Civic Intelligence
Filing

Sudbury Pines Extended Care Facility 401K Plan

Sudbury Pines Extended Care • EIN 04-2372924 • Sudbury, MA • Plan year 2001

Company ProfileSource Archive
642 Boston Post RoadSudbury, MA 01776
Filing Insights

Participants

Flat

103 → 103

0 • 0.00%

Assets

Up

$49,811 → $72,784

$22,973 • 46.12%

Investment Management Fee

-

Admin expenses - • Total expenses $354

Filing Details

Context
Net investment result
$22,973

Status Flags

Fidelity bond in place

No

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

No

Leases in default

No

Reportable party-in-interest issues

Not reported

Loss discovered during year

No

Assets with undetermined value

No

Non-cash contributions

No

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

No

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

No

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
2025147$5,218,110$345,630$7,354iApproximate average salary by contribution assumption: employee only about $183,846 at 4% or $122,564 at 6%; with 50% employer match about $122,564 at 4% or $81,709 at 6%; with 100% employer match about $91,923 at 4% or $61,282 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-47$5,218,110$345,630$7,354iApproximate average salary by contribution assumption: employee only about $183,846 at 4% or $122,564 at 6%; with 50% employer match about $122,564 at 4% or $81,709 at 6%; with 100% employer match about $91,923 at 4% or $61,282 at 6%.
2024149$4,278,567$336,306$6,863iApproximate average salary by contribution assumption: employee only about $171,585 at 4% or $114,390 at 6%; with 50% employer match about $114,390 at 4% or $76,260 at 6%; with 100% employer match about $85,792 at 4% or $57,195 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-49$4,278,567$336,306$6,863iApproximate average salary by contribution assumption: employee only about $171,585 at 4% or $114,390 at 6%; with 50% employer match about $114,390 at 4% or $76,260 at 6%; with 100% employer match about $85,792 at 4% or $57,195 at 6%.
2023155$4,019,274$363,419$6,608iApproximate average salary by contribution assumption: employee only about $165,190 at 4% or $110,127 at 6%; with 50% employer match about $110,127 at 4% or $73,418 at 6%; with 100% employer match about $82,595 at 4% or $55,063 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-55$4,019,274$363,419$6,608iApproximate average salary by contribution assumption: employee only about $165,190 at 4% or $110,127 at 6%; with 50% employer match about $110,127 at 4% or $73,418 at 6%; with 100% employer match about $82,595 at 4% or $55,063 at 6%.
2022159$3,241,563$275,065$4,662iApproximate average salary by contribution assumption: employee only about $116,553 at 4% or $77,702 at 6%; with 50% employer match about $77,702 at 4% or $51,801 at 6%; with 100% employer match about $58,276 at 4% or $38,851 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-59$3,241,563$275,065$4,662iApproximate average salary by contribution assumption: employee only about $116,553 at 4% or $77,702 at 6%; with 50% employer match about $77,702 at 4% or $51,801 at 6%; with 100% employer match about $58,276 at 4% or $38,851 at 6%.
2021162$3,965,650$271,104$4,373iApproximate average salary by contribution assumption: employee only about $109,316 at 4% or $72,877 at 6%; with 50% employer match about $72,877 at 4% or $48,585 at 6%; with 100% employer match about $54,658 at 4% or $36,439 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-62$3,965,650$271,104$4,373iApproximate average salary by contribution assumption: employee only about $109,316 at 4% or $72,877 at 6%; with 50% employer match about $72,877 at 4% or $48,585 at 6%; with 100% employer match about $54,658 at 4% or $36,439 at 6%.
2020162$3,367,200$323,070$5,211iApproximate average salary by contribution assumption: employee only about $130,270 at 4% or $86,847 at 6%; with 50% employer match about $86,847 at 4% or $57,898 at 6%; with 100% employer match about $65,135 at 4% or $43,423 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-62$3,367,200$323,070$5,211iApproximate average salary by contribution assumption: employee only about $130,270 at 4% or $86,847 at 6%; with 50% employer match about $86,847 at 4% or $57,898 at 6%; with 100% employer match about $65,135 at 4% or $43,423 at 6%.
2019158$2,669,908$311,535$5,371iApproximate average salary by contribution assumption: employee only about $134,282 at 4% or $89,522 at 6%; with 50% employer match about $89,522 at 4% or $59,681 at 6%; with 100% employer match about $67,141 at 4% or $44,761 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-58$2,669,908$311,535$5,371iApproximate average salary by contribution assumption: employee only about $134,282 at 4% or $89,522 at 6%; with 50% employer match about $89,522 at 4% or $59,681 at 6%; with 100% employer match about $67,141 at 4% or $44,761 at 6%.
2018150$1,970,630$183,573$3,671iApproximate average salary by contribution assumption: employee only about $91,787 at 4% or $61,191 at 6%; with 50% employer match about $61,191 at 4% or $40,794 at 6%; with 100% employer match about $45,893 at 4% or $30,596 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-50$1,970,630$183,573$3,671iApproximate average salary by contribution assumption: employee only about $91,787 at 4% or $61,191 at 6%; with 50% employer match about $61,191 at 4% or $40,794 at 6%; with 100% employer match about $45,893 at 4% or $30,596 at 6%.
2017144$2,087,293$258,247$5,869iApproximate average salary by contribution assumption: employee only about $146,731 at 4% or $97,821 at 6%; with 50% employer match about $97,821 at 4% or $65,214 at 6%; with 100% employer match about $73,366 at 4% or $48,910 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-44$2,087,293$258,247$5,869iApproximate average salary by contribution assumption: employee only about $146,731 at 4% or $97,821 at 6%; with 50% employer match about $97,821 at 4% or $65,214 at 6%; with 100% employer match about $73,366 at 4% or $48,910 at 6%.
2016140$1,545,929$154,354$3,859iApproximate average salary by contribution assumption: employee only about $96,471 at 4% or $64,314 at 6%; with 50% employer match about $64,314 at 4% or $42,876 at 6%; with 100% employer match about $48,236 at 4% or $32,157 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-40$1,545,929$154,354$3,859iApproximate average salary by contribution assumption: employee only about $96,471 at 4% or $64,314 at 6%; with 50% employer match about $64,314 at 4% or $42,876 at 6%; with 100% employer match about $48,236 at 4% or $32,157 at 6%.
2015198$1,387,030$135,666$1,384iApproximate average salary by contribution assumption: employee only about $34,609 at 4% or $23,072 at 6%; with 50% employer match about $23,072 at 4% or $15,382 at 6%; with 100% employer match about $17,304 at 4% or $11,536 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-98$1,387,030$135,666$1,384iApproximate average salary by contribution assumption: employee only about $34,609 at 4% or $23,072 at 6%; with 50% employer match about $23,072 at 4% or $15,382 at 6%; with 100% employer match about $17,304 at 4% or $11,536 at 6%.
2014165$1,297,519$129,755$1,996iApproximate average salary by contribution assumption: employee only about $49,906 at 4% or $33,271 at 6%; with 50% employer match about $33,271 at 4% or $22,180 at 6%; with 100% employer match about $24,953 at 4% or $16,635 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-65$1,297,519$129,755$1,996iApproximate average salary by contribution assumption: employee only about $49,906 at 4% or $33,271 at 6%; with 50% employer match about $33,271 at 4% or $22,180 at 6%; with 100% employer match about $24,953 at 4% or $16,635 at 6%.
20131101$1,193,551$108,316$1,072iApproximate average salary by contribution assumption: employee only about $26,811 at 4% or $17,874 at 6%; with 50% employer match about $17,874 at 4% or $11,916 at 6%; with 100% employer match about $13,405 at 4% or $8,937 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-101$1,193,551$108,316$1,072iApproximate average salary by contribution assumption: employee only about $26,811 at 4% or $17,874 at 6%; with 50% employer match about $17,874 at 4% or $11,916 at 6%; with 100% employer match about $13,405 at 4% or $8,937 at 6%.
2012187$924,171$87,112$1,001iApproximate average salary by contribution assumption: employee only about $25,032 at 4% or $16,688 at 6%; with 50% employer match about $16,688 at 4% or $11,125 at 6%; with 100% employer match about $12,516 at 4% or $8,344 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-87$924,171$87,112$1,001iApproximate average salary by contribution assumption: employee only about $25,032 at 4% or $16,688 at 6%; with 50% employer match about $16,688 at 4% or $11,125 at 6%; with 100% employer match about $12,516 at 4% or $8,344 at 6%.
2011172$1,179,411$140,583$1,953iApproximate average salary by contribution assumption: employee only about $48,814 at 4% or $32,542 at 6%; with 50% employer match about $32,542 at 4% or $21,695 at 6%; with 100% employer match about $24,407 at 4% or $16,271 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-72$1,179,411$140,583$1,953iApproximate average salary by contribution assumption: employee only about $48,814 at 4% or $32,542 at 6%; with 50% employer match about $32,542 at 4% or $21,695 at 6%; with 100% employer match about $24,407 at 4% or $16,271 at 6%.
20101125$1,190,205$155,724$1,246iApproximate average salary by contribution assumption: employee only about $31,145 at 4% or $20,763 at 6%; with 50% employer match about $20,763 at 4% or $13,842 at 6%; with 100% employer match about $15,572 at 4% or $10,382 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-125$1,190,205$155,724$1,246iApproximate average salary by contribution assumption: employee only about $31,145 at 4% or $20,763 at 6%; with 50% employer match about $20,763 at 4% or $13,842 at 6%; with 100% employer match about $15,572 at 4% or $10,382 at 6%.
20091124$944,520$189,283$1,526iApproximate average salary by contribution assumption: employee only about $38,162 at 4% or $25,441 at 6%; with 50% employer match about $25,441 at 4% or $16,961 at 6%; with 100% employer match about $19,081 at 4% or $12,721 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-124$944,520$189,283$1,526iApproximate average salary by contribution assumption: employee only about $38,162 at 4% or $25,441 at 6%; with 50% employer match about $25,441 at 4% or $16,961 at 6%; with 100% employer match about $19,081 at 4% or $12,721 at 6%.
20081104$638,106$192,723$1,853iApproximate average salary by contribution assumption: employee only about $46,328 at 4% or $30,885 at 6%; with 50% employer match about $30,885 at 4% or $20,590 at 6%; with 100% employer match about $23,164 at 4% or $15,443 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-104$638,106$192,723$1,853iApproximate average salary by contribution assumption: employee only about $46,328 at 4% or $30,885 at 6%; with 50% employer match about $30,885 at 4% or $20,590 at 6%; with 100% employer match about $23,164 at 4% or $15,443 at 6%.
20071109$801,515$177,985$1,633iApproximate average salary by contribution assumption: employee only about $40,822 at 4% or $27,215 at 6%; with 50% employer match about $27,215 at 4% or $18,143 at 6%; with 100% employer match about $20,411 at 4% or $13,607 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-109$801,515$177,985$1,633iApproximate average salary by contribution assumption: employee only about $40,822 at 4% or $27,215 at 6%; with 50% employer match about $27,215 at 4% or $18,143 at 6%; with 100% employer match about $20,411 at 4% or $13,607 at 6%.
20061125$575,519$159,813$1,279iApproximate average salary by contribution assumption: employee only about $31,963 at 4% or $21,308 at 6%; with 50% employer match about $21,308 at 4% or $14,206 at 6%; with 100% employer match about $15,981 at 4% or $10,654 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-125$575,519$159,813$1,279iApproximate average salary by contribution assumption: employee only about $31,963 at 4% or $21,308 at 6%; with 50% employer match about $21,308 at 4% or $14,206 at 6%; with 100% employer match about $15,981 at 4% or $10,654 at 6%.
20051134$364,783$93,054$694iApproximate average salary by contribution assumption: employee only about $17,361 at 4% or $11,574 at 6%; with 50% employer match about $11,574 at 4% or $7,716 at 6%; with 100% employer match about $8,680 at 4% or $5,787 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-134$364,783$93,054$694iApproximate average salary by contribution assumption: employee only about $17,361 at 4% or $11,574 at 6%; with 50% employer match about $11,574 at 4% or $7,716 at 6%; with 100% employer match about $8,680 at 4% or $5,787 at 6%.
2004190$295,090$127,733$1,419iApproximate average salary by contribution assumption: employee only about $35,481 at 4% or $23,654 at 6%; with 50% employer match about $23,654 at 4% or $15,770 at 6%; with 100% employer match about $17,741 at 4% or $11,827 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-90$295,090$127,733$1,419iApproximate average salary by contribution assumption: employee only about $35,481 at 4% or $23,654 at 6%; with 50% employer match about $23,654 at 4% or $15,770 at 6%; with 100% employer match about $17,741 at 4% or $11,827 at 6%.
20031105$151,124$61,489$586iApproximate average salary by contribution assumption: employee only about $14,640 at 4% or $9,760 at 6%; with 50% employer match about $9,760 at 4% or $6,507 at 6%; with 100% employer match about $7,320 at 4% or $4,880 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-105$151,124$61,489$586iApproximate average salary by contribution assumption: employee only about $14,640 at 4% or $9,760 at 6%; with 50% employer match about $9,760 at 4% or $6,507 at 6%; with 100% employer match about $7,320 at 4% or $4,880 at 6%.
20021120$75,693$25,807$215iApproximate average salary by contribution assumption: employee only about $5,376 at 4% or $3,584 at 6%; with 50% employer match about $3,584 at 4% or $2,390 at 6%; with 100% employer match about $2,688 at 4% or $1,792 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-120$75,693$25,807$215iApproximate average salary by contribution assumption: employee only about $5,376 at 4% or $3,584 at 6%; with 50% employer match about $3,584 at 4% or $2,390 at 6%; with 100% employer match about $2,688 at 4% or $1,792 at 6%.
20011103$72,784$30,037$292iApproximate average salary by contribution assumption: employee only about $7,291 at 4% or $4,860 at 6%; with 50% employer match about $4,860 at 4% or $3,240 at 6%; with 100% employer match about $3,645 at 4% or $2,430 at 6%.
Sudbury Pines Extended Care Facility 401K PlanCurrent103$72,784$30,037$292iApproximate average salary by contribution assumption: employee only about $7,291 at 4% or $4,860 at 6%; with 50% employer match about $4,860 at 4% or $3,240 at 6%; with 100% employer match about $3,645 at 4% or $2,430 at 6%.
2000198$49,811$29,281$299iApproximate average salary by contribution assumption: employee only about $7,470 at 4% or $4,980 at 6%; with 50% employer match about $4,980 at 4% or $3,320 at 6%; with 100% employer match about $3,735 at 4% or $2,490 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-98$49,811$29,281$299iApproximate average salary by contribution assumption: employee only about $7,470 at 4% or $4,980 at 6%; with 50% employer match about $4,980 at 4% or $3,320 at 6%; with 100% employer match about $3,735 at 4% or $2,490 at 6%.
1999152$24,864$19,051$366iApproximate average salary by contribution assumption: employee only about $9,159 at 4% or $6,106 at 6%; with 50% employer match about $6,106 at 4% or $4,071 at 6%; with 100% employer match about $4,580 at 4% or $3,053 at 6%.
Sudbury Pines Extended Care Facility 401K Plan-52$24,864$19,051$366iApproximate average salary by contribution assumption: employee only about $9,159 at 4% or $6,106 at 6%; with 50% employer match about $6,106 at 4% or $4,071 at 6%; with 100% employer match about $4,580 at 4% or $3,053 at 6%.
Schedule Details

Schedule A

Row 1
Filing Id
84037347310032
Form Id
23475693
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
1010372347310030002
Ins Broker 01 Name
ALYSON NOLLER
Ins Broker 01 Street Addr
45 WILLIAM ST, SUITE 110
Ins Broker 01 City
WELLESLEY
Ins Broker 01 State
MA
Ins Broker 01 ZIP Code
02481
Ins Broker Comm Pd 01 Amount
$612
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 2
Ins Carrier Name: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE U.S.
Filing Id
84037347310032
Form Id
23475693
Schedule A EIN
04-2372924
Schedule A Plan Num
002
Schedule A Plan Year Begin Date
2001-01-01
Schedule A Tax Period
20011231
Ins Carrier Name
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE U.S.
Ins Carrier EIN
13-5570651
Ins Carrier Naic Code
62944
Ins Contract Num
91652285
Ins Prsn Covered End of year Count
15
Ins Policy From Date
2001-01-01
Ins Policy To Date
2001-12-31
Ins Broker Comm Total Amount
$612
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$9,381
Pension End of year Sep Account Amount
$63,403
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pnsn Type Unalloc Cntrct I
4
Pension Oth Unalloc Type Text
GUARANTEED INTEREST CONTRACT
Pension End Prev Bal Amount
$24
Pension Contribution Dep Amount
$7,935
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$142
Pension Transfer From Amount
$1,395
Pension Other Amount
$0
Pension Total Additions Amount
$9,472
Pension Total Bal Addn Amount
$9,496
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$115
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$115
Pension End of year Bal Amount
$9,381
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0

Schedule D

Row 1
Filing Id
84037347310032
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
1010372347310030003
DFE P1 Entity 01 Name
POOLED SEPARATE ACCOUNT A
DFE P1 Spons 01 Name
EQUITABLE LIFE
DFE P1 Plan 01 EIN Plan number
135570651000
DFE P1 Entity 01 Code
P
DFE P1 Plan Interest End of year 01 Amount
$63,403
Row 2
Filing Id
84037347310032
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
1010372347310030003
Row 3
Filing Id
84037347310032
Schedule D EIN
04-2372924
Schedule D Plan number
002
Schedule D Plan Year Begin Date
2001-01-01
Schedule D Tax Period
20011231

Schedule I

Schedule I Financial Statement

Small plan result

Balance sheet and activity values reported by the filer for this small-plan annual return.

End-of-year assets$72,784$22,973 change

Balance Sheet

Beginning and end of plan year.

Total assets$49,811$72,784Increase +$22,973 (46.12%)
Total liabilities$0$0No change $0
Net assets$49,811$72,784Increase +$22,973 (46.12%)

Contributions

Employer contributions$0
Participant contributions$30,037
Other contributions$0

Income & Expenses

Total income$23,327
Total expenses$354
Net income$22,973
Source fields
Schedule I source fields
Filing Id
84037347310032
Schedule I EIN
04-2372924
Schedule I Plan Num
002
Schedule I Plan Year Begin Date
2001-01-01
Schedule I Tax Period
20011231
Small plan total assets at beginning of year
$49,811
Small plan total liabilities at beginning of year
$0
Small plan net assets at beginning of year
$49,811
Small plan total assets at end of year
$72,784
Small plan total liabilities at end of year
$0
Small plan net assets at end of year
$72,784
Small plan employer contributions
$0
Small plan participant contributions
$30,037
Small Oth Contribution Rcvd Amount
$0
Small Non Cash Contribution Bs Amount
$0
Small Other Income Amount
$-6,710
Small plan total income
$23,327
Small plan total benefit distributions
$0
Small Corrective Distribution Amount
$0
Small Dm Dstrb Ptcp Ln A
0
Small Oth Expenses Amount
$354
Small plan total expenses
$354
Small plan net income or loss
$22,973
Small Total Plan Transfers Amount
$0
Small Joint Venture End of year Indicator
No
Small Joint Venture End of year Amount
$0
Small Employer Prop End of year Indicator
No
Small Employer Prop End of year Amount
$0
Small Investment Real Est End of year I
2
Small Investment Real Est End of year A
0
Small Employer Sec End of year Indicator
No
Small Employer Sec End of year Amount
$0
Small Mortg Participants End of year Indicator
No
Small Mortg Participants End of year Amount
$0
Small Oth Lns Participants End of year Indicator
No
Small Oth Lns Participants End of year Amount
$0
Small Personal Prop End of year Indicator
No
Small Personal Prop End of year Amount
$0
Small Fail Xmt Ctb I
2
Small Fail Xmt Ctb A
0
Small plan participant loans in default
No
Small Loans In Default Amount
$0
Small plan leases in default
No
Small Leases In Default Amount
$0
Small Pt In Interest Not Reported I
2
Small Pt In Interest Not Reported A
0
Small plan fidelity bond in place
No
Small plan fidelity bond amount
$0
Small plan loss discovered during year
No
Small Loss Discovered Dur Year Amount
$0
Small plan assets with undetermined value
No
Small Asset Undeterm Valuation Amount
$0
Small plan non-cash contributions reported
No
Small Non Cash Contribution Amount
$0
Small 20 Percent Sngl Investment Indicator
No
Small 20 Percent Sngl Investment Amount
$0
Small plan all plan assets distributed
No
Waiver Annual Iqpa Report
1
Small plan resolution to terminate plan adopted
No
Small Res Terminate Plan Adpt Amount
$0