401k Plan data: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN plan

INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 401k Plan overview

Plan Name	INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN
Plan identification number	001

INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN Benefits

401k Plan Type

Defined 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.
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.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

INDIAN HEALTH CENTER OF SANTA CLARA COUNTY has sponsored the creation of one or more 401k plans.

Company Name: INDIAN HEALTH CENTER OF SANTA CLARA COUNTY

Employer identification number (EIN): 942476242

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JEFF CHERNISS
001 2016-01-01 JEFF CHERNISS 2017-10-09
001 2015-01-01 SONYA TETNOWSKI 2016-07-11
001 2014-01-01 BARBARA MIAO 2015-10-10
001 2013-01-01 ELIZABETH HUNT 2014-10-14
001 2012-01-01 ELIZABETH HUNT 2013-10-11
001 2011-01-01 ELIZABETH HUNT 2012-06-08
001 2010-01-01 ELIZABETH HUNT 2011-05-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	JEFF CHERNISS
001	2016-01-01	JEFF CHERNISS	2017-10-09
001	2015-01-01	SONYA TETNOWSKI	2016-07-11
001	2014-01-01	BARBARA MIAO	2015-10-10
001	2013-01-01	ELIZABETH HUNT	2014-10-14
001	2012-01-01	ELIZABETH HUNT	2013-10-11
001	2011-01-01	ELIZABETH HUNT	2012-06-08
001	2010-01-01	ELIZABETH HUNT	2011-05-20

Plan Statistics for INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN

401k plan membership statisitcs for INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN

Measure Date Value
2022: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 345
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 243
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 124
Total of all active and inactive participants 2022-01-01 367
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 367
Number of participants with account balances 2022-01-01 332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 240
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 105
Total of all active and inactive participants 2021-01-01 345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 345
Number of participants with account balances 2021-01-01 307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 316
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 236
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 94
Total of all active and inactive participants 2020-01-01 330
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 330
Number of participants with account balances 2020-01-01 288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 276
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 224
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 84
Total of all active and inactive participants 2019-01-01 308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 308
Number of participants with account balances 2019-01-01 260
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 208
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 63
Total of all active and inactive participants 2018-01-01 271
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 271
Number of participants with account balances 2018-01-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 207
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 38
Total of all active and inactive participants 2017-01-01 245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 245
Number of participants with account balances 2017-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	345
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	243
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	124
Total of all active and inactive participants	2022-01-01	367
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	367
Number of participants with account balances	2022-01-01	332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	240
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	105
Total of all active and inactive participants	2021-01-01	345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	345
Number of participants with account balances	2021-01-01	307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	316
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	236
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	94
Total of all active and inactive participants	2020-01-01	330
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	330
Number of participants with account balances	2020-01-01	288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	276
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	224
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	84
Total of all active and inactive participants	2019-01-01	308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	308
Number of participants with account balances	2019-01-01	260
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	208
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	63
Total of all active and inactive participants	2018-01-01	271
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	271
Number of participants with account balances	2018-01-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	207
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	38
Total of all active and inactive participants	2017-01-01	245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	245
Number of participants with account balances	2017-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN

Measure	Date	Value
2022 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-86,971
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$624,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$592,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,793,263
Value of total assets at end of year	2022-12-31	$11,218,235
Value of total assets at beginning of year	2022-12-31	$11,929,689
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$32,295
Total interest from all sources	2022-12-31	$25,525
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$3,432
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,260,461
Participant contributions at end of year	2022-12-31	$116,828
Participant contributions at beginning of year	2022-12-31	$81,945
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$5,535
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-711,454
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$11,218,235
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$11,929,689
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$8,920,370
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$10,043,606
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$4,892
Interest earned on other investments	2022-12-31	$20,633
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$2,181,037
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,804,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,905,759
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$527,267
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$592,188
Contract administrator fees	2022-12-31	$28,863
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ARMANINO LLP
Accountancy firm EIN	2022-12-31	946214841
2021 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$0
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$0
Total transfer of assets from this plan	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Expenses. Interest paid	2021-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$3,106,823
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,301,402
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,288,710
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,715,444
Value of total assets at end of year	2021-12-31	$11,929,689
Value of total assets at beginning of year	2021-12-31	$10,124,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$12,692
Total income from rents	2021-12-31	$0
Total interest from all sources	2021-12-31	$-677
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 year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$12,692
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,229,579
Participant contributions at end of year	2021-12-31	$81,945
Participant contributions at beginning of year	2021-12-31	$77,264
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$7,239
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$1,805,421
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$11,929,689
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$10,124,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$10,043,606
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$8,467,155
Interest on participant loans	2021-12-31	$4,012
Income. Interest from loans (other than to participants)	2021-12-31	$0
Interest earned on other investments	2021-12-31	$-4,689
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,804,138
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,579,849
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$35,294
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,356,762
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Net gain/loss from 103.12 investment entities	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$478,626
Income. Dividends from preferred stock	2021-12-31	$0
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,288,710
Contract administrator fees	2021-12-31	$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Aggregate proceeds on sale of assets	2021-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ARMANINO LLP
Accountancy firm EIN	2021-12-31	946214841
2020 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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
Total income from all sources (including contributions)	2020-12-31	$2,752,329
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$558,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$551,832
Value of total corrective distributions	2020-12-31	$272
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,519,730
Value of total assets at end of year	2020-12-31	$10,124,268
Value of total assets at beginning of year	2020-12-31	$7,929,989
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$5,946
Total interest from all sources	2020-12-31	$20,896
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 year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$5,946
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,078,259
Participant contributions at end of year	2020-12-31	$77,264
Participant contributions at beginning of year	2020-12-31	$99,093
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$10,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,194,279
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$10,124,268
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$7,929,989
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$8,467,155
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$6,579,609
Interest on participant loans	2020-12-31	$5,137
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$15,759
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,579,849
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,251,287
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,211,703
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$431,449
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$551,832
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	ARMANINO LLP
Accountancy firm EIN	2020-12-31	946214841
2019 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$0
Total transfer of assets from this plan	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 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 paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,707,318
Total income from all sources (including contributions)	2019-12-31	$2,707,318
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$260,897
Total of all expenses incurred	2019-12-31	$260,897
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$255,648
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$255,648
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$549
Value of total corrective distributions	2019-12-31	$549
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,584,358
Value of total assets at end of year	2019-12-31	$7,929,989
Value of total assets at end of year	2019-12-31	$7,929,989
Value of total assets at beginning of year	2019-12-31	$5,483,568
Value of total assets at beginning of year	2019-12-31	$5,483,568
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,700
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,700
Total income from rents	2019-12-31	$0
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$18,207
Total interest from all sources	2019-12-31	$18,207
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 year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$4,700
Administrative expenses professional fees incurred	2019-12-31	$4,700
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$928,791
Contributions received from participants	2019-12-31	$928,791
Participant contributions at end of year	2019-12-31	$99,093
Participant contributions at end of year	2019-12-31	$99,093
Participant contributions at beginning of year	2019-12-31	$52,194
Participant contributions at beginning of year	2019-12-31	$52,194
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$273,791
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$273,791
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
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	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	2019-12-31	No
Income. Non cash contributions	2019-12-31	$0
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$2,446,421
Value of net income/loss	2019-12-31	$2,446,421
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$7,929,989
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$7,929,989
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,483,568
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,483,568
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in pooled separate accounts at end of year	2019-12-31	$6,579,609
Value of interest in pooled separate accounts at end of year	2019-12-31	$6,579,609
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,247,463
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,247,463
Interest on participant loans	2019-12-31	$4,241
Interest on participant loans	2019-12-31	$4,241
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 investments	2019-12-31	$0
Interest earned on other investments	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$13,966
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$13,966
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,251,287
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,251,287
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,183,911
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,183,911
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,104,753
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,104,753
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$381,776
Contributions received in cash from employer	2019-12-31	$381,776
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$255,648
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$255,648
Contract administrator fees	2019-12-31	$0
Contract administrator fees	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ARMANINO LLP
Accountancy firm name	2019-12-31	ARMANINO LLP
Accountancy firm EIN	2019-12-31	946214841
Accountancy firm EIN	2019-12-31	946214841
2018 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$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
Total income from all sources (including contributions)	2018-12-31	$1,002,060
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$667,882
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$652,208
Expenses. Certain deemed distributions of participant loans	2018-12-31	$2,611
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,312,290
Value of total assets at end of year	2018-12-31	$5,483,568
Value of total assets at beginning of year	2018-12-31	$5,149,390
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$13,063
Total interest from all sources	2018-12-31	$15,598
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 year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$13,063
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$848,111
Participant contributions at end of year	2018-12-31	$52,194
Participant contributions at beginning of year	2018-12-31	$45,219
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$77,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$334,178
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$5,483,568
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,149,390
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$4,247,463
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,697,623
Interest on participant loans	2018-12-31	$2,594
Interest earned on other investments	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$13,004
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,183,911
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,406,548
Net investment gain/loss from pooled separate accounts	2018-12-31	$-325,828
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$386,997
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$652,208
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ARMANINO LLP
Accountancy firm EIN	2018-12-31	946214841
2017 : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,451,512
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$123,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$122,006
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$952,855
Value of total assets at end of year	2017-12-31	$5,149,390
Value of total assets at beginning of year	2017-12-31	$3,821,609
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,725
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$17,256
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$1,725
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$683,854
Participant contributions at end of year	2017-12-31	$45,219
Participant contributions at beginning of year	2017-12-31	$53,486
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$10,091
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$1,327,781
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,149,390
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,821,609
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$3,697,623
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,506,602
Interest on participant loans	2017-12-31	$1,865
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$15,391
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,406,548
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,261,521
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$481,401
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$258,910
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$122,006
Contract administrator fees	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ARMANINO LLP
Accountancy firm EIN	2017-12-31	946214841

Form 5500 Responses for INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN

2022: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G50528

Policy instance

Insurance contract or identification number	G50528
Number of Individuals Covered	332
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

877998

Policy instance

Insurance contract or identification number	877998
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $25,566
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,566
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G50528

Policy instance

Insurance contract or identification number	G50528
Number of Individuals Covered	307
Insurance policy start date	2021-10-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

877998

Policy instance

Insurance contract or identification number	877998
Number of Individuals Covered	288
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $20,621
Total amount of fees paid to insurance company	USD $3,963
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,621
Amount paid for insurance broker fees	3963
Additional information about fees paid to insurance broker	SERVICE PROGRAM FEES
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

877998

Policy instance

Insurance contract or identification number	877998
Number of Individuals Covered	260
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $16,441
Total amount of fees paid to insurance company	USD $3,144
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,441
Amount paid for insurance broker fees	3144
Additional information about fees paid to insurance broker	SERVICE PROGRAM FEES
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

877998

Policy instance

Insurance contract or identification number	877998
Number of Individuals Covered	205
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $13,252
Total amount of fees paid to insurance company	USD $2,594
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,252
Amount paid for insurance broker fees	2594
Additional information about fees paid to insurance broker	SERVICE PROGRAM FEES
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

877998

Policy instance

Insurance contract or identification number	877998
Number of Individuals Covered	145
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,931
Total amount of fees paid to insurance company	USD $3,363
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,931
Amount paid for insurance broker fees	3363
Additional information about fees paid to insurance broker	SERVICE PROGRAM FEES
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS AND INSURANCE SERVICE

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Company Name:	INDIAN HEALTH CENTER OF SANTA CLARA COUNTY
Employer identification number (EIN):	942476242
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers