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FORM 5500 DATA

Basin Home Health, Inc. Retirement Plan

Overview

Plan Information

  • Plan Year01/01/2018 — 12/31/2018
  • Date of Plan01/01/1994
  • Net Assets as of 12/31/2018 $1,964,923
  • 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 Arrangement Trust

Participant Information as of 12/31/2018

  • Active (Eligible) Participants654
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits12
  • Subtotal666
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total666
  • Total number of participants as of 01/01/2018763
  • Number of participants with account balances77
  • 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

  • Address200 North Orchard Avenue
  • CityFarmington
  • StateNM
  • Zip87401
  • Telephone(505) 325-8231
  • EIN85-0404923
  • Industry Code621610

Audit Information

  • Audit StatusAudited
  • AuditorChandler & Company, LLP
  • Auditor EIN85-0336896
  • 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.
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? Yes $82
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 $-15,099
Contributions $140,445
Cash Contributions $140,445
Cash from Employers $8,772
Cash from Participants $124,632
Others (including rollovers) $7,041
Noncash Contributions $0
Total Earnings on Investments $-155,544
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 $-155,544
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 $222,446
Total Benefit Payments $212,228
Directly to participants or beneficiaries, including direct rollovers $212,228
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $855
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $9,363
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $9,363
Other Administrative Fees $0
Net Income $-237,545
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2018 12/31/2017 Change YOY
Total Assets $1,964,923 $2,202,468 -10.79%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $13,808 $20,514 -32.69%
Employer Contributions $8,772 $20,461 -57.13%
Participant Contributions $5,036 $53 9401.89%
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 $1,940,027 $2,171,348 -10.65%
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 $11,088 $10,606 4.54%
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 $1,964,923 $2,202,468 -10.79%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Transamerica Life Insurance Company

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
Transamerica Life Insurance Company Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant loan processing, Investment management fees paid indirectly by plan, Float revenue, Recordkeeping fees, Other insurance wrap fees Recordkeeper $7,712 $0 $7,712
Total $7,712 $0 $7,712

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
Transamerica Life Insurance Company Transamerica Asset Allocation - Moderate Growth Portfolio Ret Opt DFE: Pooled Separate Account $480,884
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2020 Ret Opt DFE: Pooled Separate Account $360,474
Transamerica Life Insurance Company Transamerica Asset Allocation - Moderate Portfolio Ret Opt DFE: Pooled Separate Account $264,885
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2040 Ret Opt DFE: Pooled Separate Account $148,073
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2030 Ret Opt DFE: Pooled Separate Account $101,414
Transamerica Life Insurance Company American Funds Amcap Ret Opt DFE: Pooled Separate Account $95,738
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2025 Ret Opt DFE: Pooled Separate Account $55,574
Transamerica Life Insurance Company Goldman Sachs Mid Cap Value Ret Opt DFE: Pooled Separate Account $50,989
Transamerica Life Insurance Company First Eagle Overseas Ret Opt DFE: Pooled Separate Account $46,395
Transamerica Life Insurance Company Janus Henderson Balanced Ret Opt DFE: Pooled Separate Account $45,940
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2035 Ret Opt DFE: Pooled Separate Account $44,869
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2050 Ret Opt DFE: Pooled Separate Account $35,683
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2045 Ret Opt DFE: Pooled Separate Account $34,373
Transamerica Life Insurance Company Transamerica Asset Allocation - Growth Portfolio Ret Opt DFE: Pooled Separate Account $14,795
Transamerica Life Insurance Company Pimco Total Return Ret Opt DFE: Pooled Separate Account $14,487
Transamerica Life Insurance Company Nuveen Real Estate Securities Ret Opt DFE: Pooled Separate Account $13,796
Transamerica Life Insurance Company Fidelity Advisor Small Cap Ret Opt DFE: Pooled Separate Account $13,068
Transamerica Life Insurance Company Transamerica Asset Allocation - Conservative Portfolio Ret Opt DFE: Pooled Separate Account $12,818
Transamerica Life Insurance Company Invesco Mid Cap Core Equity Ret Opt DFE: Pooled Separate Account $11,669
Transamerica Life Insurance Company Neuberger Berman Genesis Ret Opt DFE: Pooled Separate Account $11,494
Transamerica Life Insurance Company Pioneer Disciplined Value Ret Opt DFE: Pooled Separate Account $11,179
Transamerica Life Insurance Company Franklin Mutual Shares Ret Opt DFE: Pooled Separate Account $10,967
Transamerica Life Insurance Company Ta Vanguard Small-Cap Value Index Ret Opt DFE: Pooled Separate Account $9,103
Transamerica Life Insurance Company Nuveen Mid Cap Growth Opportunities Ret Opt DFE: Pooled Separate Account $8,907
Transamerica Life Insurance Company Pgim Jennison Natural Resources Ret Opt DFE: Pooled Separate Account $7,894
Transamerica Life Insurance Company Thornburg International Value Ret Opt DFE: Pooled Separate Account $6,505
Transamerica Life Insurance Company Jpmorgan Government Securities Ret Opt DFE: Pooled Separate Account $4,973
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2060 Ret Opt DFE: Pooled Separate Account $4,849
Transamerica Life Insurance Company Jpmorgan High Yield Ret Opt DFE: Pooled Separate Account $4,522
Transamerica Life Insurance Company Ta Blackrock Lifepath Index Retirement Ret Opt DFE: Pooled Separate Account $3,303
Transamerica Life Insurance Company Templeton Global Bond Ret Opt DFE: Pooled Separate Account $2,848
Transamerica Life Insurance Company Wells Fargo Precious Metals Ret Opt DFE: Pooled Separate Account $2,651
Transamerica Life Insurance Company Transamerica Partners High Quality Bond Ret Opt DFE: Pooled Separate Account $2,590
Transamerica Life Insurance Company Ta Blackrock Lifepath Index 2055 Ret Opt DFE: Pooled Separate Account $2,317
Total $1,940,026

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Transamerica Life Insurance Company 92
EIN 39-0989781
Industry Code 86231
Contract Number 801527-000
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $0
Value in Separate Accounts at Year End $1,940,027
Insurance Fees and Commissions $9,547
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Wells Fargo Wealth Brokerage Ins Mail Code D1150-111, 401 S Try Charlotte, NC 28202 Insurance Agent or Broker $5,308 $0
Kidder Benefits Consultants, I 5700 Westown Pkwy., Suite 100 West Des Moines, IA 50266 Third Party Administrator $0 $4,239 REIMBURSEMENT FOR INVESTMENT PLATFORM OPERATIONAL SUPPORT
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 Guaranteed Investment
Balance at the end of the previous year $10,907
Additions $4,640
Contributions Deposited during the year $3,624
Dividends and credits $0
Interest credited during the year $83
Transferred from separate account $348
Other $585
Total of Balance and Additions $15,547
Deductions $4,460
Disbursed from fund to pay benefits or purchase annuities during the year $2,001
Administration charge made by carrier $41
Transferred to Separate Account $345
Other $2,073
Balance at the end of the current year $11,087