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CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 401k Plan overview

Plan NameCLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN
Plan identification number 001

CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 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.

401k Sponsoring company profile

CLINICA DE SALUD DEL VALLE DE SALINAS has sponsored the creation of one or more 401k plans.

Company Name:CLINICA DE SALUD DEL VALLE DE SALINAS
Employer identification number (EIN):942652757
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about CLINICA DE SALUD DEL VALLE DE SALINAS

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0973117

More information about CLINICA DE SALUD DEL VALLE DE SALINAS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01HAROLD M. MCCOY
0012017-01-01HAROLD M. MCCOY
0012016-01-01HAROLD M. MCCOY
0012015-01-01HAROLD M. MCCOY HAROLD M. MCCOY2016-10-17

Plan Statistics for CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN

401k plan membership statisitcs for CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN

Measure Date Value
2022: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01337
Total number of active participants reported on line 7a of the Form 55002022-01-01308
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0133
Total of all active and inactive participants2022-01-01345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01345
Number of participants with account balances2022-01-0194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01329
Total number of active participants reported on line 7a of the Form 55002021-01-01284
Number of retired or separated participants receiving benefits2021-01-017
Number of other retired or separated participants entitled to future benefits2021-01-0134
Total of all active and inactive participants2021-01-01325
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01325
Number of participants with account balances2021-01-0196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-011
2020: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01345
Total number of active participants reported on line 7a of the Form 55002020-01-01303
Number of retired or separated participants receiving benefits2020-01-016
Number of other retired or separated participants entitled to future benefits2020-01-0127
Total of all active and inactive participants2020-01-01336
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01336
Number of participants with account balances2020-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01332
Total number of active participants reported on line 7a of the Form 55002019-01-01304
Number of retired or separated participants receiving benefits2019-01-016
Number of other retired or separated participants entitled to future benefits2019-01-0136
Total of all active and inactive participants2019-01-01346
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01346
Number of participants with account balances2019-01-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01286
Total number of active participants reported on line 7a of the Form 55002018-01-01299
Number of retired or separated participants receiving benefits2018-01-016
Number of other retired or separated participants entitled to future benefits2018-01-0124
Total of all active and inactive participants2018-01-01329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01329
Number of participants with account balances2018-01-0181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01273
Total number of active participants reported on line 7a of the Form 55002017-01-01263
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-0123
Total of all active and inactive participants2017-01-01288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01288
Number of participants with account balances2017-01-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01244
Total number of active participants reported on line 7a of the Form 55002016-01-01244
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0122
Total of all active and inactive participants2016-01-01269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01269
Number of participants with account balances2016-01-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01218
Total number of active participants reported on line 7a of the Form 55002015-01-01220
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0120
Total of all active and inactive participants2015-01-01242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01242
Number of participants with account balances2015-01-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN

Measure Date Value
2022 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$140,163
Total income from all sources (including contributions)2022-12-31$-581,453
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$278,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$278,431
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$604,264
Value of total assets at end of year2022-12-31$5,805,985
Value of total assets at beginning of year2022-12-31$6,806,032
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$0
Total interest from all sources2022-12-31$2,268
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$557,550
Participant contributions at end of year2022-12-31$58,037
Participant contributions at beginning of year2022-12-31$37,961
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$72,193
Liabilities. Value of operating payables at end of year2022-12-31$0
Liabilities. Value of operating payables at beginning of year2022-12-31$140,163
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-859,884
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,805,985
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,665,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,701,234
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$6,539,681
Interest on participant loans2022-12-31$2,268
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,187,985
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$46,714
Employer contributions (assets) at end of year2022-12-31$46,714
Employer contributions (assets) at beginning of year2022-12-31$156,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$278,431
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31OSCAR G ARMIJO CPA
Accountancy firm EIN2022-12-31330278891
2021 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$140,163
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$136,626
Total income from all sources (including contributions)2021-12-31$1,766,385
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$811,094
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$745,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,099,886
Value of total assets at end of year2021-12-31$6,806,032
Value of total assets at beginning of year2021-12-31$5,847,204
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$65,943
Total interest from all sources2021-12-31$488
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$943,689
Participant contributions at end of year2021-12-31$37,961
Participant contributions at beginning of year2021-12-31$7,641
Participant contributions at end of year2021-12-31$72,193
Participant contributions at beginning of year2021-12-31$86,138
Liabilities. Value of operating payables at end of year2021-12-31$140,163
Liabilities. Value of operating payables at beginning of year2021-12-31$136,626
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$955,291
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,665,869
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$5,710,578
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$65,943
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$6,539,681
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$5,581,511
Interest on participant loans2021-12-31$488
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$402,653
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$666,011
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$156,197
Employer contributions (assets) at end of year2021-12-31$156,197
Employer contributions (assets) at beginning of year2021-12-31$171,914
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$342,498
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31OSCAR G ARMIJO, CPA
Accountancy firm EIN2021-12-31330278891
2020 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$136,626
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$125,750
Total income from all sources (including contributions)2020-12-31$1,790,879
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$843,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$765,397
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,090,361
Value of total assets at end of year2020-12-31$5,847,204
Value of total assets at beginning of year2020-12-31$4,888,760
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$77,914
Total interest from all sources2020-12-31$359
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$918,447
Participant contributions at end of year2020-12-31$7,641
Participant contributions at beginning of year2020-12-31$8,635
Participant contributions at end of year2020-12-31$86,138
Participant contributions at beginning of year2020-12-31$82,254
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$0
Liabilities. Value of operating payables at end of year2020-12-31$136,626
Liabilities. Value of operating payables at beginning of year2020-12-31$125,750
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$947,568
Value of net assets at end of year (total assets less liabilities)2020-12-31$5,710,578
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,763,010
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$77,914
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$5,581,511
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$4,648,715
Interest on participant loans2020-12-31$359
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$393,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$700,159
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$171,914
Employer contributions (assets) at end of year2020-12-31$171,914
Employer contributions (assets) at beginning of year2020-12-31$149,156
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$371,427
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31OSCAR G ARMIJO, CPA
Accountancy firm EIN2020-12-31330278891
2019 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$125,750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$97,161
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$97,161
Total income from all sources (including contributions)2019-12-31$1,887,847
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$807,557
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$735,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,045,198
Value of total assets at end of year2019-12-31$4,888,760
Value of total assets at end of year2019-12-31$4,888,760
Value of total assets at beginning of year2019-12-31$3,779,881
Value of total assets at beginning of year2019-12-31$3,779,881
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$72,494
Total interest from all sources2019-12-31$467
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$877,540
Participant contributions at end of year2019-12-31$8,635
Participant contributions at end of year2019-12-31$8,635
Participant contributions at beginning of year2019-12-31$11,748
Participant contributions at beginning of year2019-12-31$11,748
Participant contributions at end of year2019-12-31$82,254
Participant contributions at end of year2019-12-31$82,254
Participant contributions at beginning of year2019-12-31$91,891
Participant contributions at beginning of year2019-12-31$91,891
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$18,502
Liabilities. Value of operating payables at end of year2019-12-31$125,750
Liabilities. Value of operating payables at beginning of year2019-12-31$97,161
Liabilities. Value of operating payables at beginning of year2019-12-31$97,161
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,080,290
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,763,010
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,682,720
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,682,720
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$72,494
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,648,715
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,648,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,554,201
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,554,201
Income. Interest from loans (other than to participants)2019-12-31$467
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$348,206
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$842,182
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$149,156
Employer contributions (assets) at end of year2019-12-31$149,156
Employer contributions (assets) at end of year2019-12-31$149,156
Employer contributions (assets) at beginning of year2019-12-31$122,041
Employer contributions (assets) at beginning of year2019-12-31$122,041
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$386,857
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31OSCAR G. ARMIJO, CPA
Accountancy firm EIN2019-12-31330278891
2018 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$97,161
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$68,972
Total income from all sources (including contributions)2018-12-31$601,948
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$496,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$434,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$859,076
Value of total assets at end of year2018-12-31$3,779,881
Value of total assets at beginning of year2018-12-31$3,646,117
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$61,680
Total interest from all sources2018-12-31$471
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$737,035
Participant contributions at end of year2018-12-31$11,748
Participant contributions at beginning of year2018-12-31$10,595
Participant contributions at end of year2018-12-31$91,891
Participant contributions at beginning of year2018-12-31$29,338
Liabilities. Value of operating payables at end of year2018-12-31$97,161
Liabilities. Value of operating payables at beginning of year2018-12-31$68,972
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$105,575
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,682,720
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,577,145
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$61,680
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,554,201
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,524,434
Interest on participant loans2018-12-31$471
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$288,492
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-257,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$122,041
Employer contributions (assets) at end of year2018-12-31$122,041
Employer contributions (assets) at beginning of year2018-12-31$81,750
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$146,201
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31OSCAR G. ARMIJO, CPA
Accountancy firm EIN2018-12-31330278891
2017 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$68,972
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$55,413
Total income from all sources (including contributions)2017-12-31$1,169,945
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$883,268
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$823,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$590,552
Value of total assets at end of year2017-12-31$3,646,117
Value of total assets at beginning of year2017-12-31$3,345,881
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$59,691
Total interest from all sources2017-12-31$472
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 year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$508,802
Participant contributions at end of year2017-12-31$10,595
Participant contributions at beginning of year2017-12-31$11,936
Participant contributions at end of year2017-12-31$29,338
Participant contributions at beginning of year2017-12-31$25,483
Liabilities. Value of operating payables at end of year2017-12-31$68,972
Liabilities. Value of operating payables at beginning of year2017-12-31$55,413
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$286,677
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,577,145
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,290,468
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$59,691
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,524,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,224,395
Interest on participant loans2017-12-31$472
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$230,600
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$578,921
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$81,750
Employer contributions (assets) at end of year2017-12-31$81,750
Employer contributions (assets) at beginning of year2017-12-31$84,067
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$592,977
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31OSCAR G. ARMIJO, CPA
Accountancy firm EIN2017-12-31330278891
2016 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$55,413
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$55,084
Total income from all sources (including contributions)2016-12-31$838,016
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$511,941
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$424,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$599,284
Value of total assets at end of year2016-12-31$3,345,881
Value of total assets at beginning of year2016-12-31$3,019,477
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$87,420
Total interest from all sources2016-12-31$544
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$507,240
Participant contributions at end of year2016-12-31$11,936
Participant contributions at beginning of year2016-12-31$13,530
Participant contributions at end of year2016-12-31$25,483
Participant contributions at beginning of year2016-12-31$21,231
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$7,977
Liabilities. Value of operating payables at end of year2016-12-31$55,413
Liabilities. Value of operating payables at beginning of year2016-12-31$55,084
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$326,075
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,290,468
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,964,393
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$87,420
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,224,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,884,932
Interest on participant loans2016-12-31$544
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$188,414
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$238,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$84,067
Employer contributions (assets) at end of year2016-12-31$84,067
Employer contributions (assets) at beginning of year2016-12-31$99,784
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$236,107
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31OSCAR G ARMIJO, CPA
Accountancy firm EIN2016-12-31330278891
2015 : CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$55,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$55,312
Total income from all sources (including contributions)2015-12-31$546,559
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$283,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$204,093
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$549,359
Value of total assets at end of year2015-12-31$3,019,477
Value of total assets at beginning of year2015-12-31$2,756,494
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$79,255
Total interest from all sources2015-12-31$575
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31No
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$449,575
Participant contributions at end of year2015-12-31$13,530
Participant contributions at beginning of year2015-12-31$13,093
Participant contributions at end of year2015-12-31$21,231
Participant contributions at beginning of year2015-12-31$27,988
Liabilities. Value of operating payables at end of year2015-12-31$55,084
Liabilities. Value of operating payables at beginning of year2015-12-31$55,312
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$263,211
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,964,393
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,701,182
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$79,255
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,884,932
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,647,478
Interest on participant loans2015-12-31$575
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$180,637
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-3,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$99,784
Employer contributions (assets) at end of year2015-12-31$99,784
Employer contributions (assets) at beginning of year2015-12-31$67,935
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$23,456
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31OSCAR G ARMIJO, CPA
Accountancy firm EIN2015-12-31330278891

Form 5500 Responses for CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN

2022: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CLINICA DE SALUD DEL VALLE DE SALINAS 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Number of Individuals Covered285
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $18,874
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,470
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,776
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,132
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $43,680
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $40,455
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberGS10
Policy instance 1
Insurance contract or identification numberGS10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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