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HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameHEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN
Plan identification number 001

HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

HEALTHCENTER NORTHWEST, LLC has sponsored the creation of one or more 401k plans.

Company Name:HEALTHCENTER NORTHWEST, LLC
Employer identification number (EIN):810540517
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01BRIAN MATHEWS2021-11-15
0012020-01-01BRIAN MATHEWS2021-10-13
0012019-01-01
0012018-01-01
0012017-01-01SUSAN STEVENS
0012016-01-01SUSAN STEVENS
0012015-01-01SUSAN STEVENS
0012014-01-01SUSAN STEVENS
0012013-01-01SUSAN STEVENS
0012012-01-01SUSAN STEVENS
0012011-01-01SUSAN STEVENS
0012010-01-01SUSAN STEVENS
0012009-01-01SUSAN STEVENS

Plan Statistics for HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN

401k plan membership statisitcs for HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN

Measure Date Value
2021: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01317
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-010
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01337
Total number of active participants reported on line 7a of the Form 55002020-01-01250
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0167
Total of all active and inactive participants2020-01-01317
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01317
Number of participants with account balances2020-01-01248
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0116
2019: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01326
Total number of active participants reported on line 7a of the Form 55002019-01-01282
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0154
Total of all active and inactive participants2019-01-01337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01337
Number of participants with account balances2019-01-01249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0115
2018: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01333
Total number of active participants reported on line 7a of the Form 55002018-01-01277
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0149
Total of all active and inactive participants2018-01-01326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01326
Number of participants with account balances2018-01-01231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0123
2017: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01318
Total number of active participants reported on line 7a of the Form 55002017-01-01295
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0137
Total of all active and inactive participants2017-01-01332
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01332
Number of participants with account balances2017-01-01223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0113
2016: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01243
Total number of active participants reported on line 7a of the Form 55002016-01-01269
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0130
Total of all active and inactive participants2016-01-01299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-011
Total participants2016-01-01300
Number of participants with account balances2016-01-01204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-017
2015: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01210
Total number of active participants reported on line 7a of the Form 55002015-01-01223
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0120
Total of all active and inactive participants2015-01-01243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01243
Number of participants with account balances2015-01-01153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-015
2014: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01204
Total number of active participants reported on line 7a of the Form 55002014-01-01179
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0131
Total of all active and inactive participants2014-01-01210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01210
Number of participants with account balances2014-01-01134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013
2013: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01198
Total number of active participants reported on line 7a of the Form 55002013-01-01173
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0132
Total of all active and inactive participants2013-01-01205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01205
Number of participants with account balances2013-01-01130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0111
2012: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01179
Total number of active participants reported on line 7a of the Form 55002012-01-01170
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0127
Total of all active and inactive participants2012-01-01197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01197
Number of participants with account balances2012-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01166
Total number of active participants reported on line 7a of the Form 55002011-01-01159
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0121
Total of all active and inactive participants2011-01-01180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01180
Number of participants with account balances2011-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-016
2010: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01159
Total number of active participants reported on line 7a of the Form 55002010-01-01129
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0135
Total of all active and inactive participants2010-01-01164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01164
Number of participants with account balances2010-01-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0114
2009: HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01142
Total number of active participants reported on line 7a of the Form 55002009-01-01130
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0126
Total of all active and inactive participants2009-01-01156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01156
Number of participants with account balances2009-01-01122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-013

Financial Data on HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN

Measure Date Value
2021 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-01-31$0
Total transfer of assets from this plan2021-01-31$19,312,744
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$17,608
Total income from all sources (including contributions)2021-01-31$-76,014
Total loss/gain on sale of assets2021-01-31$0
Total of all expenses incurred2021-01-31$259,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-01-31$259,918
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-01-31$0
Value of total assets at end of year2021-01-31$0
Value of total assets at beginning of year2021-01-31$19,666,284
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-01-31$0
Total interest from all sources2021-01-31$68
Total dividends received (eg from common stock, registered investment company shares)2021-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-01-31No
Was this plan covered by a fidelity bond2021-01-31Yes
Value of fidelity bond cover2021-01-31$1,000,000
If this is an individual account plan, was there a blackout period2021-01-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-01-31$0
Were there any nonexempt tranactions with any party-in-interest2021-01-31No
Participant contributions at end of year2021-01-31$0
Participant contributions at beginning of year2021-01-31$28,513
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-01-31$1,455
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-01-31$0
Liabilities. Value of operating payables at end of year2021-01-31$0
Liabilities. Value of operating payables at beginning of year2021-01-31$17,608
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Value of net income/loss2021-01-31$-335,932
Value of net assets at end of year (total assets less liabilities)2021-01-31$0
Value of net assets at beginning of year (total assets less liabilities)2021-01-31$19,648,676
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-01-31No
Were any leases to which the plan was party in default or uncollectible2021-01-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-01-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-01-31$18,704,110
Value of interest in pooled separate accounts at end of year2021-01-31$0
Value of interest in pooled separate accounts at beginning of year2021-01-31$931,974
Interest on participant loans2021-01-31$68
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-01-31$-76,239
Net investment gain/loss from pooled separate accounts2021-01-31$157
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-01-31No
Was there a failure to transmit to the plan any participant contributions2021-01-31No
Has the plan failed to provide any benefit when due under the plan2021-01-31No
Employer contributions (assets) at end of year2021-01-31$0
Employer contributions (assets) at beginning of year2021-01-31$232
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-01-31$259,918
Did the plan have assets held for investment2021-01-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-01-31Yes
Opinion of an independent qualified public accountant for this plan2021-01-31Unqualified
Accountancy firm name2021-01-31JCCS, PC
Accountancy firm EIN2021-01-31810348775
2020 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$17,608
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$15,539
Total income from all sources (including contributions)2020-12-31$4,832,697
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,701,251
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,700,226
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,865,719
Value of total assets at end of year2020-12-31$19,666,284
Value of total assets at beginning of year2020-12-31$16,532,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,025
Total interest from all sources2020-12-31$709
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$20,364
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$20,364
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,129,466
Participant contributions at end of year2020-12-31$28,513
Participant contributions at beginning of year2020-12-31$35,857
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$107,912
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$66,417
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$1,455
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$55
Administrative expenses (other) incurred2020-12-31$1,025
Liabilities. Value of operating payables at end of year2020-12-31$17,608
Liabilities. Value of operating payables at beginning of year2020-12-31$15,539
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$3,131,446
Value of net assets at end of year (total assets less liabilities)2020-12-31$19,648,676
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,517,230
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$18,704,110
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$15,535,769
Value of interest in pooled separate accounts at end of year2020-12-31$931,974
Value of interest in pooled separate accounts at beginning of year2020-12-31$961,024
Interest on participant loans2020-12-31$709
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,941,411
Net investment gain/loss from pooled separate accounts2020-12-31$4,439
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$628,341
Employer contributions (assets) at end of year2020-12-31$232
Employer contributions (assets) at beginning of year2020-12-31$119
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,633,809
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31JCCS, PC
Accountancy firm EIN2020-12-31810348775
2019 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$15,539
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$27,449
Total income from all sources (including contributions)2019-12-31$4,579,974
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$969,139
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$968,039
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,827,819
Value of total assets at end of year2019-12-31$16,532,769
Value of total assets at beginning of year2019-12-31$12,933,844
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,100
Total interest from all sources2019-12-31$1,713
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,072,129
Participant contributions at end of year2019-12-31$35,857
Participant contributions at beginning of year2019-12-31$43,836
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$136,484
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$13,500
Other income not declared elsewhere2019-12-31$13,407
Administrative expenses (other) incurred2019-12-31$1,100
Liabilities. Value of operating payables at end of year2019-12-31$15,539
Liabilities. Value of operating payables at beginning of year2019-12-31$13,949
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$3,610,835
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,517,230
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$12,906,395
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$15,535,769
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$12,140,882
Value of interest in pooled separate accounts at end of year2019-12-31$961,024
Value of interest in pooled separate accounts at beginning of year2019-12-31$748,854
Interest on participant loans2019-12-31$1,713
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,732,696
Net investment gain/loss from pooled separate accounts2019-12-31$4,339
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$619,206
Employer contributions (assets) at end of year2019-12-31$119
Employer contributions (assets) at beginning of year2019-12-31$272
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$968,039
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31JCCS, PC
Accountancy firm EIN2019-12-31810348775
2018 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$27,449
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$13,264
Total income from all sources (including contributions)2018-12-31$881,567
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$860,293
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$858,304
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,647,175
Value of total assets at end of year2018-12-31$12,933,844
Value of total assets at beginning of year2018-12-31$12,898,385
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,989
Total interest from all sources2018-12-31$3,640
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$914,481
Participant contributions at end of year2018-12-31$43,836
Participant contributions at beginning of year2018-12-31$63,902
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$166,948
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$13,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Liabilities. Value of operating payables at end of year2018-12-31$13,949
Liabilities. Value of operating payables at beginning of year2018-12-31$13,264
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$21,274
Value of net assets at end of year (total assets less liabilities)2018-12-31$12,906,395
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$12,885,121
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$12,140,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$12,203,524
Value of interest in pooled separate accounts at end of year2018-12-31$748,854
Value of interest in pooled separate accounts at beginning of year2018-12-31$630,781
Interest on participant loans2018-12-31$3,640
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-772,256
Net investment gain/loss from pooled separate accounts2018-12-31$3,008
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$565,746
Employer contributions (assets) at end of year2018-12-31$272
Employer contributions (assets) at beginning of year2018-12-31$178
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$858,304
Contract administrator fees2018-12-31$1,989
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31JCCS, PC
Accountancy firm EIN2018-12-31810348775
2017 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$13,264
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$11,484
Total income from all sources (including contributions)2017-12-31$3,489,839
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,064,986
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,059,996
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,657,785
Value of total assets at end of year2017-12-31$12,898,385
Value of total assets at beginning of year2017-12-31$10,471,752
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,990
Total interest from all sources2017-12-31$4,066
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$893,227
Participant contributions at end of year2017-12-31$63,902
Participant contributions at beginning of year2017-12-31$65,382
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$262,001
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Liabilities. Value of operating payables at end of year2017-12-31$13,264
Liabilities. Value of operating payables at beginning of year2017-12-31$11,484
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,424,853
Value of net assets at end of year (total assets less liabilities)2017-12-31$12,885,121
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$10,460,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$12,203,524
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$9,853,550
Value of interest in pooled separate accounts at end of year2017-12-31$630,781
Value of interest in pooled separate accounts at beginning of year2017-12-31$552,820
Interest on participant loans2017-12-31$4,066
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,825,435
Net investment gain/loss from pooled separate accounts2017-12-31$2,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$502,557
Employer contributions (assets) at end of year2017-12-31$178
Employer contributions (assets) at beginning of year2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,059,996
Contract administrator fees2017-12-31$4,990
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31JCCS, PC
Accountancy firm EIN2017-12-31810348775
2016 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$11,484
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$10,189
Total income from all sources (including contributions)2016-12-31$2,100,662
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$72,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$71,316
Value of total corrective distributions2016-12-31$364
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,465,870
Value of total assets at end of year2016-12-31$10,471,752
Value of total assets at beginning of year2016-12-31$8,441,956
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$481
Total interest from all sources2016-12-31$5,553
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$679,976
Participant contributions at end of year2016-12-31$65,382
Participant contributions at beginning of year2016-12-31$78,804
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$383,317
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Liabilities. Value of operating payables at end of year2016-12-31$11,484
Liabilities. Value of operating payables at beginning of year2016-12-31$10,189
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$2,028,501
Value of net assets at end of year (total assets less liabilities)2016-12-31$10,460,268
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$8,431,767
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$9,853,550
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$8,071,533
Value of interest in pooled separate accounts at end of year2016-12-31$552,820
Value of interest in pooled separate accounts at beginning of year2016-12-31$291,469
Interest on participant loans2016-12-31$5,553
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$627,304
Net investment gain/loss from pooled separate accounts2016-12-31$1,935
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$402,577
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$150
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$71,316
Contract administrator fees2016-12-31$481
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31JCCS, PC
Accountancy firm EIN2016-12-31810348775
2015 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$10,189
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$9,171
Total income from all sources (including contributions)2015-12-31$1,273,559
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$374,487
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$365,445
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,291,124
Value of total assets at end of year2015-12-31$8,441,956
Value of total assets at beginning of year2015-12-31$7,541,866
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$9,042
Total interest from all sources2015-12-31$2,936
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$1
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$1
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$518,284
Participant contributions at end of year2015-12-31$78,804
Participant contributions at beginning of year2015-12-31$42,113
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$456,548
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$9,171
Liabilities. Value of operating payables at end of year2015-12-31$10,189
Liabilities. Value of operating payables at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$899,072
Value of net assets at end of year (total assets less liabilities)2015-12-31$8,431,767
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$7,532,695
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$8,071,533
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$7,266,572
Value of interest in pooled separate accounts at end of year2015-12-31$291,469
Value of interest in pooled separate accounts at beginning of year2015-12-31$233,181
Interest on participant loans2015-12-31$2,936
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-21,736
Net investment gain/loss from pooled separate accounts2015-12-31$1,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$316,292
Employer contributions (assets) at end of year2015-12-31$150
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$365,445
Contract administrator fees2015-12-31$9,042
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31JCCS, PC
Accountancy firm EIN2015-12-31810348775
2014 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$9,171
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,196,412
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$630,836
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$620,552
Value of total corrective distributions2014-12-31$9,814
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$751,905
Value of total assets at end of year2014-12-31$7,541,866
Value of total assets at beginning of year2014-12-31$6,967,119
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$470
Total interest from all sources2014-12-31$994
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$18,258
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$18,258
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$401,004
Participant contributions at end of year2014-12-31$42,113
Participant contributions at beginning of year2014-12-31$17,245
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$91,520
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$9,171
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$565,576
Value of net assets at end of year (total assets less liabilities)2014-12-31$7,532,695
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$6,967,119
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$470
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$7,266,572
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$6,949,874
Value of interest in pooled separate accounts at end of year2014-12-31$233,181
Value of interest in pooled separate accounts at beginning of year2014-12-31$0
Interest on participant loans2014-12-31$994
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$424,503
Net investment gain/loss from pooled separate accounts2014-12-31$752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$259,381
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$620,552
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31JCCS, PC
Accountancy firm EIN2014-12-31810348775
2013 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,796,993
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$540,843
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$539,482
Value of total corrective distributions2013-12-31$1,161
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$630,010
Value of total assets at end of year2013-12-31$6,967,119
Value of total assets at beginning of year2013-12-31$5,710,969
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$200
Total interest from all sources2013-12-31$1,041
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$235,775
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$235,775
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$370,766
Participant contributions at end of year2013-12-31$17,245
Participant contributions at beginning of year2013-12-31$22,404
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$22,936
Other income not declared elsewhere2013-12-31$111
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$1,256,150
Value of net assets at end of year (total assets less liabilities)2013-12-31$6,967,119
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$5,710,969
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$6,949,874
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$5,688,565
Interest on participant loans2013-12-31$1,041
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$930,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$236,308
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$539,482
Contract administrator fees2013-12-31$200
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31JCCS, PC
Accountancy firm EIN2013-12-31810348775
2012 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$1,279,337
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$203,636
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$203,366
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$633,776
Value of total assets at end of year2012-12-31$5,710,969
Value of total assets at beginning of year2012-12-31$4,635,268
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$270
Total interest from all sources2012-12-31$1,318
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$88,962
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$88,962
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$370,509
Participant contributions at end of year2012-12-31$22,404
Participant contributions at beginning of year2012-12-31$28,668
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$25,244
Administrative expenses (other) incurred2012-12-31$20
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,075,701
Value of net assets at end of year (total assets less liabilities)2012-12-31$5,710,969
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$4,635,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$5,688,565
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$4,606,600
Interest on participant loans2012-12-31$1,318
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$555,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$238,023
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$203,366
Contract administrator fees2012-12-31$250
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31JCCS, PC
Accountancy firm EIN2012-12-31810348775
2011 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$590,953
Total loss/gain on sale of assets2011-12-31$-4,011
Total of all expenses incurred2011-12-31$375,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$370,104
Value of total corrective distributions2011-12-31$5,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$700,382
Value of total assets at end of year2011-12-31$4,635,268
Value of total assets at beginning of year2011-12-31$4,419,879
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$2,941
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$77,324
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$75,534
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$166,001
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$356,479
Participant contributions at end of year2011-12-31$28,668
Participant contributions at beginning of year2011-12-31$14,626
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$79,794
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$781
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$215,389
Value of net assets at end of year (total assets less liabilities)2011-12-31$4,635,268
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,419,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$4,606,600
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$4,317,148
Interest on participant loans2011-12-31$1,285
Income. Interest from US Government securities2011-12-31$119
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$65,605
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$65,605
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,537
Asset value of US Government securities at end of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$10,071
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-185,683
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$264,109
Income. Dividends from common stock2011-12-31$1,790
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$370,104
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$11,648
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$84,507
Aggregate carrying amount (costs) on sale of assets2011-12-31$88,518
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31JCCS, PC
Accountancy firm EIN2011-12-31810348775
2010 : HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-1,893
Total unrealized appreciation/depreciation of assets2010-12-31$-1,893
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$959,165
Total loss/gain on sale of assets2010-12-31$-3,625
Total of all expenses incurred2010-12-31$189,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$187,205
Value of total corrective distributions2010-12-31$2,394
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$581,924
Value of total assets at end of year2010-12-31$4,419,879
Value of total assets at beginning of year2010-12-31$3,650,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$7,244
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$66,613
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$66,613
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$461,009
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$336,171
Participant contributions at end of year2010-12-31$14,626
Participant contributions at beginning of year2010-12-31$15,285
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$32,793
Total non interest bearing cash at end of year2010-12-31$781
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$769,566
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,419,879
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,650,313
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$4,317,148
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$3,476,372
Interest on participant loans2010-12-31$898
Income. Interest from US Government securities2010-12-31$4,764
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$65,605
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$70,429
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$70,429
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,582
Asset value of US Government securities at end of year2010-12-31$10,071
Asset value of US Government securities at beginning of year2010-12-31$88,227
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$308,902
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$212,960
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$187,205
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$11,648
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$153,000
Aggregate carrying amount (costs) on sale of assets2010-12-31$156,625
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31JCCS, PC
Accountancy firm EIN2010-12-31810348775

Form 5500 Responses for HEALTHCENTER NORTHWEST 401K PROFIT SHARING PLAN

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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered248
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $81,827
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,827
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered249
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $70,788
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,788
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered15
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $46,490
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,490
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
Insurance broker nameHOSEK/WHITE, ERIC/ROBERT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered9
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $39,063
Total amount of fees paid to insurance companyUSD $0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,063
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
Insurance broker nameWHITE ROBERT C
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number1400605-01
Policy instance 1
Insurance contract or identification number1400605-01
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $19,195
Total amount of fees paid to insurance companyUSD $0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,195
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFINANCIAL CONSULTING
Insurance broker organization code?3
Insurance broker nameWHITE ROBERT C

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