401k Plan data: WINDSOR HEALTHCARE 401(K) PLAN plan

WINDSOR HEALTHCARE 401(K) PLAN 401k Plan overview

Plan Name	WINDSOR HEALTHCARE 401(K) PLAN
Plan identification number	001

WINDSOR HEALTHCARE 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
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.
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 contribtions 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WINDSOR HEALTHCARE MANAGEMENT LLC has sponsored the creation of one or more 401k plans.

Company Name: WINDSOR HEALTHCARE MANAGEMENT LLC

Employer identification number (EIN): 262578442

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WINDSOR HEALTHCARE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 JOAN ORSO 2024-10-13 JOAN ORSO 2024-10-13
001 2022-01-01
001 2021-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	JOAN ORSO	2024-10-13	JOAN ORSO	2024-10-13
001	2022-01-01
001	2021-01-01

Plan Statistics for WINDSOR HEALTHCARE 401(K) PLAN

401k plan membership statisitcs for WINDSOR HEALTHCARE 401(K) PLAN

Measure Date Value
2023: WINDSOR HEALTHCARE 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 1,149
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 1,120
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 62
Total of all active and inactive participants 2023-01-01 1,182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 1,182
Number of participants with account balances 2023-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 0
2022: WINDSOR HEALTHCARE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 879
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 994
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 71
Total of all active and inactive participants 2022-01-01 1,065
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,065
Number of participants with account balances 2022-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: WINDSOR HEALTHCARE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 923
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 801
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 71
Total of all active and inactive participants 2021-01-01 872
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 872
Number of participants with account balances 2021-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0

Measure	Date	Value
2023: WINDSOR HEALTHCARE 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	1,149
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	1,120
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	62
Total of all active and inactive participants	2023-01-01	1,182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	1,182
Number of participants with account balances	2023-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	0
2022: WINDSOR HEALTHCARE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	879
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	994
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	71
Total of all active and inactive participants	2022-01-01	1,065
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,065
Number of participants with account balances	2022-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: WINDSOR HEALTHCARE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	923
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	801
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	71
Total of all active and inactive participants	2021-01-01	872
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	872
Number of participants with account balances	2021-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0

Financial Data on WINDSOR HEALTHCARE 401(K) PLAN

Measure	Date	Value
2023 : WINDSOR HEALTHCARE 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$1,162,548
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$832,293
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$799,075
Value of total corrective distributions	2023-12-31	$4,513
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$441,061
Value of total assets at end of year	2023-12-31	$4,880,514
Value of total assets at beginning of year	2023-12-31	$4,550,259
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$28,705
Total interest from all sources	2023-12-31	$25,241
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$431,404
Participant contributions at end of year	2023-12-31	$167,598
Participant contributions at beginning of year	2023-12-31	$136,582
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$9,657
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$330,255
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$4,880,514
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$4,550,259
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Investment advisory and management fees	2023-12-31	$22,998
Value of interest in pooled separate accounts at end of year	2023-12-31	$4,073,008
Value of interest in pooled separate accounts at beginning of year	2023-12-31	$3,727,674
Interest on participant loans	2023-12-31	$10,857
Interest earned on other investments	2023-12-31	$14,384
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$639,908
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$686,003
Net investment gain/loss from pooled separate accounts	2023-12-31	$696,246
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$799,075
Contract administrator fees	2023-12-31	$5,707
Did the plan have assets held for investment	2023-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	CYWIAK & COMPANY LLC
Accountancy firm EIN	2023-12-31	112626200
2022 : WINDSOR HEALTHCARE 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-260,807
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$722,810
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$645,983
Value of total corrective distributions	2022-12-31	$48,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$486,472
Value of total assets at end of year	2022-12-31	$4,550,259
Value of total assets at beginning of year	2022-12-31	$5,533,876
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$28,343
Total interest from all sources	2022-12-31	$17,541
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$250,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$459,490
Participant contributions at end of year	2022-12-31	$136,582
Participant contributions at beginning of year	2022-12-31	$106,206
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$26,982
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-983,617
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,550,259
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,533,876
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in pooled separate accounts at end of year	2022-12-31	$3,727,674
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$4,669,822
Interest on participant loans	2022-12-31	$5,357
Interest earned on other investments	2022-12-31	$12,184
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$686,003
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$757,848
Net investment gain/loss from pooled separate accounts	2022-12-31	$-764,820
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$645,983
Contract administrator fees	2022-12-31	$28,343
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CHAIM CYWIAK, CPA
Accountancy firm EIN	2022-12-31	112626200
2021 : WINDSOR HEALTHCARE 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,252,531
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$378,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$298,620
Value of total corrective distributions	2021-12-31	$51,289
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$575,835
Value of total assets at end of year	2021-12-31	$5,533,876
Value of total assets at beginning of year	2021-12-31	$4,660,187
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$28,933
Total interest from all sources	2021-12-31	$12,982
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$446,750
Participant contributions at end of year	2021-12-31	$106,206
Participant contributions at beginning of year	2021-12-31	$41,725
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$129,085
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$873,689
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,533,876
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,660,187
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$4,669,822
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,966,520
Interest on participant loans	2021-12-31	$3,991
Interest earned on other investments	2021-12-31	$8,991
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$757,848
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$651,942
Net investment gain/loss from pooled separate accounts	2021-12-31	$663,714
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$298,620
Contract administrator fees	2021-12-31	$28,933
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	CHAIM CYWIAK, CPA
Accountancy firm EIN	2021-12-31	112626200

Form 5500 Responses for WINDSOR HEALTHCARE 401(K) PLAN

2023: WINDSOR HEALTHCARE 401(K) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Mulitple employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: WINDSOR HEALTHCARE 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: WINDSOR HEALTHCARE 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

069916

Policy instance

Insurance contract or identification number	069916
Number of Individuals Covered	1182
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

069916

Policy instance

Insurance contract or identification number	069916
Number of Individuals Covered	1065
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

069916

Policy instance

Insurance contract or identification number	069916
Number of Individuals Covered	872
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	WINDSOR HEALTHCARE MANAGEMENT LLC
Employer identification number (EIN):	262578442
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities