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CHAMPION CARE, LLC 401(K) PLAN 401k Plan overview

Plan NameCHAMPION CARE, LLC 401(K) PLAN
Plan identification number 001

CHAMPION CARE, LLC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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

CHAMPION CARE, LLC has sponsored the creation of one or more 401k plans.

Company Name:CHAMPION CARE, LLC
Employer identification number (EIN):814194408
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about CHAMPION CARE, LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2015-01-30
Company Identification Number: L15000018170
Legal Registered Office Address: 3131 NW 13th St

Gainesville

32609

More information about CHAMPION CARE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHAMPION CARE, LLC 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
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01ESTEE RUBINSTEIN2019-10-04 ESTEE RUBINSTEIN2019-10-04
0012017-01-01GRETCHEN GARTLEY LOZANO2018-10-11 GRETCHEN GARTLEY LOZANO2018-10-11

Plan Statistics for CHAMPION CARE, LLC 401(K) PLAN

401k plan membership statisitcs for CHAMPION CARE, LLC 401(K) PLAN

Measure Date Value
2022: CHAMPION CARE, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01793
Total number of active participants reported on line 7a of the Form 55002022-01-01969
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0149
Total of all active and inactive participants2022-01-011,018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,018
Number of participants with account balances2022-01-01102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CHAMPION CARE, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01818
Total number of active participants reported on line 7a of the Form 55002021-01-01737
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0156
Total of all active and inactive participants2021-01-01793
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01793
Number of participants with account balances2021-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-014
2020: CHAMPION CARE, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,241
Total number of active participants reported on line 7a of the Form 55002020-01-01768
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0150
Total of all active and inactive participants2020-01-01818
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01818
Number of participants with account balances2020-01-01121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: CHAMPION CARE, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,086
Total number of active participants reported on line 7a of the Form 55002019-01-011,198
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0143
Total of all active and inactive participants2019-01-011,241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-011,241
Number of participants with account balances2019-01-01119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-011
2018: CHAMPION CARE, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01851
Total number of active participants reported on line 7a of the Form 55002018-01-011,086
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0119
Total of all active and inactive participants2018-01-011,105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-011,105
Number of participants with account balances2018-01-01100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on CHAMPION CARE, LLC 401(K) PLAN

Measure Date Value
2022 : CHAMPION CARE, LLC 401(K) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets2022-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$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$242
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$-82,376
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$245,420
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$223,091
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Value of total corrective distributions2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$198,463
Value of total assets at end of year2022-12-31$1,517,410
Value of total assets at beginning of year2022-12-31$1,845,448
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$22,329
Total income from rents2022-12-31$0
Total interest from all sources2022-12-31$1,371
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$37,654
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$37,654
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Administrative expenses professional fees incurred2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$203,590
If this is an individual account plan, was there a blackout period2022-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$198,463
Participant contributions at end of year2022-12-31$21,988
Participant contributions at beginning of year2022-12-31$12,545
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
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$242
Other income not declared elsewhere2022-12-31$22,958
Administrative expenses (other) incurred2022-12-31$22,329
Liabilities. Value of operating payables at end of year2022-12-31$0
Liabilities. Value of operating payables at beginning of year2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$5,755
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
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-327,796
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,517,410
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,845,206
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
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Investment advisory and management fees2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,474,981
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,766,863
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$1,276
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$0
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$20,441
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$95
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-32,485
Net investment gain/loss from pooled separate accounts2022-12-31$-310,337
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
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 contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Assets. Invements in employer securities at end of year2022-12-31$0
Assets. Invements in employer securities at beginning of year2022-12-31$0
Assets. Value of employer real property at end of year2022-12-31$0
Assets. Value of employer real property at beginning of year2022-12-31$0
Contributions received in cash from employer2022-12-31$0
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$60,285
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$223,091
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Contract administrator fees2022-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Liabilities. Value of benefit claims payable at end of year2022-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$0
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
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2022-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2022-12-31261556810
2021 : CHAMPION CARE, LLC 401(K) PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$0
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$0
Total transfer of assets from this plan2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$242
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Expenses. Interest paid2021-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022021-12-31$0
Total income from all sources (including contributions)2021-12-31$555,040
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$745,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$714,514
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$328,076
Value of total assets at end of year2021-12-31$1,845,448
Value of total assets at beginning of year2021-12-31$2,035,893
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$30,972
Total income from rents2021-12-31$0
Total interest from all sources2021-12-31$812
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
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$0
Assets. Real estate other than employer real property at end of year2021-12-31$0
Assets. Real estate other than employer real property at beginning of year2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$203,590
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$204,092
Participant contributions at end of year2021-12-31$12,545
Participant contributions at beginning of year2021-12-31$22,015
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$63,699
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Assets. Loans (other than to participants) at end of year2021-12-31$0
Assets. Loans (other than to participants) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$242
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$0
Liabilities. Value of operating payables at end of year2021-12-31$0
Liabilities. Value of operating payables at beginning of year2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$5,755
Total non interest bearing cash at beginning of year2021-12-31$5,946
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
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$-190,687
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,845,206
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,035,893
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
Assets. partnership/joint venture interests at end of year2021-12-31$0
Assets. partnership/joint venture interests at beginning of year2021-12-31$0
Investment advisory and management fees2021-12-31$30,972
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,766,863
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,949,080
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$812
Income. Interest from loans (other than to participants)2021-12-31$0
Interest earned on other investments2021-12-31$0
Income. Interest from US Government securities2021-12-31$0
Income. Interest from corporate debt instruments2021-12-31$0
Value of interest in master investment trust accounts at end of year2021-12-31$0
Value of interest in master investment trust accounts at beginning of year2021-12-31$0
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2021-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Asset value of US Government securities at end of year2021-12-31$0
Asset value of US Government securities at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$226,152
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$0
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Assets. Value of employer real property at end of year2021-12-31$0
Assets. Value of employer real property at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$60,285
Employer contributions (assets) at end of year2021-12-31$60,285
Employer contributions (assets) at beginning of year2021-12-31$58,852
Income. Dividends from preferred stock2021-12-31$0
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$714,514
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$0
Contract administrator fees2021-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$0
Liabilities. Value of benefit claims payable at end of year2021-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$0
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
Aggregate proceeds on sale of assets2021-12-31$0
Aggregate carrying amount (costs) on sale of assets2021-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2021-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2021-12-31261556810
2020 : CHAMPION CARE, LLC 401(K) PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$0
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets to this plan2020-12-31$0
Total transfer of assets from this plan2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Expenses. Interest paid2020-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-12-31$0
Total income from all sources (including contributions)2020-12-31$505,172
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$71,090
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$49,567
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$300,674
Value of total assets at end of year2020-12-31$2,035,893
Value of total assets at beginning of year2020-12-31$1,601,811
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$21,523
Total income from rents2020-12-31$0
Total interest from all sources2020-12-31$1,233
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
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$0
Assets. Real estate other than employer real property at end of year2020-12-31$0
Assets. Real estate other than employer real property at beginning of year2020-12-31$0
Administrative expenses professional fees incurred2020-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$203,590
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$200,434
Participant contributions at end of year2020-12-31$22,015
Participant contributions at beginning of year2020-12-31$31,877
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$41,388
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Assets. Loans (other than to participants) at end of year2020-12-31$0
Assets. Loans (other than to participants) 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$0
Administrative expenses (other) incurred2020-12-31$0
Liabilities. Value of operating payables at end of year2020-12-31$0
Liabilities. Value of operating payables at beginning of year2020-12-31$0
Total non interest bearing cash at end of year2020-12-31$5,946
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$434,082
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,035,893
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,601,811
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
Assets. partnership/joint venture interests at end of year2020-12-31$0
Assets. partnership/joint venture interests at beginning of year2020-12-31$0
Investment advisory and management fees2020-12-31$21,523
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$1,949,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,569,934
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$1,233
Income. Interest from loans (other than to participants)2020-12-31$0
Interest earned on other investments2020-12-31$0
Income. Interest from US Government securities2020-12-31$0
Income. Interest from corporate debt instruments2020-12-31$0
Value of interest in master investment trust accounts at end of year2020-12-31$0
Value of interest in master investment trust accounts at beginning of year2020-12-31$0
Value of interest in common/collective trusts at end of year2020-12-31$0
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2020-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Asset value of US Government securities at end of year2020-12-31$0
Asset value of US Government securities at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$203,265
Net investment gain/loss from pooled separate accounts2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$0
Net gain/loss from 103.12 investment entities2020-12-31$0
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
Assets. Invements in employer securities at end of year2020-12-31$0
Assets. Invements in employer securities at beginning of year2020-12-31$0
Assets. Value of employer real property at end of year2020-12-31$0
Assets. Value of employer real property at beginning of year2020-12-31$0
Contributions received in cash from employer2020-12-31$58,852
Employer contributions (assets) at end of year2020-12-31$58,852
Employer contributions (assets) at beginning of year2020-12-31$0
Income. Dividends from preferred stock2020-12-31$0
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$49,567
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$0
Contract administrator fees2020-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$0
Liabilities. Value of benefit claims payable at end of year2020-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$0
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
Aggregate proceeds on sale of assets2020-12-31$0
Aggregate carrying amount (costs) on sale of assets2020-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2020-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-12-31$0
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2020-12-31261556810
2019 : CHAMPION CARE, LLC 401(K) PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$0
Total transfer of assets to this plan2019-12-31$0
Total transfer of assets from this plan2019-12-31$0
Total transfer of assets from this plan2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Total income from all sources (including contributions)2019-12-31$937,709
Total income from all sources (including contributions)2019-12-31$937,709
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$469,891
Total of all expenses incurred2019-12-31$469,891
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$456,066
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$456,066
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$710,760
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$710,760
Value of total assets at end of year2019-12-31$1,601,811
Value of total assets at end of year2019-12-31$1,601,811
Value of total assets at beginning of year2019-12-31$1,133,993
Value of total assets at beginning of year2019-12-31$1,133,993
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$13,825
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$13,825
Total income from rents2019-12-31$0
Total income from rents2019-12-31$0
Total interest from all sources2019-12-31$1,058
Total interest from all sources2019-12-31$1,058
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Assets. Real estate other than employer real property at end of year2019-12-31$0
Assets. Real estate other than employer real property at end of year2019-12-31$0
Assets. Real estate other than employer real property at beginning of year2019-12-31$0
Assets. Real estate other than employer real property at beginning of year2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$170,000
Value of fidelity bond cover2019-12-31$170,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$171,441
Contributions received from participants2019-12-31$171,441
Participant contributions at end of year2019-12-31$31,877
Participant contributions at beginning of year2019-12-31$35,346
Participant contributions at beginning of year2019-12-31$35,346
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$539,319
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$539,319
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Assets. Loans (other than to participants) at end of year2019-12-31$0
Assets. Loans (other than to participants) at end of year2019-12-31$0
Assets. Loans (other than to participants) at beginning of year2019-12-31$0
Assets. Loans (other than to participants) at beginning of year2019-12-31$0
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 end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$467,818
Value of net income/loss2019-12-31$467,818
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,601,811
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,601,811
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,133,993
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,133,993
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Assets. partnership/joint venture interests at end of year2019-12-31$0
Assets. partnership/joint venture interests at end of year2019-12-31$0
Assets. partnership/joint venture interests at beginning of year2019-12-31$0
Assets. partnership/joint venture interests at beginning of year2019-12-31$0
Investment advisory and management fees2019-12-31$13,825
Investment advisory and management fees2019-12-31$13,825
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,569,934
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,569,934
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,098,647
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,098,647
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$1,058
Interest on participant loans2019-12-31$1,058
Income. Interest from loans (other than to participants)2019-12-31$0
Income. Interest from loans (other than to participants)2019-12-31$0
Interest earned on other investments2019-12-31$0
Interest earned on other investments2019-12-31$0
Income. Interest from US Government securities2019-12-31$0
Income. Interest from US Government securities2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Value of interest in master investment trust accounts at end of year2019-12-31$0
Value of interest in master investment trust accounts at end of year2019-12-31$0
Value of interest in master investment trust accounts at beginning of year2019-12-31$0
Value of interest in master investment trust accounts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$225,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$225,891
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Value of employer real property at end of year2019-12-31$0
Assets. Value of employer real property at end of year2019-12-31$0
Assets. Value of employer real property at beginning of year2019-12-31$0
Assets. Value of employer real property at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$0
Contributions received in cash from employer2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$456,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$456,066
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$0
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$0
Contract administrator fees2019-12-31$0
Contract administrator fees2019-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$0
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ALAN GOODMAN, CPA PC
Accountancy firm name2019-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2019-12-31261556810
Accountancy firm EIN2019-12-31261556810
2018 : CHAMPION CARE, LLC 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$841,461
Total transfer of assets from this plan2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$150,771
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$32,214
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$20,355
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$203,917
Value of total assets at end of year2018-12-31$1,133,993
Value of total assets at beginning of year2018-12-31$173,975
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$11,859
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$1,245
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
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$0
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$120,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$203,917
Participant contributions at end of year2018-12-31$35,346
Participant contributions at beginning of year2018-12-31$41,573
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$0
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash 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
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$118,557
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,133,993
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$173,975
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
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$11,859
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$1,098,647
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$132,402
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$1,245
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$0
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-54,391
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$0
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$20,355
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$0
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
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
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 name2018-12-31ALAN GOODMAN, CPA PC
Accountancy firm EIN2018-12-31261556810

Form 5500 Responses for CHAMPION CARE, LLC 401(K) PLAN

2022: CHAMPION CARE, LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
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 planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CHAMPION CARE, LLC 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 – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CHAMPION CARE, LLC 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 – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CHAMPION CARE, LLC 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: CHAMPION CARE, LLC 401(K) 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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number801697
Policy instance 1
Insurance contract or identification number801697
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-11-14
Total amount of commissions paid to insurance brokerUSD $3,208
Total amount of fees paid to insurance companyUSD $10,368
Are there contracts with allocated funds for individual policies?0
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 fees10368
Commission paid to Insurance BrokerUSD $3,208
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number801697
Policy instance 1
Insurance contract or identification number801697
Number of Individuals Covered117
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,037
Total amount of fees paid to insurance companyUSD $11,422
Are there contracts with allocated funds for group deferred annuity?Yes
Commission paid to Insurance BrokerUSD $5,037
Insurance broker organization code?4
Amount paid for insurance broker fees11422
Additional information about fees paid to insurance brokerFEES PAID
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number801697
Policy instance 1
Insurance contract or identification number801697
Number of Individuals Covered121
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,033
Total amount of fees paid to insurance companyUSD $5,225
Are there contracts with allocated funds for group deferred annuity?Yes
Commission paid to Insurance BrokerUSD $4,033
Insurance broker organization code?4
Amount paid for insurance broker fees1645
Additional information about fees paid to insurance brokerFEES PAID
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number801697
Policy instance 1
Insurance contract or identification number801697
Number of Individuals Covered119
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,025
Total amount of fees paid to insurance companyUSD $1,450
Are there contracts with allocated funds for group deferred annuity?Yes
Commission paid to Insurance BrokerUSD $3,025
Insurance broker organization code?4
Amount paid for insurance broker fees1450
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number
Policy instance 1
Number of Individuals Covered100
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,286
Total amount of fees paid to insurance companyUSD $300
Are there contracts with allocated funds for group deferred annuity?Yes
Commission paid to Insurance BrokerUSD $1,820
Amount paid for insurance broker fees0
Insurance broker organization code?3

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