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Intercare Community Health Network
Plan RatingFORM 5500 DATA
Overview
Plan Information
- Plan Year04/01/2016 — 03/31/2017
- Date of Plan06/01/2004
- Net Assets as of 03/31/2017 $8,039,216
- 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 ArrangementInsurance Trust
Participant Information as of 03/31/2017
- Active (Eligible) Participants424
- Retired or separated participants receiving benefits0
- Other retired or separated participants entitled to future benefits38
- Subtotal462
- Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
- Total462
- Total number of participants as of 04/01/2016430
- Number of participants with account balances295
- Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested5
Expenses
- Total Benefit Payments$0
- Corrective Distributions$0
- Administrative Service Providers$0
- Other Expenses$0
- Total Expenses$0
- Total Transfers$0
Sponsor Information
- Address50 Industrial Park Rd
- CityBangor
- StateMI
- Zip49013-1246
- Telephone(269) 427-7937
- EIN38-2009364
- Industry Code621498
- Named AdministratorAmy Mulhall
- Named Plan SponsorAmy Mulhall
Audit Information
- Audit StatusAudited
- AuditorYeo & Yeo
- Auditor EIN38-2706146
- 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. |
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 | $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 | $2,001,367 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Expenses | $255,818 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Net Income | $1,745,549 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Asset and Liability Statement
03/31/2017 | 03/31/2016 | Change YOY | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Total Assets | $8,039,216 | $6,293,667 | 27.74% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Total Liabilities | $0 | $0 | 0.0% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Net Assets | $8,039,216 | $6,293,667 | 27.74% |
Service Providers
Persons Receiving Only Eligible Indirect Compensation
- Principal 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 |
---|---|---|---|---|---|
Principal Life Insurance Company | Contract Administrator, Participant loan processing, Direct payment from the plan, Recordkeeping fees | Contract Administrator | $3,152 | $0 | $3,152 |
Total | $3,152 | $0 | $3,152 |
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 |
---|---|---|---|
Prin Lifetime 2040 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $778,292 |
Prin Lifetime 2030 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $712,222 |
Prin Lifetime 2020 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $658,680 |
Prin Largecap Value III Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $621,694 |
Prin Lgcap S&P 500 Index Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $602,451 |
Prin Diversified Intl Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $584,012 |
Prin U.S. Property Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $447,402 |
Prin Midcap Value I Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $441,428 |
Prin Core Plus Bond Sep Act-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $416,794 |
Prin Midcap Growth III Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $315,598 |
Prin Smallcap Value II Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $308,847 |
Prin Largecap Growth I Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $290,197 |
Prin Lifetime 2025 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $287,245 |
Prin Smcap S&P 600 Index Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $242,972 |
Prin Lifetime 2050 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $187,344 |
Prin Lifetime 2045 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $181,884 |
Prin Smallcap Growth I Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $167,027 |
Prin Lifetime 2055 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $146,492 |
Prin Lifetime 2035 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $126,123 |
Prin Liquid Assets Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $105,797 |
Prin Lifetime 2015 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $69,011 |
Prin Lifetime 2010 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $62,153 |
Prin Lifetime Strat Inc Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $52,503 |
Prin Midcap S&P 400 Idx Sa-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $24,186 |
Prin Lifetime 2060 Sep Acct-R1 | Principal Life Insurance Company | DFE: Pooled Separate Account | $3,677 |
Total | $7,834,031 |
Insurance Information
Insurance Information
Insurance Carrier Summary | Persons Covered | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Principal Life Insurance Company | 462 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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