401k Plan data: SAFE HAVEN 401(K) PLAN plan

SAFE HAVEN 401(K) PLAN 401k Plan overview

Plan Name	SAFE HAVEN 401(K) PLAN
Plan identification number	001

SAFE HAVEN 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.

401k Sponsoring company profile

SAFE HAVEN HEALTH CARE, LLC has sponsored the creation of one or more 401k plans.

Company Name: SAFE HAVEN HEALTH CARE, LLC

Employer identification number (EIN): 271736817

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAFE HAVEN 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01 ALLAN BURPEE ALLAN BURPEE 2017-10-16
001 2015-01-01 ALLAN BURPEE
001 2014-01-01 LYNNE POTTS
001 2013-01-01 REBECCA TAYLOR
001 2012-04-01 REBECCA TAYLOR

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01	ALLAN BURPEE	ALLAN BURPEE	2017-10-16
001	2015-01-01	ALLAN BURPEE
001	2014-01-01	LYNNE POTTS
001	2013-01-01	REBECCA TAYLOR
001	2012-04-01	REBECCA TAYLOR

Plan Statistics for SAFE HAVEN 401(K) PLAN

401k plan membership statisitcs for SAFE HAVEN 401(K) PLAN

Measure Date Value
2017: SAFE HAVEN 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 485
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 80
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 230
Total of all active and inactive participants 2017-01-01 310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 310
Number of participants with account balances 2017-01-01 247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SAFE HAVEN 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 525
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 268
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 217
Total of all active and inactive participants 2016-01-01 485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 485
Number of participants with account balances 2016-01-01 274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 6
2015: SAFE HAVEN 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 507
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 237
Total of all active and inactive participants 2015-01-01 237
Total participants 2015-01-01 237
Number of participants with account balances 2015-01-01 300
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 10
2014: SAFE HAVEN 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 405
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 339
Number of other retired or separated participants entitled to future benefits 2014-01-01 160
Total of all active and inactive participants 2014-01-01 499
Total participants 2014-01-01 499
Number of participants with account balances 2014-01-01 303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 18
2013: SAFE HAVEN 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 284
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 188
Number of other retired or separated participants entitled to future benefits 2013-01-01 85
Total of all active and inactive participants 2013-01-01 273
Total participants 2013-01-01 273
Number of participants with account balances 2013-01-01 273
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 87
2012: SAFE HAVEN 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-04-01 209
Total number of active participants reported on line 7a of the Form 5500 2012-04-01 305
Total of all active and inactive participants 2012-04-01 305
Total participants 2012-04-01 305
Number of participants with account balances 2012-04-01 305

Measure	Date	Value
2017: SAFE HAVEN 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	485
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	80
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	230
Total of all active and inactive participants	2017-01-01	310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	310
Number of participants with account balances	2017-01-01	247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SAFE HAVEN 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	525
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	268
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	217
Total of all active and inactive participants	2016-01-01	485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	485
Number of participants with account balances	2016-01-01	274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	6
2015: SAFE HAVEN 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	507
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	237
Total of all active and inactive participants	2015-01-01	237
Total participants	2015-01-01	237
Number of participants with account balances	2015-01-01	300
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	10
2014: SAFE HAVEN 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	405
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	339
Number of other retired or separated participants entitled to future benefits	2014-01-01	160
Total of all active and inactive participants	2014-01-01	499
Total participants	2014-01-01	499
Number of participants with account balances	2014-01-01	303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	18
2013: SAFE HAVEN 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	284
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	188
Number of other retired or separated participants entitled to future benefits	2013-01-01	85
Total of all active and inactive participants	2013-01-01	273
Total participants	2013-01-01	273
Number of participants with account balances	2013-01-01	273
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	87
2012: SAFE HAVEN 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-04-01	209
Total number of active participants reported on line 7a of the Form 5500	2012-04-01	305
Total of all active and inactive participants	2012-04-01	305
Total participants	2012-04-01	305
Number of participants with account balances	2012-04-01	305

Financial Data on SAFE HAVEN 401(K) PLAN

Measure	Date	Value
2017 : SAFE HAVEN 401(K) PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$20,536
Total of all expenses incurred	2017-12-31	$20,814
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$10,888
Expenses. Certain deemed distributions of participant loans	2017-12-31	$1,022
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$9,281
Value of total assets at end of year	2017-12-31	$115,244
Value of total assets at beginning of year	2017-12-31	$115,522
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$8,904
Total interest from all sources	2017-12-31	$102
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$7,436
Participant contributions at end of year	2017-12-31	$841
Participant contributions at beginning of year	2017-12-31	$3,515
Participant contributions at end of year	2017-12-31	$5,166
Participant contributions at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-278
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$115,244
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$115,522
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$8,904
Value of interest in pooled separate accounts at end of year	2017-12-31	$102,170
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$103,456
Interest on participant loans	2017-12-31	$102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$7,023
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$8,551
Net investment gain/loss from pooled separate accounts	2017-12-31	$11,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$1,845
Employer contributions (assets) at end of year	2017-12-31	$44
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$10,888
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	WIPFLI LLP
Accountancy firm EIN	2017-12-31	390758449
2016 : SAFE HAVEN 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$28,788
Total of all expenses incurred	2016-12-31	$65,297
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$50,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$17,268
Value of total assets at end of year	2016-12-31	$115,522
Value of total assets at beginning of year	2016-12-31	$152,031
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$14,327
Total interest from all sources	2016-12-31	$157
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$14,327
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$13,284
Participant contributions at end of year	2016-12-31	$3,515
Participant contributions at beginning of year	2016-12-31	$5,901
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-36,509
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$115,522
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$152,031
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$103,456
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$130,650
Interest on participant loans	2016-12-31	$157
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$8,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$9,872
Net investment gain/loss from pooled separate accounts	2016-12-31	$11,363
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$3,984
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$5,590
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$50,970
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	WIPFLI LLP
Accountancy firm EIN	2016-12-31	390758449
2015 : SAFE HAVEN 401(K) PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$29,032
Total of all expenses incurred	2015-12-31	$84,729
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$81,934
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$29,473
Value of total assets at end of year	2015-12-31	$152,031
Value of total assets at beginning of year	2015-12-31	$207,728
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,795
Total interest from all sources	2015-12-31	$271
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$25,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Funding deficiency by the employer to the plan for this plan year	2015-12-31	$0
Minimum employer required contribution for this plan year	2015-12-31	$0
Amount contributed by the employer to the plan for this plan year	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$23,462
Participant contributions at end of year	2015-12-31	$5,901
Participant contributions at beginning of year	2015-12-31	$11,010
Participant contributions at end of year	2015-12-31	$18
Participant contributions at beginning of year	2015-12-31	$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-55,697
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$152,031
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$207,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$130,650
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$184,125
Interest on participant loans	2015-12-31	$271
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$9,872
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$8,073
Net investment gain/loss from pooled separate accounts	2015-12-31	$-712
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$6,011
Employer contributions (assets) at end of year	2015-12-31	$5,590
Employer contributions (assets) at beginning of year	2015-12-31	$4,502
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$81,934
Contract administrator fees	2015-12-31	$2,795
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WIPFLI LLP
Accountancy firm EIN	2015-12-31	390758449
2014 : SAFE HAVEN 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$52,902
Total of all expenses incurred	2014-12-31	$1,559
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$44,387
Value of total assets at end of year	2014-12-31	$207,728
Value of total assets at beginning of year	2014-12-31	$156,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$258
Total interest from all sources	2014-12-31	$278
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	No
If this is an individual account plan, was there a blackout period	2014-12-31	No
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$37,631
Participant contributions at end of year	2014-12-31	$11,010
Participant contributions at beginning of year	2014-12-31	$10,262
Participant contributions at end of year	2014-12-31	$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$51,343
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$207,728
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$156,385
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$184,125
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$136,260
Interest on participant loans	2014-12-31	$278
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$8,073
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$7,404
Net investment gain/loss from pooled separate accounts	2014-12-31	$8,237
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$6,756
Employer contributions (assets) at end of year	2014-12-31	$4,502
Employer contributions (assets) at beginning of year	2014-12-31	$2,459
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,301
Contract administrator fees	2014-12-31	$258
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WIPFLI LLP
Accountancy firm EIN	2014-12-31	390758449
2013 : SAFE HAVEN 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$53,417
Total of all expenses incurred	2013-12-31	$290
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$177
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$43,332
Value of total assets at end of year	2013-12-31	$156,385
Value of total assets at beginning of year	2013-12-31	$103,258
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$113
Total interest from all sources	2013-12-31	$393
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	No
If this is an individual account plan, was there a blackout period	2013-12-31	No
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$36,225
Participant contributions at end of year	2013-12-31	$10,262
Participant contributions at beginning of year	2013-12-31	$39,500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$53,127
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$156,385
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$103,258
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$136,260
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$11,215
Interest on participant loans	2013-12-31	$241
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$152
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$7,404
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,543
Net investment gain/loss from pooled separate accounts	2013-12-31	$9,692
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$7,107
Employer contributions (assets) at end of year	2013-12-31	$2,459
Employer contributions (assets) at beginning of year	2013-12-31	$50,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$177
Contract administrator fees	2013-12-31	$113
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	RELIANT GROUP, INC.
Accountancy firm EIN	2013-12-31	273756990
2012 : SAFE HAVEN 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$105,701
Total of all expenses incurred	2012-12-31	$2,443
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,383
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$105,379
Value of total assets at end of year	2012-12-31	$103,258
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$60
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$25,000
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$55,251
Participant contributions at end of year	2012-12-31	$39,500
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$128
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$103,258
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$103,258
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$11,215
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,543
Net investment gain/loss from pooled separate accounts	2012-12-31	$322
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$50,000
Employer contributions (assets) at end of year	2012-12-31	$50,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,383
Contract administrator fees	2012-12-31	$60
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	RELIANT GROUP, INC.
Accountancy firm EIN	2012-12-31	273756990

Form 5500 Responses for SAFE HAVEN 401(K) PLAN

2017: SAFE HAVEN 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: SAFE HAVEN 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: SAFE HAVEN 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: SAFE HAVEN 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: SAFE HAVEN 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: SAFE HAVEN 401(K) PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	First time form 5500 has been submitted	Yes
2012-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-04-01	Plan funding arrangement – Insurance	Yes
2012-04-01	Plan funding arrangement – Trust	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831053

Policy instance

Insurance contract or identification number	GA-831053
Number of Individuals Covered	251
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $541
Total amount of fees paid to insurance company	USD $68
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831053

Policy instance

Insurance contract or identification number	GA-831053
Number of Individuals Covered	301
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $694
Total amount of fees paid to insurance company	USD $87
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $694
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker organization code?	3
Amount paid for insurance broker fees	87
Insurance broker name	COOK MARTIN POULSON, PC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831053

Policy instance

Insurance contract or identification number	GA-831053
Number of Individuals Covered	305
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $606
Total amount of fees paid to insurance company	USD $76
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $606
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker organization code?	3
Amount paid for insurance broker fees	76
Insurance broker name	COOK MARTIN POULSON, PC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831053

Policy instance

Insurance contract or identification number	GA-831053
Number of Individuals Covered	305
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $212
Total amount of fees paid to insurance company	USD $81
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $212
Amount paid for insurance broker fees	54
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker organization code?	3
Insurance broker name	COOK MARTIN POULSON, PC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-831053

Policy instance

Insurance contract or identification number	GA-831053
Number of Individuals Covered	11
Insurance policy start date	2012-04-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4
Total amount of fees paid to insurance company	USD $400
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4
Amount paid for insurance broker fees	400
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	5
Insurance broker name	COOK MARTIN POULSON, PC

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Company Name:	SAFE HAVEN HEALTH CARE, LLC
Employer identification number (EIN):	271736817
NAIC Classification:	621610
NAIC Description:	Home Health Care Services