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Iberia Comprehensive Community Health Center, Inc.

Plan Rating
FORM 5500 DATA

Iberia Comprehensive Community Health Center, Inc 401k Plan and Trust

Overview

Plan Information

  • Plan Year06/01/2017 — 05/31/2018
  • Date of Plan02/01/2003
  • Net Assets as of 05/31/2018 $4,031,718
  • 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?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 05/31/2018

  • Active (Eligible) Participants130
  • Retired or separated participants receiving benefits1
  • Other retired or separated participants entitled to future benefits7
  • Subtotal138
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total138
  • Total number of participants as of 06/01/2017137
  • Number of participants with account balances88
  • 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

  • Address806 Jefferson Terrace Boulevard
  • CityNew Iberia
  • StateLA
  • Zip70560
  • Telephone(337) 365-4945
  • EIN58-2164455
  • Industry Code621498
  • Named AdministratorRoderick Campbell

Audit Information

  • Audit StatusAudited
  • AuditorSteven M. Derouen & Associates
  • Auditor EIN80-0488055
  • 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.

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 $871,302
Contributions $606,654
Cash Contributions $606,654
Cash from Employers $197,036
Cash from Participants $400,167
Others (including rollovers) $9,451
Noncash Contributions $0
Total Earnings on Investments $264,648
Total Interest $0
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $0
Interest from Other Investments $0
Total Dividends $0
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 $0
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 $264,648
Other Income $0
Expenses $555,107
Total Benefit Payments $554,512
Directly to participants or beneficiaries, including direct rollovers $554,512
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 $595
Professional Fees $420
Contract Administrator Fees $175
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $316,195
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

05/31/2018 05/31/2017 Change YOY
Total Assets $4,031,718 $3,715,523 8.51%
Total noninterest-bearing cash $292 $4,468 -93.46%
Receivables $0 $0 0.0%
Employer Contributions $0 $0 0.0%
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 $0 $0 0.0%
Value of interest in common/collective trusts $0 $0 0.0%
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 $4,031,426 $3,711,055 8.63%
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 $4,031,718 $3,715,523 8.51%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

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
Edward D. Jones & Co., L.P. Investment advisory (participants) Investment Advisor $14,420 $0 $14,420
John Hancock Life Insurance Company Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Shareholder servicing fees, Sub-transfer agency fees, Float revenue, Distribution (12b-1) fees, Soft dollars commissions Recordkeeper $0 $0 $0
Total $14,420 $0 $14,420

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

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
Jh Multi-Index 2030 Preserv John Hancock USA DFE: Pooled Separate Account $1,100,560
Jh Multi-Index 2035 Preserv John Hancock USA DFE: Pooled Separate Account $762,232
Jh Multimanager Balanced Ls John Hancock USA DFE: Pooled Separate Account $391,556
Jh Multi-Index 2025 Preserv John Hancock USA DFE: Pooled Separate Account $378,664
Jh Multimanager Growth Ls John Hancock USA DFE: Pooled Separate Account $239,304
Jh Multi-Index 2045 Preserv John Hancock USA DFE: Pooled Separate Account $195,790
Jh Multi-Index Income Preserv John Hancock USA DFE: Pooled Separate Account $146,597
Jh Multi-Index 2040 Preserv John Hancock USA DFE: Pooled Separate Account $124,491
Jh Multimanager 2055 Lifetime John Hancock USA DFE: Pooled Separate Account $97,158
Real Return Bond Fund John Hancock USA DFE: Pooled Separate Account $92,279
Jh Multi-Index 2050 Preserv John Hancock USA DFE: Pooled Separate Account $84,971
Jh Multimanager 2030 Lifetime John Hancock USA DFE: Pooled Separate Account $67,196
Jh Multi-Index 2055 Preserv John Hancock USA DFE: Pooled Separate Account $42,840
Jh Multimanager 2035 Lifetime John Hancock USA DFE: Pooled Separate Account $35,758
Jh Multimanager Aggressive Ls John Hancock USA DFE: Pooled Separate Account $31,803
Jh Multimanager Conserv Ls John Hancock USA DFE: Pooled Separate Account $27,935
Amg Managers Fairpointe Midcap John Hancock USA DFE: Pooled Separate Account $17,126
Vanguard Value Index Fund John Hancock USA DFE: Pooled Separate Account $15,925
T. Rowe Price Cap Appreciation John Hancock USA DFE: Pooled Separate Account $15,444
Lord Abbett Value Opps Fund John Hancock USA DFE: Pooled Separate Account $15,240
Dfa U.S. Small Cap Fund John Hancock USA DFE: Pooled Separate Account $15,230
Oppenheimer Developing Mkt John Hancock USA DFE: Pooled Separate Account $14,921
Vanguard Small Cap Grow Index John Hancock USA DFE: Pooled Separate Account $11,790
Jh Multimanager 2050 Lifetime John Hancock USA DFE: Pooled Separate Account $10,216
Jh Multimanager Moderate Ls John Hancock USA DFE: Pooled Separate Account $9,823
Vanguard Mid-Cap Growth Etf John Hancock USA DFE: Pooled Separate Account $9,226
Mid Cap Index Fund John Hancock USA DFE: Pooled Separate Account $8,254
Capital World Growth & Income John Hancock USA DFE: Pooled Separate Account $7,620
Intl Equity Index Fund John Hancock USA DFE: Pooled Separate Account $7,313
Total Stock Market Index Fund John Hancock USA DFE: Pooled Separate Account $6,160
Fidelity Real Estate Index John Hancock USA DFE: Pooled Separate Account $5,791
New Perspective Fund John Hancock USA DFE: Pooled Separate Account $5,764
Washington Mutual Investors John Hancock USA DFE: Pooled Separate Account $4,270
Strategic Income Opp Fund John Hancock USA DFE: Pooled Separate Account $3,970
Intl Small Cap Fund John Hancock USA DFE: Pooled Separate Account $3,681
Jh Multi-Index 2060 Preserv John Hancock USA DFE: Pooled Separate Account $3,654
High Yield Fund John Hancock USA DFE: Pooled Separate Account $3,527
Vanguard Mid-Cap Value Etf John Hancock USA DFE: Pooled Separate Account $3,399
Blue Chip Growth Fund John Hancock USA DFE: Pooled Separate Account $2,878
Vanguard Growth Index Fund John Hancock USA DFE: Pooled Separate Account $2,598
Dfa International Value John Hancock USA DFE: Pooled Separate Account $2,354
Pimco Global Bond John Hancock USA DFE: Pooled Separate Account $2,059
Mutual Global Discovery John Hancock USA DFE: Pooled Separate Account $1,976
Dfa Emerging Markets Value John Hancock USA DFE: Pooled Separate Account $1,511
Jh Multimanager 2040 Lifetime John Hancock USA DFE: Pooled Separate Account $868
Total $4,031,722

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
John Hancock Life Insurance Company 88
EIN 01-0233346
Industry Code 65838
Contract Number 109490
Contract Year 06/01/2017 — 05/31/2018
Value in General Account at Year End $0
Value in Separate Accounts at Year End $4,031,426
Insurance Fees and Commissions $1,936
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Acuff & Associates, Inc. 210 Westwood Pl, Suite 100 Brentwood, TN 37027 Third Party Administrator $0 $1,936 TPA COMPENSATION
Allocated Funds
Type of Contract Individual Policies
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 Unspecified
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