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FORM 5500 DATA

Health Centers 401k Plan

Overview

Plan Information

  • Plan Year01/01/2017 — 12/31/2017
  • Date of Plan01/01/2015
  • Net Assets as of 12/31/2017 $805,146
  • 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
  • Report Description This is an amended report.
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit Arrangement Trust

Participant Information as of 12/31/2017

  • Active (Eligible) Participants708
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits5
  • Subtotal713
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total713
  • Total number of participants as of 01/01/2017819
  • Number of participants with account balances43
  • 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

  • Address7 Loring Hills Avenue
  • CitySalem
  • StateMA
  • Zip01970
  • Telephone(732) 710-4431
  • EIN47-3373524
  • Industry Code623000
  • Named AdministratorDavid Weinstock

Audit Information

  • Audit StatusAudited
  • AuditorPease & Associates, LLC
  • Auditor EIN36-4267431
  • 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.
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 $200,000
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 $289,558
Contributions $193,469
Cash Contributions $193,469
Cash from Employers $0
Cash from Participants $122,499
Others (including rollovers) $70,970
Noncash Contributions $0
Total Earnings on Investments $96,089
Total Interest $610
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $610
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 $95,479
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $0
Other Income $0
Expenses $7,836
Total Benefit Payments $7,836
Directly to participants or beneficiaries, including direct rollovers $7,836
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 $0
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $281,722
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 $805,146 $523,424 53.82%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $0 $665 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $665 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 $10,105 $16,385 -38.33%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $795,041 $506,374 57.01%
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 $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 $805,146 $523,424 53.82%

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
John Hancock Life Insurance Company Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Float revenue, Distribution (12b-1) fees, Other insurance wrap fees, Soft dollars commissions Recordkeeper $191 $0 $191
Total $191 $0 $191

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
Vanguard Value Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $200,376
Vanguard Growth Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $173,715
Vanguard Small Cap Grow Index John Hancock Life Insurance Co DFE: Pooled Separate Account $137,947
Jh Multi-Index 2020 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $75,294
Jh Stable Value Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $65,212
Jh Multi-Index 2035 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $47,092
500 Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $17,936
Jh Multi-Index 2030 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $17,656
Jh Multi-Index 2040 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $16,124
Jh Multi-Index 2050 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $10,193
Jh Multi-Index 2055 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $8,391
Jh Multi-Index 2025 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $6,509
Total Bond Market Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $5,296
New Perspective Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $4,122
Jh Multi-Index 2045 Preserv John Hancock Life Insurance Co DFE: Pooled Separate Account $3,661
Vanguard Mid-Cap Growth Etf John Hancock Life Insurance Co DFE: Pooled Separate Account $1,252
Vanguard Mid-Cap Value Eft John Hancock Life Insurance Co DFE: Pooled Separate Account $1,112
Small Cap Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $922
Vanguard Small Cap Value Index John Hancock Life Insurance Co DFE: Pooled Separate Account $664
Mid Cap Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $580
Intl Equity Index Fund John Hancock Life Insurance Co DFE: Pooled Separate Account $571
Dfa International Value John Hancock Life Insurance Co DFE: Pooled Separate Account $416
Total $795,041

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
John Hancock Life Insurance Company 52
EIN 01-0233346
Industry Code 65838
Contract Number 119857
Contract Year
Value in General Account at Year End $0
Value in Separate Accounts at Year End $795,041
Insurance Fees and Commissions $3,980
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Park Avenue Securities Insurance Agent or Broker $2,452 $0
Intac Actuarial Services Third Party Administrator $0 $1,528
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 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