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FORM 5500 DATA

Optima Healthcare Solutions, LLC 401k Plan

Overview

Plan Information

  • Plan Year01/01/2017 — 12/31/2017
  • Date of Plan01/01/2014
  • Net Assets as of 12/31/2017 $4,854,521
  • 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 12/31/2017

  • Active (Eligible) Participants157
  • Retired or separated participants receiving benefits2
  • Other retired or separated participants entitled to future benefits68
  • Subtotal227
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits1
  • Total228
  • Total number of participants as of 01/01/2017178
  • Number of participants with account balances228
  • 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

  • Address4229 SW High Meadows Avenue
  • CityPalm City
  • StateFL
  • Zip34990-3726
  • Telephone(772) 403-1200
  • EIN65-0356561
  • Industry Code541512
  • Named AdministratorCarol Lewis

Audit Information

  • Audit StatusAudited
  • AuditorBdo, USA, LLP
  • Auditor EIN13-5381590
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2A 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 threshold or additional rate allowed under the permitted disparity rules of section 401(l)
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
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.
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 $1,851,910
Contributions $1,212,382
Cash Contributions $1,212,382
Cash from Employers $441,853
Cash from Participants $690,059
Others (including rollovers) $80,470
Noncash Contributions $0
Total Earnings on Investments $639,528
Total Interest $1,938
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 $1,938
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 $637,590
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 $0
Other Income $0
Expenses $551,200
Total Benefit Payments $546,693
Directly to participants or beneficiaries, including direct rollovers $546,693
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 $4,507
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $4,507
Net Income $1,300,710
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2017 12/31/2016 Change YOY
Total Assets $4,854,521 $3,553,811 36.60%
Total noninterest-bearing cash $0 $0 0.0%
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 $4,707,043 $3,387,251 38.96%
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 $0 $0 0.0%
Value of funds held in insurance co. general account $147,478 $166,560 -11.46%
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 $4,854,521 $3,553,811 36.60%

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
Massmutual Life Insurance Co. Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication, Shareholder servicing fees, Distribution (12b-1) fees, Insurance mortality and expense charge, Insurance services, Sales loads (front end and deferred), Sub-transfer agency fees, Recordkeeping fees, Other fees, Participant loan processing, Other commissions, Float revenue, Account maintenance fees, Direct payment from the plan Record-Keeper $4,507 $0 $4,507
Massmutual Life Insurance Co. Float revenue Custodian $0 $463 $463
Morningstar Associates, LLC Other services Management Fee $0 $21 $21
Mesirow Financial Investments, Inc. Other services Investment Advisory $0 $20 $20
Total $4,507 $504 $5,011

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Massachusetts Mutual Life Insurance American Funds The New Econmy Ri Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 1.10% Times Assets $0
Massachusetts Mutual Life Insurance Clearbridge Sm Cap Gr R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Eaton Vance Atl Cap Smid Cap R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Franklin High Income R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12/ Participant $0
Massachusetts Mutual Life Insurance Franklin Income R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12/ Participant $0
Massachusetts Mutual Life Insurance Franklin Mutual Global Disc R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12/ Participant $0
Massachusetts Mutual Life Insurance Franklin Strategic Income R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12/ Participant $0
Massachusetts Mutual Life Insurance Franklin Total Return R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12/ Participant $0
Massachusetts Mutual Life Insurance Goldman Sachs Small Cap Value R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Ivy Asset Strategy R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.75% Times Assets $0
Massachusetts Mutual Life Insurance Ivy Science and Technology R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.75% Times Assets $0
Massachusetts Mutual Life Insurance Lord Abbett Fndamental Equity R3 Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.75% Times Assets $0
Massachusetts Mutual Life Insurance Mfs International Value R2 Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Mfs Utilities R2 Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Oppenheimer Equity Income R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Oppenheimer Rising Dividends R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Janus Henderson Mid Cap Value R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.75% Times Assets $0
Massachusetts Mutual Life Insurance Prud Jenn Natural Resources R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Prud Jessison 20/20 Focus R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Massachusetts Mutual Life Insurance Putnam Equity Income Fund R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.75% Times Assets $0
Massachusetts Mutual Life Insurance Templeton Global Bond R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.60% Times Assets Plus $12 Per Participant $0
Massachusetts Mutual Life Insurance The Hartford Balanced Income R3 Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.85% Times Assets $0
Massachusetts Mutual Life Insurance The Hartford Healthcare R3 Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.85% Times Assets $0
Massachusetts Mutual Life Insurance Victory Sycamore Small Co Opp R Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant communication 0.80% Times Assets $0
Morningstar Associates, LLC Massmutual Life Insurance Company Other services Estimate Determined By Dividing A Flat Annual Fee Paid To Morningstar By The Number of Plans To Whom This Feature Is Made Available. $0
Mesirow Financial Invest. Mgmt, Inc Massmutual Life Insurance Company Other services Estimate Based On The Annual Platform Package Fee Paid To Mesirow Divided By The Number of Plans Using This Feature $0
*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
Massachusett Mutual Life Insurance Separate Account 401 DFE: Pooled Separate Account $4,707,043
Total $4,707,043

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Massachusetts Mutual Life Insurance Company 228
EIN 04-1590850
Industry Code 65935
Contract Number GA-833673
Contract Year 01/01/2017 — 12/31/2017
Value in General Account at Year End $147,478
Value in Separate Accounts at Year End $4,707,043
Insurance Fees and Commissions $25,570
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Janney Montgomery Scott, LLC 1717 Arch St Fl 16 Philadelphia, PA 19013 Insurance Agent or Broker $19,576 $0
Multi-Financial Sec Corp 4600 S. Syracuse St. Suite 600 Denver, CO 80237 Insurance Agent or Broker $5,994 $0
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 FUNDING AGREEMENT
Balance at the end of the previous year $166,560
Additions $34,157
Contributions Deposited during the year $29,654
Dividends and credits $0
Interest credited during the year $1,938
Transferred from separate account $0
Other $2,565
Total of Balance and Additions $200,717
Deductions $53,239
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $375
Transferred to Separate Account $52,864
Other $0
Balance at the end of the current year $147,478