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WEST HARBOR HEALTHCARE 401(K) PLAN 401k Plan overview

Plan NameWEST HARBOR HEALTHCARE 401(K) PLAN
Plan identification number 001

WEST HARBOR HEALTHCARE 401(K) 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.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WEST HARBOR HEALTHCARE LLC has sponsored the creation of one or more 401k plans.

Company Name:WEST HARBOR HEALTHCARE LLC
Employer identification number (EIN):813033798
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WEST HARBOR HEALTHCARE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01DAN GILL2020-10-14
0012018-01-01DAN GILL2019-10-15

Plan Statistics for WEST HARBOR HEALTHCARE 401(K) PLAN

401k plan membership statisitcs for WEST HARBOR HEALTHCARE 401(K) PLAN

Measure Date Value
2022: WEST HARBOR HEALTHCARE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01461
Total number of active participants reported on line 7a of the Form 55002022-01-01570
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0136
Total of all active and inactive participants2022-01-01606
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01606
Number of participants with account balances2022-01-01178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0118
2021: WEST HARBOR HEALTHCARE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01419
Total number of active participants reported on line 7a of the Form 55002021-01-01362
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-0122
Total of all active and inactive participants2021-01-01387
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01387
Number of participants with account balances2021-01-01162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0129
2020: WEST HARBOR HEALTHCARE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01367
Total number of active participants reported on line 7a of the Form 55002020-01-01406
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0112
Total of all active and inactive participants2020-01-01418
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01418
Number of participants with account balances2020-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-016
2019: WEST HARBOR HEALTHCARE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01311
Total number of active participants reported on line 7a of the Form 55002019-01-01273
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-018
Total of all active and inactive participants2019-01-01281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01281
Number of participants with account balances2019-01-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: WEST HARBOR HEALTHCARE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01188
Total number of active participants reported on line 7a of the Form 55002018-01-01306
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-01311
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01311
Number of participants with account balances2018-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on WEST HARBOR HEALTHCARE 401(K) PLAN

Measure Date Value
2022 : WEST HARBOR HEALTHCARE 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$533,083
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$149,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$126,967
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,006,045
Value of total assets at end of year2022-12-31$2,894,771
Value of total assets at beginning of year2022-12-31$2,511,451
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$22,796
Total interest from all sources2022-12-31$2,141
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$3,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$669,946
Participant contributions at end of year2022-12-31$48,607
Participant contributions at beginning of year2022-12-31$35,556
Participant contributions at end of year2022-12-31$449
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$54,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Administrative expenses (other) incurred2022-12-31$1,750
Total non interest bearing cash at end of year2022-12-31$5,744
Total non interest bearing cash at beginning of year2022-12-31$62,319
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$383,320
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,894,771
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,511,451
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$14,169
Value of interest in pooled separate accounts at end of year2022-12-31$2,792,914
Value of interest in pooled separate accounts at beginning of year2022-12-31$2,358,859
Income. Interest from loans (other than to participants)2022-12-31$2,141
Value of interest in common/collective trusts at end of year2022-12-31$46,878
Value of interest in common/collective trusts at beginning of year2022-12-31$54,717
Net investment gain/loss from pooled separate accounts2022-12-31$-475,691
Net investment gain or loss from common/collective trusts2022-12-31$588
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$281,969
Employer contributions (assets) at end of year2022-12-31$179
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$126,967
Contract administrator fees2022-12-31$6,877
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31DUFFY KRUSPODIN
Accountancy firm EIN2022-12-31954244393
2021 : WEST HARBOR HEALTHCARE 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$144,014
Total income from all sources (including contributions)2021-12-31$1,309,652
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$157,858
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$139,579
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,058,505
Value of total assets at end of year2021-12-31$2,511,451
Value of total assets at beginning of year2021-12-31$1,503,671
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$18,279
Total interest from all sources2021-12-31$1,110
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$140,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$662,659
Participant contributions at end of year2021-12-31$35,556
Participant contributions at beginning of year2021-12-31$15,719
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$77,822
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$144,014
Administrative expenses (other) incurred2021-12-31$2,875
Total non interest bearing cash at end of year2021-12-31$62,319
Total non interest bearing cash at beginning of year2021-12-31$21,838
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,151,794
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,511,451
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,359,657
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$10,978
Value of interest in pooled separate accounts at end of year2021-12-31$2,358,859
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,287,986
Interest on participant loans2021-12-31$1,045
Interest earned on other investments2021-12-31$65
Value of interest in common/collective trusts at end of year2021-12-31$54,717
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$249,758
Net investment gain or loss from common/collective trusts2021-12-31$279
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$318,024
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$178,128
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$139,579
Contract administrator fees2021-12-31$4,426
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31DUFFY KRUSPODIN
Accountancy firm EIN2021-12-31954244393
2020 : WEST HARBOR HEALTHCARE 401(K) 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$144,014
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$48,478
Total income from all sources (including contributions)2020-12-31$903,471
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$156,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$5,912
Value of total corrective distributions2020-12-31$147,719
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$685,729
Value of total assets at end of year2020-12-31$1,503,671
Value of total assets at beginning of year2020-12-31$661,424
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$3,129
Total interest from all sources2020-12-31$581
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$65,000
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$430,119
Participant contributions at end of year2020-12-31$15,719
Participant contributions at beginning of year2020-12-31$9,473
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$77,482
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$144,014
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$48,478
Other income not declared elsewhere2020-12-31$4,342
Administrative expenses (other) incurred2020-12-31$725
Total non interest bearing cash at end of year2020-12-31$21,838
Total non interest bearing cash at beginning of year2020-12-31$4,342
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$746,711
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,359,657
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$612,946
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
Investment advisory and management fees2020-12-31$428
Value of interest in pooled separate accounts at end of year2020-12-31$1,287,986
Value of interest in pooled separate accounts at beginning of year2020-12-31$572,676
Interest on participant loans2020-12-31$581
Net investment gain/loss from pooled separate accounts2020-12-31$212,819
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$178,128
Employer contributions (assets) at end of year2020-12-31$178,128
Employer contributions (assets) at beginning of year2020-12-31$74,933
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$5,912
Contract administrator fees2020-12-31$1,976
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DUFFY KRUSPODIN
Accountancy firm EIN2020-12-31954244393
2019 : WEST HARBOR HEALTHCARE 401(K) 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$48,478
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,458
Total income from all sources (including contributions)2019-12-31$540,401
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$59,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$14,116
Value of total corrective distributions2019-12-31$44,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$474,577
Value of total assets at end of year2019-12-31$661,424
Value of total assets at beginning of year2019-12-31$136,318
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,063
Total interest from all sources2019-12-31$384
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$25,000
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$191,045
Participant contributions at end of year2019-12-31$9,473
Participant contributions at beginning of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$1,239
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$208,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$48,478
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$4,458
Total non interest bearing cash at end of year2019-12-31$4,342
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$481,086
Value of net assets at end of year (total assets less liabilities)2019-12-31$612,946
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$131,860
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
Investment advisory and management fees2019-12-31$198
Value of interest in pooled separate accounts at end of year2019-12-31$572,676
Value of interest in pooled separate accounts at beginning of year2019-12-31$135,079
Interest on participant loans2019-12-31$268
Interest earned on other investments2019-12-31$116
Net investment gain/loss from pooled separate accounts2019-12-31$65,440
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 contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$74,933
Employer contributions (assets) at end of year2019-12-31$74,933
Employer contributions (assets) at beginning of year2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$14,116
Contract administrator fees2019-12-31$865
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 name2019-12-31DUFFY KRUSPODIN LLP
Accountancy firm EIN2019-12-31954244393
2018 : WEST HARBOR HEALTHCARE 401(K) 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$4,458
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$133,250
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$140,981
Value of total assets at end of year2018-12-31$136,318
Value of total assets at beginning of year2018-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,390
Total interest from all sources2018-12-31$0
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$25,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$87,997
Participant contributions at end of year2018-12-31$1,239
Participant contributions at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$52,984
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$4,458
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$131,860
Value of net assets at end of year (total assets less liabilities)2018-12-31$131,860
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$0
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
Investment advisory and management fees2018-12-31$1,390
Value of interest in pooled separate accounts at end of year2018-12-31$135,079
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-7,731
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 contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
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 name2018-12-31DUFFY KRUSPODIN LLP
Accountancy firm EIN2018-12-31954244393

Form 5500 Responses for WEST HARBOR HEALTHCARE 401(K) PLAN

2022: WEST HARBOR HEALTHCARE 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: WEST HARBOR HEALTHCARE 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: WEST HARBOR HEALTHCARE 401(K) 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 - TrustYes
2019: WEST HARBOR HEALTHCARE 401(K) 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: WEST HARBOR HEALTHCARE 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number136092
Policy instance 1
Insurance contract or identification number136092
Number of Individuals Covered184
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,045
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,750
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA FEES PAID
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number136092
Policy instance 1
Insurance contract or identification number136092
Number of Individuals Covered159
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,873
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 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
Amount paid for insurance broker fees2875
Additional information about fees paid to insurance brokerTPA FEES PAID
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number136092
Policy instance 1
Insurance contract or identification number136092
Number of Individuals Covered142
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,096
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 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
Amount paid for insurance broker fees3968
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?4
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number136092
Policy instance 1
Insurance contract or identification number136092
Number of Individuals Covered63
Insurance policy start date2019-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,373
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 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
Amount paid for insurance broker fees1851
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number136092
Policy instance 1
Insurance contract or identification number136092
Number of Individuals Covered34
Insurance policy start date2018-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $885
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 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
Amount paid for insurance broker fees811
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5

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