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LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 401k Plan overview

Plan NameLIVINGSTON COMMUNITY HEALTH 403(B) PLAN
Plan identification number 003

LIVINGSTON COMMUNITY HEALTH 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

LIVINGSTON COMMUNITY HEALTH has sponsored the creation of one or more 401k plans.

Company Name:LIVINGSTON COMMUNITY HEALTH
Employer identification number (EIN):941719656
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about LIVINGSTON COMMUNITY HEALTH

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0604262

More information about LIVINGSTON COMMUNITY HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIVINGSTON COMMUNITY HEALTH 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032019-05-01
0032018-05-01
0032018-05-01

Plan Statistics for LIVINGSTON COMMUNITY HEALTH 403(B) PLAN

401k plan membership statisitcs for LIVINGSTON COMMUNITY HEALTH 403(B) PLAN

Measure Date Value
2019: LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01232
Total number of active participants reported on line 7a of the Form 55002019-05-01206
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-0183
Total of all active and inactive participants2019-05-01289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-05-010
Total participants2019-05-01289
Number of participants with account balances2019-05-01266
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-05-0126
2018: LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01191
Total number of active participants reported on line 7a of the Form 55002018-05-01190
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-0142
Total of all active and inactive participants2018-05-01232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-05-010
Total participants2018-05-01232
Number of participants with account balances2018-05-01213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-05-0124

Financial Data on LIVINGSTON COMMUNITY HEALTH 403(B) PLAN

Measure Date Value
2020 : LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$942
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$0
Total income from all sources (including contributions)2020-04-30$700,433
Total loss/gain on sale of assets2020-04-30$0
Total of all expenses incurred2020-04-30$95,789
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$70,102
Expenses. Certain deemed distributions of participant loans2020-04-30$6,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$765,552
Value of total assets at end of year2020-04-30$2,287,626
Value of total assets at beginning of year2020-04-30$1,682,040
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$19,277
Total interest from all sources2020-04-30$2,165
Total dividends received (eg from common stock, registered investment company shares)2020-04-30$116,654
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Was this plan covered by a fidelity bond2020-04-30Yes
Value of fidelity bond cover2020-04-30$250,000
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$520,031
Participant contributions at end of year2020-04-30$27,781
Participant contributions at beginning of year2020-04-30$40,447
Income. Received or receivable in cash from other sources (including rollovers)2020-04-30$176,962
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-04-30$942
Administrative expenses (other) incurred2020-04-30$684
Total non interest bearing cash at end of year2020-04-30$21
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$604,644
Value of net assets at end of year (total assets less liabilities)2020-04-30$2,286,684
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$1,682,040
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Investment advisory and management fees2020-04-30$10,370
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-04-30$2,200,937
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-04-30$1,612,828
Interest on participant loans2020-04-30$2,140
Interest earned on other investments2020-04-30$25
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-04-30$58,887
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-04-30$28,765
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-04-30$-183,938
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30Yes
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$68,559
Income. Dividends from preferred stock2020-04-30$116,654
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-04-30$70,102
Contract administrator fees2020-04-30$8,223
Did the plan have assets held for investment2020-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30Yes
Opinion of an independent qualified public accountant for this plan2020-04-30Disclaimer
Accountancy firm name2020-04-30MOSS ADAMS LLP
Accountancy firm EIN2020-04-30910189318
2019 : LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$0
Total income from all sources (including contributions)2019-04-30$1,697,510
Total loss/gain on sale of assets2019-04-30$0
Total of all expenses incurred2019-04-30$15,470
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-04-30$10,528
Value of total corrective distributions2019-04-30$345
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-04-30$1,616,961
Value of total assets at end of year2019-04-30$1,682,040
Value of total assets at beginning of year2019-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-04-30$4,597
Total interest from all sources2019-04-30$695
Total dividends received (eg from common stock, registered investment company shares)2019-04-30$25,673
Total dividends received from registered investment company shares (eg mutual funds)2019-04-30$25,673
Was this plan covered by a fidelity bond2019-04-30Yes
Value of fidelity bond cover2019-04-30$250,000
If this is an individual account plan, was there a blackout period2019-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-04-30$0
Were there any nonexempt tranactions with any party-in-interest2019-04-30No
Contributions received from participants2019-04-30$455,702
Participant contributions at end of year2019-04-30$40,447
Participant contributions at beginning of year2019-04-30$0
Income. Received or receivable in cash from other sources (including rollovers)2019-04-30$1,092,575
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Value of net income/loss2019-04-30$1,682,040
Value of net assets at end of year (total assets less liabilities)2019-04-30$1,682,040
Value of net assets at beginning of year (total assets less liabilities)2019-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-04-30No
Were any leases to which the plan was party in default or uncollectible2019-04-30No
Investment advisory and management fees2019-04-30$2,173
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-04-30$1,612,828
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-04-30$0
Interest on participant loans2019-04-30$452
Interest earned on other investments2019-04-30$242
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-04-30$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-04-30$28,765
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-04-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-04-30$54,181
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-04-30No
Was there a failure to transmit to the plan any participant contributions2019-04-30Yes
Has the plan failed to provide any benefit when due under the plan2019-04-30No
Contributions received in cash from employer2019-04-30$68,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-04-30$10,528
Contract administrator fees2019-04-30$2,424
Did the plan have assets held for investment2019-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-04-30Yes
Opinion of an independent qualified public accountant for this plan2019-04-30Disclaimer
Accountancy firm name2019-04-30MOSS ADAMS LLP
Accountancy firm EIN2019-04-30910189318

Form 5500 Responses for LIVINGSTON COMMUNITY HEALTH 403(B) PLAN

2019: LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: LIVINGSTON COMMUNITY HEALTH 403(B) PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01First time form 5500 has been submittedYes
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

CMFG LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62626 )
Policy contract number10443071
Policy instance 1
Insurance contract or identification number10443071
Number of Individuals Covered289
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CMFG LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62626 )
Policy contract number10443071
Policy instance 1
Insurance contract or identification number10443071
Number of Individuals Covered232
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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