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Plan Name | PACIFICSOURCE PENSION PLAN |
Plan identification number | 001 |
401k Plan Type | Defined Benefit Pension |
Plan Features/Benefits |
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Company Name: | PACIFICSOURCE HEALTH PLANS |
Employer identification number (EIN): | 930245545 |
NAIC Classification: | 524140 |
Additional information about PACIFICSOURCE HEALTH PLANS
Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
Incorporation Date: | 2033-04-12 |
Company Identification Number: | 3651213 |
Legal Registered Office Address: |
110 INTERNATIONAL WAY SPRINGFIELD United States of America (USA) 97477 |
More information about PACIFICSOURCE HEALTH PLANS
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
001 | 2012-01-01 | PETER DAVIDSON | |||
001 | 2011-01-01 | PETER DAVIDSON | |||
001 | 2010-01-01 | PETER DAVIDSON | |||
001 | 2009-01-01 | JOHN CLEMENTS |
Measure | Date | Value |
---|---|---|
2012: PACIFICSOURCE PENSION PLAN 2012 401k membership | ||
Total participants, beginning-of-year | 2012-01-01 | 686 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 507 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 20 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 161 |
Total of all active and inactive participants | 2012-01-01 | 688 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 1 |
Total participants | 2012-01-01 | 689 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
2011: PACIFICSOURCE PENSION PLAN 2011 401k membership | ||
Total participants, beginning-of-year | 2011-01-01 | 509 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 505 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 12 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 169 |
Total of all active and inactive participants | 2011-01-01 | 686 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
Total participants | 2011-01-01 | 686 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 1 |
2010: PACIFICSOURCE PENSION PLAN 2010 401k membership | ||
Total participants, beginning-of-year | 2010-01-01 | 461 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 327 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 107 |
Total of all active and inactive participants | 2010-01-01 | 441 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
Total participants | 2010-01-01 | 441 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 17 |
2009: PACIFICSOURCE PENSION PLAN 2009 401k membership | ||
Total participants, beginning-of-year | 2009-01-01 | 423 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 350 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 107 |
Total of all active and inactive participants | 2009-01-01 | 461 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
Total participants | 2009-01-01 | 461 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 5 |
Measure | Date | Value |
---|---|---|
2012 : PACIFICSOURCE PENSION PLAN 2012 401k financial data | ||
Total income from all sources (including contributions) | 2012-12-31 | $3,323,749 |
Total of all expenses incurred | 2012-12-31 | $1,027,706 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $1,003,696 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $253,806 |
Value of total assets at end of year | 2012-12-31 | $29,646,024 |
Value of total assets at beginning of year | 2012-12-31 | $27,349,981 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $24,010 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $783,081 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $783,081 |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $1,300,000 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Other income not declared elsewhere | 2012-12-31 | $-37,857 |
Administrative expenses (other) incurred | 2012-12-31 | $24,010 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $2,296,043 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $29,646,024 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $27,349,981 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $29,646,024 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $25,603,787 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $2,324,719 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $253,806 |
Employer contributions (assets) at beginning of year | 2012-12-31 | $1,746,194 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $1,003,696 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
Accountancy firm name | 2012-12-31 | KERNUTT STOKES LLP |
Accountancy firm EIN | 2012-12-31 | 930396435 |
2011 : PACIFICSOURCE PENSION PLAN 2011 401k financial data | ||
Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $3,376,485 |
Total unrealized appreciation/depreciation of assets | 2011-12-31 | $3,376,485 |
Total income from all sources (including contributions) | 2011-12-31 | $3,407,284 |
Total of all expenses incurred | 2011-12-31 | $372,899 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $308,539 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $3,380,912 |
Value of total assets at end of year | 2011-12-31 | $27,349,981 |
Value of total assets at beginning of year | 2011-12-31 | $24,315,596 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $64,360 |
Total interest from all sources | 2011-12-31 | $72,508 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $394,192 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $394,192 |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $1,300,000 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Administrative expenses (other) incurred | 2011-12-31 | $64,360 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $3,034,385 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $27,349,981 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $24,315,596 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $25,603,787 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $3,346,850 |
Value of interest in pooled separate accounts at end of year | 2011-12-31 | $0 |
Value of interest in pooled separate accounts at beginning of year | 2011-12-31 | $12,847,125 |
Interest earned on other investments | 2011-12-31 | $72,508 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $0 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $5,256,339 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-4,413,197 |
Net investment gain/loss from pooled separate accounts | 2011-12-31 | $596,384 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $3,380,912 |
Employer contributions (assets) at end of year | 2011-12-31 | $1,746,194 |
Employer contributions (assets) at beginning of year | 2011-12-31 | $2,865,282 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $308,539 |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
Accountancy firm name | 2011-12-31 | KERNUTT STOKES LLP |
Accountancy firm EIN | 2011-12-31 | 930396435 |
2010 : PACIFICSOURCE PENSION PLAN 2010 401k financial data | ||
Total unrealized appreciation/depreciation of assets | 2010-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
Total income from all sources (including contributions) | 2010-12-31 | $5,862,558 |
Total loss/gain on sale of assets | 2010-12-31 | $0 |
Total of all expenses incurred | 2010-12-31 | $346,222 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $308,018 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $4,211,914 |
Value of total assets at end of year | 2010-12-31 | $24,315,596 |
Value of total assets at beginning of year | 2010-12-31 | $18,799,260 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $38,204 |
Total interest from all sources | 2010-12-31 | $148,184 |
Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $168,029 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $168,029 |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $1,300,000 |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $5,516,336 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $24,315,596 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $18,799,260 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $3,346,850 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $3,178,822 |
Value of interest in pooled separate accounts at end of year | 2010-12-31 | $12,847,125 |
Value of interest in pooled separate accounts at beginning of year | 2010-12-31 | $9,761,126 |
Interest earned on other investments | 2010-12-31 | $148,184 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $5,256,339 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2010-12-31 | $3,205,944 |
Net investment gain/loss from pooled separate accounts | 2010-12-31 | $1,334,431 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contributions received in cash from employer | 2010-12-31 | $4,211,914 |
Employer contributions (assets) at end of year | 2010-12-31 | $2,865,282 |
Employer contributions (assets) at beginning of year | 2010-12-31 | $2,653,368 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $308,018 |
Contract administrator fees | 2010-12-31 | $38,204 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2010-12-31 | No |
Did the plan have assets held for investment | 2010-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
Accountancy firm name | 2010-12-31 | KERNUTT STOKES LLP |
Accountancy firm EIN | 2010-12-31 | 930396435 |
2012: PACIFICSOURCE PENSION PLAN 2012 form 5500 responses | ||
---|---|---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Trust | Yes |
2012-01-01 | Plan benefit arrangement - Trust | Yes |
2011: PACIFICSOURCE PENSION PLAN 2011 form 5500 responses | ||
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – Trust | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement - Trust | Yes |
2010: PACIFICSOURCE PENSION PLAN 2010 form 5500 responses | ||
2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Submission has been amended | No |
2010-01-01 | This submission is the final filing | No |
2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-01-01 | Plan is a collectively bargained plan | No |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: PACIFICSOURCE PENSION PLAN 2009 form 5500 responses | ||
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |