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FORM 5500 DATA

Madison-Haywood Developmental Services, Inc. Retirement Plan

Overview

Plan Information

  • Plan Year07/01/2018 — 06/30/2019
  • Date of Plan07/01/1979
  • Net Assets as of 06/30/2019 $1,921,412
  • 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
  • Plan Benefit ArrangementInsurance

Participant Information as of 06/30/2019

  • Active (Eligible) Participants480
  • Retired or separated participants receiving benefits9
  • Other retired or separated participants entitled to future benefits14
  • Subtotal503
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total503
  • Total number of participants as of 07/01/2018520
  • Number of participants with account balances113
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2

Expenses

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

Sponsor Information

  • Address38 Garland Drive
  • CityJackson
  • StateTN
  • Zip38305
  • Telephone(731) 664-0983
  • EIN62-1046018
  • Industry Code813000
  • Named AdministratorBill Brewer

Audit Information

  • Audit StatusAudited
  • AuditorAlexander Thompson Arnold PLLC
  • Auditor EIN62-1110839
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2L Code section 403(b)(1) arrangement A 403(b) plan, also known as a tax-sheltered annuity (TSA) plan, is a retirement plan for certain employees of public schools, employees of certain tax-exempt organizations, and certain ministers.

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 $267,245
Contributions $198,580
Cash Contributions $198,580
Cash from Employers $93,521
Cash from Participants $105,059
Others (including rollovers) $0
Noncash Contributions $0
Total Earnings on Investments $68,665
Total Interest $5,400
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $1,336
Interest from Other Investments $4,064
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 $63,265
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 $379,777
Total Benefit Payments $379,583
Directly to participants or beneficiaries, including direct rollovers $379,583
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 $194
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $194
Net Income $-112,532
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

06/30/2019 06/30/2018 Change YOY
Total Assets $1,921,412 $2,033,944 -5.53%
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 $31,082 $62,726 -50.45%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $1,232,011 $1,224,864 0.58%
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 $658,319 $746,354 -11.80%
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 $1,921,412 $2,033,944 -5.53%

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

There are no service providers listed for this plan.

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
VOYA VOYA DFE: Pooled Separate Account $1,142,307
Valic Valic DFE: Pooled Separate Account $89,704
Total $1,232,011

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Voya Retirement Insurance and Annuity Company 90
EIN 71-0294708
Industry Code 86509
Contract Number VF7298
Contract Year 07/01/2018 — 06/30/2019
Value in General Account at Year End $625,040
Value in Separate Accounts at Year End $1,142,307
Insurance Fees and Commissions $3,153
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Little Stephen 24 Old Hickory Cv Jackson, TN 38305 Insurance Agent or Broker $1,700 $0
Little Bradley 24 Old Hickory Cv Jackson, TN 38305 Insurance Agent or Broker $1,453 $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 Unspecified
Balance at the end of the previous year $714,028
Additions $105,778
Contributions Deposited during the year $82,079
Dividends and credits $0
Interest credited during the year $20,347
Transferred from separate account $1,751
Other $1,601
Total of Balance and Additions $819,806
Deductions $194,765
Disbursed from fund to pay benefits or purchase annuities during the year $187,762
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $7,003
Balance at the end of the current year $625,041
Variable Annuity Life Insurance Co. 34
EIN 74-1625348
Industry Code 70238
Contract Number 46715
Contract Year 07/01/2018 — 06/30/2019
Value in General Account at Year End $33,280
Value in Separate Accounts at Year End $89,704
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 Unspecified
Balance at the end of the previous year $32,326
Additions $1,280
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $1,225
Transferred from separate account $55
Other $0
Total of Balance and Additions $33,606
Deductions $327
Disbursed from fund to pay benefits or purchase annuities during the year $327
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $33,279