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FORM 5500 DATA

S and J Home Care Retirement Savings Plan

Overview

Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan08/01/2009
  • Net Assets as of 12/31/2019 $2,139,230
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program? No
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2019

  • Active (Eligible) Participants180
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits19
  • Subtotal199
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total199
  • Total number of participants as of 01/01/2019228
  • Number of participants with account balances64
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address3240 University Avenue, Suite 3A
  • CityMadison
  • StateWI
  • Zip53705
  • Telephone(608) 310-3184
  • EIN20-5453007
  • Industry Code621610

Audit Information

  • Audit StatusAudited
  • AuditorOlsen Thielen & Co., Ltd.
  • Auditor EIN41-1360831
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2J 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.
2K 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 contributions 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.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D 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.
3H Controlled Group Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $500,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $654,922
Contributions $375,111
Cash Contributions $375,111
Cash from Employers $97,815
Cash from Participants $254,035
Others (including rollovers) $23,261
Noncash Contributions $0
Total Earnings on Investments $279,811
Total Interest $4,522
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $4,522
Interest from Other Investments $0
Total Dividends $526
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $271,514
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $3,249
Other Income $0
Expenses $133,709
Total Benefit Payments $115,837
Directly to participants or beneficiaries, including direct rollovers $115,837
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $17,872
Professional Fees $0
Contract Administrator Fees $17,872
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $521,213
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $2,139,230 $1,618,017 32.21%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $5,846 $2,151 171.78%
Employer Contributions $5,846 $2,151 171.78%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $46,439 $4,341 969.78%
Value of interest in common/collective trusts $2,065,467 $1,603,008 28.85%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $21,478 $8,517 152.18%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $2,139,230 $1,618,017 32.21%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Great-West Life & Annuity

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Great-West Life & Annuity Insurance Recordkeeping fees Recordkeeper $8,553 $0 $8,553
Kestra Advisory Services, LLC Investment advisory (plan) Investment Advisor $5,907 $0 $5,907
Gallagher Benefit Services Contract Administrator Contract Admin $3,738 $934 $4,672
Kelly Financial, Inc. Contract Administrator Contract Admin $1,025 $426 $1,451
Total $19,223 $1,360 $20,583

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Kelly Financial, Inc. Great-West Life & Annuity Insurance Contract Administrator Tpa Allowance Payment $425
Gallagher Benefit Servics Inc. Great-West Life & Annuity Insurance Contract Administrator Tpa Allowance Payment $934
*As outlined by the Form 5500 Instructions for service providers with indirect compensation.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Putnam Retirement Advantage 2025 I Putnam Investments DFE: Common/Collective Trust $976,463
Putnam Retirement Advantage Maturit Putnam Investments DFE: Common/Collective Trust $260,078
Putnam Retirement Advantage 2045 I Putnam Investments DFE: Common/Collective Trust $235,638
Putnam Retirement Advantage 2040 I Putnam Investments DFE: Common/Collective Trust $226,766
Putnam Retirement Advantage 2035 I Putnam Investments DFE: Common/Collective Trust $102,026
Putnam Retirement Advantage 2030 I Putnam Investments DFE: Common/Collective Trust $101,213
Putnam Retirement Advantage 2050 I Putnam Investments DFE: Common/Collective Trust $66,458
Putnam Retirement Advantage 2055 I Putnam Investments DFE: Common/Collective Trust $63,209
Putnam Retirement Advantage 2020 I Putnam Investments DFE: Common/Collective Trust $26,516
Putnam Retirement Advantage 2060 I Putnam Investments DFE: Common/Collective Trust $7,100
Total $2,065,467

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Great-West Life & Annuity Insurance Company 64
EIN 84-0467907
Industry Code 68322
Contract Number 503937-01
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $0
Persons Receiving Commissions and Fees There are no brokers listed for this plan.
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract GROUP ANNUITY CONTRACT
Balance at the end of the previous year $0
Additions $0
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $0
Transferred from separate account $0
Other $0
Total of Balance and Additions $0
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0