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FORM 5500 DATA

Odyssey House Of Utah 403(B) Plan

Overview

Plan Information

  • Plan Year07/01/2016 — 06/30/2017
  • Date of Plan07/01/1987
  • Net Assets as of 06/30/2017 $2,387,535
  • 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 06/30/2017

  • Active (Eligible) Participants167
  • Retired or separated participants receiving benefits5
  • Other retired or separated participants entitled to future benefits66
  • Subtotal238
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total238
  • Total number of participants as of 07/01/2016227
  • Number of participants with account balances150
  • 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

  • Address344 East 100 South, Ste 301
  • CitySalt Lake City
  • StateUT
  • Zip84111
  • Telephone(801) 438-3449
  • EIN87-0292487
  • Industry Code813000
  • Named AdministratorBrian Pilcher

Audit Information

  • Audit StatusAudited
  • AuditorKHSA
  • Auditor EIN87-0470666
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
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.
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.
2M Code section 403(b)(7) accounts A 403(b)(7) plan is a tax-deferred retirement plan often available to employees of public schools or non-profit organizations.

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 $509,431
Contributions $286,410
Cash Contributions $286,410
Cash from Employers $162,401
Cash from Participants $124,009
Others (including rollovers) $0
Noncash Contributions $0
Total Earnings on Investments $223,021
Total Interest $195
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $195
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 $222,826
Other Income $0
Expenses $129,258
Total Benefit Payments $129,258
Directly to participants or beneficiaries, including direct rollovers $129,258
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 $380,173
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

06/30/2017 06/30/2016 Change YOY
Total Assets $2,387,535 $2,007,362 18.94%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $22,856 $10,684 113.93%
Employer Contributions $17,110 $5,856 192.18%
Participant Contributions $5,746 $4,828 19.01%
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 $14,712 $25,465 -42.23%
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 $1,812,260 $1,427,443 26.96%
Value of funds held in insurance co. general account $537,707 $543,770 -1.11%
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 $2,387,535 $2,007,362 18.94%

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

No investments information available for this plan.

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Axa Equitable Life Insurance Company 70
EIN 13-5570651
Industry Code 62944
Contract Number 732115
Contract Year 07/01/2016 — 06/30/2017
Value in General Account at Year End $468,716
Value in Separate Accounts at Year End $479,890
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 Guaranteed Investment
Balance at the end of the previous year $543,770
Additions $20,225
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $15,569
Transferred from separate account $0
Other $4,656
Total of Balance and Additions $563,995
Deductions $26,288
Disbursed from fund to pay benefits or purchase annuities during the year $26,321
Administration charge made by carrier $314
Transferred to Separate Account $0
Other $-347
Balance at the end of the current year $537,707