. Dividends from preferred stock2014-11-30$4,732
Income. Dividends from common stock2014-11-30$32,982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-11-30$370,460
Asset. Corporate debt instrument debt (other) at end of year2014-11-30$436,330
Asset. Corporate debt instrument debt (other) at beginning of year2014-11-30$425,565
Assets. Corporate common stocks other than exployer securities at end of year2014-11-30$1,363,355
Assets. Corporate common stocks other than exployer securities at beginning of year2014-11-30$1,509,527
Did the plan have assets held for investment2014-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-11-30No
Aggregate proceeds on sale of assets2014-11-30$536,673
Aggregate carrying amount (costs) on sale of assets2014-11-30$536,380
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-11-30Yes
Opinion of an independent qualified public accountant for this plan2014-11-30Disclaimer
Accountancy firm name2014-11-30BLAZEK & VETTERLING LLP
Accountancy firm EIN2014-11-30760269860
2013 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-11-30$215,260
Total unrealized appreciation/depreciation of assets2013-11-30$215,260
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-11-30$0
Total income from all sources (including contributions)2013-11-30$489,095
Total loss/gain on sale of assets2013-11-30$70,353
Total of all expenses incurred2013-11-30$352,419
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-11-30$352,419
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-11-30$139,496
Value of total assets at end of year2013-11-30$3,696,482
Value of total assets at beginning of year2013-11-30$3,559,806
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-11-30$0
Total interest from all sources2013-11-30$21,415
Total dividends received (eg from common stock, registered investment company shares)2013-11-30$42,571
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-11-30$155
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-11-30$101,387
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-11-30$98,320
Was this plan covered by a fidelity bond2013-11-30Yes
Value of fidelity bond cover2013-11-30$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-11-30$0
Were there any nonexempt tranactions with any party-in-interest2013-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-11-30$36,963
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-11-30$11,169
Total non interest bearing cash at end of year2013-11-30$22,821
Total non interest bearing cash at beginning of year2013-11-30$23,129
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-11-30No
Value of net income/loss2013-11-30$136,676
Value of net assets at end of year (total assets less liabilities)2013-11-30$3,696,482
Value of net assets at beginning of year (total assets less liabilities)2013-11-30$3,559,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-11-30No
Were any leases to which the plan was party in default or uncollectible2013-11-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-11-30$1,575,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-11-30$1,564,279
Income. Interest from corporate debt instruments2013-11-30$21,415
Expenses. Payments to insurance carriers foe the provision of benefits2013-11-30$4,744
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-11-30Yes
Was there a failure to transmit to the plan any participant contributions2013-11-30No
Has the plan failed to provide any benefit when due under the plan2013-11-30No
Contributions received in cash from employer2013-11-30$139,496
Employer contributions (assets) at end of year2013-11-30$24,368
Employer contributions (assets) at beginning of year2013-11-30$81,415
Income. Dividends from preferred stock2013-11-30$4,392
Income. Dividends from common stock2013-11-30$38,024
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-11-30$347,675
Asset. Corporate debt instrument debt (other) at end of year2013-11-30$425,565
Asset. Corporate debt instrument debt (other) at beginning of year2013-11-30$438,430
Assets. Corporate common stocks other than exployer securities at end of year2013-11-30$1,509,527
Assets. Corporate common stocks other than exployer securities at beginning of year2013-11-30$1,343,064
Did the plan have assets held for investment2013-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-11-30No
Aggregate proceeds on sale of assets2013-11-30$583,908
Aggregate carrying amount (costs) on sale of assets2013-11-30$513,555
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-11-30Yes
Opinion of an independent qualified public accountant for this plan2013-11-30Disclaimer
Accountancy firm name2013-11-30BLAZEK & VETTERLING LLP
Accountancy firm EIN2013-11-30760269860
2012 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-11-30$74,392
Total unrealized appreciation/depreciation of assets2012-11-30$74,392
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-11-30$0
Total income from all sources (including contributions)2012-11-30$353,025
Total loss/gain on sale of assets2012-11-30$57,702
Total of all expenses incurred2012-11-30$307,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-11-30$307,306
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-11-30$161,227
Value of total assets at end of year2012-11-30$3,559,806
Value of total assets at beginning of year2012-11-30$3,514,087
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-11-30$0
Total interest from all sources2012-11-30$30,268
Total dividends received (eg from common stock, registered investment company shares)2012-11-30$29,436
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-11-30$148
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-11-30$98,320
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-11-30$86,640
Was this plan covered by a fidelity bond2012-11-30Yes
Value of fidelity bond cover2012-11-30$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-11-30$0
Were there any nonexempt tranactions with any party-in-interest2012-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-11-30$11,169
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-11-30$16,950
Total non interest bearing cash at end of year2012-11-30$23,129
Total non interest bearing cash at beginning of year2012-11-30$20,768
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-11-30No
Value of net income/loss2012-11-30$45,719
Value of net assets at end of year (total assets less liabilities)2012-11-30$3,559,806
Value of net assets at beginning of year (total assets less liabilities)2012-11-30$3,514,087
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-11-30No
Were any leases to which the plan was party in default or uncollectible2012-11-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-11-30$1,564,279
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-11-30$1,577,395
Income. Interest from corporate debt instruments2012-11-30$30,268
Expenses. Payments to insurance carriers foe the provision of benefits2012-11-30$5,466
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-11-30Yes
Was there a failure to transmit to the plan any participant contributions2012-11-30No
Has the plan failed to provide any benefit when due under the plan2012-11-30No
Contributions received in cash from employer2012-11-30$161,227
Employer contributions (assets) at end of year2012-11-30$81,415
Employer contributions (assets) at beginning of year2012-11-30$105,346
Income. Dividends from preferred stock2012-11-30$3,812
Income. Dividends from common stock2012-11-30$25,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-11-30$301,840
Asset. Corporate debt instrument debt (other) at end of year2012-11-30$438,430
Asset. Corporate debt instrument debt (other) at beginning of year2012-11-30$683,163
Assets. Corporate common stocks other than exployer securities at end of year2012-11-30$1,343,064
Assets. Corporate common stocks other than exployer securities at beginning of year2012-11-30$1,023,825
Did the plan have assets held for investment2012-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-11-30No
Aggregate proceeds on sale of assets2012-11-30$633,353
Aggregate carrying amount (costs) on sale of assets2012-11-30$575,651
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-11-30Yes
Opinion of an independent qualified public accountant for this plan2012-11-30Disclaimer
Accountancy firm name2012-11-30ALONZO, BACARISSE, IRVINE & PALMER
Accountancy firm EIN2012-11-30760689865
2011 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-11-30$-344,212
Total unrealized appreciation/depreciation of assets2011-11-30$-344,212
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-11-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-11-30$0
Total income from all sources (including contributions)2011-11-30$266,137
Total loss/gain on sale of assets2011-11-30$408,348
Total of all expenses incurred2011-11-30$265,720
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-11-30$265,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-11-30$117,064
Value of total assets at end of year2011-11-30$3,514,087
Value of total assets at beginning of year2011-11-30$3,513,670
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-11-30$25
Total interest from all sources2011-11-30$44,164
Total dividends received (eg from common stock, registered investment company shares)2011-11-30$40,729
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-11-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-11-30$83
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-11-30$86,640
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-11-30$66,450
Was this plan covered by a fidelity bond2011-11-30Yes
Value of fidelity bond cover2011-11-30$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-11-30$0
Were there any nonexempt tranactions with any party-in-interest2011-11-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-11-30$16,950
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-11-30$22,694
Other income not declared elsewhere2011-11-30$44
Administrative expenses (other) incurred2011-11-30$25
Total non interest bearing cash at end of year2011-11-30$20,768
Total non interest bearing cash at beginning of year2011-11-30$22,206
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-11-30No
Value of net income/loss2011-11-30$417
Value of net assets at end of year (total assets less liabilities)2011-11-30$3,514,087
Value of net assets at beginning of year (total assets less liabilities)2011-11-30$3,513,670
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-11-30No
Were any leases to which the plan was party in default or uncollectible2011-11-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-11-30$1,577,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-11-30$93,866
Income. Interest from corporate debt instruments2011-11-30$44,164
Expenses. Payments to insurance carriers foe the provision of benefits2011-11-30$4,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-11-30Yes
Was there a failure to transmit to the plan any participant contributions2011-11-30No
Has the plan failed to provide any benefit when due under the plan2011-11-30No
Contributions received in cash from employer2011-11-30$117,064
Employer contributions (assets) at end of year2011-11-30$105,346
Employer contributions (assets) at beginning of year2011-11-30$2,607
Income. Dividends from preferred stock2011-11-30$3,325
Income. Dividends from common stock2011-11-30$37,321
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-11-30$260,767
Asset. Corporate debt instrument debt (other) at end of year2011-11-30$683,163
Asset. Corporate debt instrument debt (other) at beginning of year2011-11-30$965,796
Assets. Corporate common stocks other than exployer securities at end of year2011-11-30$1,023,825
Assets. Corporate common stocks other than exployer securities at beginning of year2011-11-30$2,340,051
Did the plan have assets held for investment2011-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-11-30No
Aggregate proceeds on sale of assets2011-11-30$1,948,096
Aggregate carrying amount (costs) on sale of assets2011-11-30$1,539,748
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-11-30Yes
Opinion of an independent qualified public accountant for this plan2011-11-30Disclaimer
Accountancy firm name2011-11-30ALONZO, BACARISSE, IRVINE & PALMER
Accountancy firm EIN2011-11-30760689865
2010 : HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-11-30$0

Form 5500 Responses for HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN

2021: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)No
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes
2020: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Submission has been amendedNo
2020-12-01This submission is the final filingNo
2020-12-01This return/report is a short plan year return/report (less than 12 months)No
2020-12-01Plan is a collectively bargained planNo
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – TrustYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement - TrustYes
2019: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Submission has been amendedNo
2019-12-01This submission is the final filingNo
2019-12-01This return/report is a short plan year return/report (less than 12 months)No
2019-12-01Plan is a collectively bargained planNo
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan funding arrangement – TrustYes
2019-12-01Plan benefit arrangement – InsuranceYes
2019-12-01Plan benefit arrangement - TrustYes
2018: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Submission has been amendedNo
2018-12-01This submission is the final filingNo
2018-12-01This return/report is a short plan year return/report (less than 12 months)No
2018-12-01Plan is a collectively bargained planNo
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan funding arrangement – TrustYes
2018-12-01Plan benefit arrangement – InsuranceYes
2018-12-01Plan benefit arrangement - TrustYes
2017: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)No
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – TrustYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement - TrustYes
2016: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)No
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement - TrustYes
2015: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – TrustYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement - TrustYes
2014: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – TrustYes
2014-12-01Plan benefit arrangement – InsuranceYes
2014-12-01Plan benefit arrangement - TrustYes
2013: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – TrustYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement - TrustYes
2012: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Submission has been amendedNo
2012-12-01This submission is the final filingNo
2012-12-01This return/report is a short plan year return/report (less than 12 months)No
2012-12-01Plan is a collectively bargained planNo
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan funding arrangement – TrustYes
2012-12-01Plan benefit arrangement – InsuranceYes
2012-12-01Plan benefit arrangement - TrustYes
2011: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedNo
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – TrustYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement - TrustYes
2010: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2010 form 5500 responses
2010-12-01Type of plan entitySingle employer plan
2010-12-01Submission has been amendedNo
2010-12-01This submission is the final filingNo
2010-12-01This return/report is a short plan year return/report (less than 12 months)No
2010-12-01Plan is a collectively bargained planNo
2010-12-01Plan funding arrangement – InsuranceYes
2010-12-01Plan funding arrangement – TrustYes
2010-12-01Plan benefit arrangement – InsuranceYes
2010-12-01Plan benefit arrangement - TrustYes
2009: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedYes
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – TrustYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement - TrustYes
2008: HOLLY HALL RETIREMENT COMMUNITY 401(K) PLAN 2008 form 5500 responses
2008-12-01Type of plan entitySingle employer plan
2008-12-01Submission has been amendedNo
2008-12-01This submission is the final filingNo
2008-12-01This return/report is a short plan year return/report (less than 12 months)No
2008-12-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered9
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered10
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered12
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered12
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered13
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered21
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered22
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered18
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered22
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG603626
Policy instance 1
Insurance contract or identification numberG603626
Number of Individuals Covered25
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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