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FORM 5500 DATA

403(b) Thrift Plan for Employees of Affinia Healthcare

Overview

Plan Information

  • Plan Year01/01/2018 — 12/31/2018
  • Date of Plan01/01/2008
  • Net Assets as of 12/31/2018 $17,362,032
  • Plan Number3
  • 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
  • Plan Benefit ArrangementInsurance

Participant Information as of 12/31/2018

  • Active (Eligible) Participants423
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits208
  • Subtotal631
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits1
  • Total632
  • Total number of participants as of 01/01/2018627
  • Number of participants with account balances607
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested8

Expenses

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

Sponsor Information

  • Address1717 Biddle Street
  • CitySt. Louis
  • StateMO
  • Zip63106
  • Telephone(314) 898-1700
  • EIN43-0817642
  • Industry Code624100
  • Named AdministratorJanet Voss
  • Named Plan SponsorJanet Voss

Audit Information

  • Audit StatusAudited
  • AuditorBkd LLP
  • Auditor EIN44-0160260
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
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.
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.
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 $3,000,000
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 $678,694
Contributions $1,642,467
Cash Contributions $1,642,467
Cash from Employers $464,180
Cash from Participants $1,115,800
Others (including rollovers) $62,487
Noncash Contributions $0
Total Earnings on Investments $-963,773
Total Interest $35,115
Interest-Bearing Cash $35,115
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 $-998,888
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 $1,357,746
Total Benefit Payments $1,357,746
Directly to participants or beneficiaries, including direct rollovers $1,357,746
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 $-679,052
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 $17,362,032 $18,041,084 -3.76%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $209,000 $209,000 0.00%
Employer Contributions $209,000 $209,000 0.00%
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 $14,807,152 $15,164,797 -2.36%
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 $2,345,880 $2,667,287 -12.05%
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 $17,362,032 $18,041,084 -3.76%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Fidelity Management and Research Co
  • The Vanguard Group
  • Deutsche Investment Mgmt Americas
  • American Century Investment Managem
  • Calvert Asset Management Inc
  • Oppenheimer Funds, Inc
  • Capital Research and Management Com
  • Pimco
  • T. Rowe Price Associates, Inc.
  • Mfs Variable Insurance Trust III

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
Mutual of America Life Insurance Co Claims processing, Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant loan processing NONE $87 $0 $87
Total $87 $0 $87

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
Mutual of America Eqity Index Fund Mutual of America Life Insurance DFE: Pooled Separate Account $1,230,395
Mutual of America 2020 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $1,189,248
Vanguard Vif International Portfoli Mutual of America Like Insurance DFE: Pooled Separate Account $1,040,634
Mutual of America Mid-Cap Equity In Mutual of America Life Insurance DFE: Pooled Separate Account $976,764
Mutual of America 2025 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $959,300
T Rowe Price Blue Chip Growth Port Mutual of America Life Insurance DFE: Pooled Separate Account $846,241
Mutual of America 2030 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $803,130
Fidelity Vip Contrafund Mutual of America Life Insurance DFE: Pooled Separate Account $769,535
Deutsche Vsi Cap Gwth Vip Fund Mutual of America Life Insurance DFE: Pooled Separate Account $700,270
Mutual of America Bond Fund Mutual of America Life Insurance DFE: Pooled Separate Account $655,730
American Century VP Capital Appreci Mutual of America Life Insurance DFE: Pooled Separate Account $550,087
Vanguard Vif Diversified Value Port Mutual of America Life Insurance DFE: Pooled Separate Account $539,998
Mutual of America Mid-Term Bond Fun Mutual of America Life Insurance DFE: Pooled Separate Account $498,054
Mutual of America 2040 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $435,951
Fidelity Vip Equity-Income Fund Mutual of America Life Insurance DFE: Pooled Separate Account $379,201
Mutual of America Small Cap Value F Mutual of America Life Insurance DFE: Pooled Separate Account $364,570
Mutual of America Moderate Allocati Mutual of America Life Insurance DFE: Pooled Separate Account $338,756
Fidelity Vip Mid Cap Portfolio Mutual of America Life Insurance DFE: Pooled Separate Account $315,051
Mutual of America Small Cap Growth Mutual of America Life Insurance DFE: Pooled Separate Account $264,456
Mutual of America Aggressive All Mutual of America Life Insurance DFE: Pooled Separate Account $235,283
Fidelity Vip Asset Manager Fund Mutual of America Life Insurance DFE: Pooled Separate Account $209,916
Mutual of America Composite Fund Mutual of America Life Insurance DFE: Pooled Separate Account $182,401
Calvert VP Sri Balanced Portfolio Mutual of America Life Insurance DFE: Pooled Separate Account $173,452
Mutual of America 2035 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $167,240
Mutual of America 2015 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $132,062
Mutual of America Mid Cap Value Fun Mutual of America Life Insurance DFE: Pooled Separate Account $113,708
Mutual of America Money Market Fund Mutual of America Life Insurance DFE: Pooled Separate Account $108,734
Mutual of America All America Fund Mutual of America Life Insurance DFE: Pooled Separate Account $103,089
Mutual of America 2045 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $91,135
Mutual of America Conservative Al Mutual of America Life Insurance DFE: Pooled Separate Account $86,304
Mutual of America International Fun Mutual of America Life Insurance DFE: Pooled Separate Account $81,044
Mutual of America 2050 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $77,698
Vanguard Vif Reit Index Portfolio Mutual of America Life Insurance DFE: Pooled Separate Account $61,344
Mutual of America Retirement Income Mutual of America Life Insurance DFE: Pooled Separate Account $34,406
American Funds Is New World Fund Mutual of America Life Insurance DFE: Pooled Separate Account $32,119
Mutual of America 2010 Retirement Mutual of America Life Insurance DFE: Pooled Separate Account $29,350
Pimco Vit Real Return Portfolio Mutual of America Life Insurance DFE: Pooled Separate Account $20,077
Oppenheimer Main Street Va Mutual of America Life Insurance DFE: Pooled Separate Account $6,703
Mutual of America 2055 Retirement F Mutual of America Life Insurance DFE: Pooled Separate Account $3,162
Mfs Vit III Mid Cap Value Portfolio Mutual of America Life Insurance DFE: Pooled Separate Account $554
Total $14,807,152

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Mutual of America Life Insurance Company 632
EIN 13-1614399
Industry Code 88668
Contract Number 089007-H
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $2,345,880
Value in Separate Accounts at Year End $14,807,152
Insurance Fees and Commissions $2,779
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
St. Louis Regional Office 7777 Bonhomme Avenue St. Louis, MO 63105 -1940 Insurance Agent or Broker $0 $2,779 PORTION OF INCENTIVE COMP. PROGRAM
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 Deposit Administration
Balance at the end of the previous year $2,667,287
Additions $180,326
Contributions Deposited during the year $123,364
Dividends and credits $0
Interest credited during the year $35,115
Transferred from separate account $2,740
Other $19,107
Total of Balance and Additions $2,847,613
Deductions $501,733
Disbursed from fund to pay benefits or purchase annuities during the year $501,733
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,345,880