401k Plan data: GENESIS HEALTHCARE SYSTEM 401(K) PLAN plan

GENESIS HEALTHCARE SYSTEM 401(K) PLAN 401k Plan overview

Plan Name	GENESIS HEALTHCARE SYSTEM 401(K) PLAN
Plan identification number	003

GENESIS HEALTHCARE SYSTEM 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GENESIS HEALTHCARE SYSTEM has sponsored the creation of one or more 401k plans.

Company Name: GENESIS HEALTHCARE SYSTEM

Employer identification number (EIN): 311480941

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about GENESIS HEALTHCARE SYSTEM

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1996-09-20

Company Identification Number: 953587

Legal Registered Office Address: 2951 MAPLE AVE
-
ZANESVILLE
United States of America (USA)
43701

More information about GENESIS HEALTHCARE SYSTEM

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2023-01-01 TERRY WILSON 2024-10-11
003 2022-01-01 TERRY WILSON 2023-10-13
003 2021-01-01 TERRY WILSON 2022-10-13
003 2020-01-01 TERRY WILSON 2021-10-13
003 2019-01-01 TERRY WILSON 2020-10-14
003 2018-01-01 TERRY WILSON 2019-10-15
003 2017-01-01 TERRY WILSON TERRY WILSON 2018-10-15
003 2016-01-01 MARTHA NASH
003 2015-01-01 MARTHA NASH
003 2014-01-01 MARTHA NASH
003 2014-01-01 MARTHA NASH
003 2013-01-01 MARTHA NASH
003 2012-01-01 MARTHA NASH
003 2011-01-01 JEFF ROBINSON
003 2009-01-01 JEFF ROBINSON 2010-10-16
003 2009-01-01 JEFF ROBINSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2023-01-01	TERRY WILSON	2024-10-11
003	2022-01-01	TERRY WILSON	2023-10-13
003	2021-01-01	TERRY WILSON	2022-10-13
003	2020-01-01	TERRY WILSON	2021-10-13
003	2019-01-01	TERRY WILSON	2020-10-14
003	2018-01-01	TERRY WILSON	2019-10-15
003	2017-01-01	TERRY WILSON		TERRY WILSON	2018-10-15
003	2016-01-01	MARTHA NASH
003	2015-01-01	MARTHA NASH
003	2014-01-01	MARTHA NASH
003	2014-01-01	MARTHA NASH
003	2013-01-01	MARTHA NASH
003	2012-01-01	MARTHA NASH
003	2011-01-01	JEFF ROBINSON
003	2009-01-01			JEFF ROBINSON	2010-10-16
003	2009-01-01	JEFF ROBINSON

Plan Statistics for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

401k plan membership statisitcs for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

Measure Date Value
2023: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 1,007
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 3,834
Number of retired or separated participants receiving benefits 2023-01-01 1
Number of other retired or separated participants entitled to future benefits 2023-01-01 353
Total of all active and inactive participants 2023-01-01 4,188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 4,188
Number of participants with account balances 2023-01-01 4,188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 2
2022: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 946
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 856
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 150
Total of all active and inactive participants 2022-01-01 1,007
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,007
Number of participants with account balances 2022-01-01 1,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 847
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 794
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 151
Total of all active and inactive participants 2021-01-01 946
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 946
Number of participants with account balances 2021-01-01 946
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 766
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 740
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 106
Total of all active and inactive participants 2020-01-01 847
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 847
Number of participants with account balances 2020-01-01 847
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 631
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 683
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 82
Total of all active and inactive participants 2019-01-01 766
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 766
Number of participants with account balances 2019-01-01 766
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 541
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 541
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 88
Total of all active and inactive participants 2018-01-01 631
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 631
Number of participants with account balances 2018-01-01 631
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 514
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 496
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 80
Total of all active and inactive participants 2017-01-01 578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 578
Number of participants with account balances 2017-01-01 578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 481
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 456
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 56
Total of all active and inactive participants 2016-01-01 514
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 514
Number of participants with account balances 2016-01-01 514
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 400
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 419
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 60
Total of all active and inactive participants 2015-01-01 481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 481
Number of participants with account balances 2015-01-01 481
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 338
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 355
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 43
Total of all active and inactive participants 2014-01-01 400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 400
Number of participants with account balances 2014-01-01 400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 289
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 306
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 31
Total of all active and inactive participants 2013-01-01 338
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 338
Number of participants with account balances 2013-01-01 338
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 268
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 20
Total of all active and inactive participants 2012-01-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 289
Number of participants with account balances 2012-01-01 289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 215
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 12
Total of all active and inactive participants 2011-01-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 228
Number of participants with account balances 2011-01-01 228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 161
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 17
Total of all active and inactive participants 2009-01-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 179
Number of participants with account balances 2009-01-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2023: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	1,007
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	3,834
Number of retired or separated participants receiving benefits	2023-01-01	1
Number of other retired or separated participants entitled to future benefits	2023-01-01	353
Total of all active and inactive participants	2023-01-01	4,188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	4,188
Number of participants with account balances	2023-01-01	4,188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	2
2022: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	946
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	856
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	150
Total of all active and inactive participants	2022-01-01	1,007
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,007
Number of participants with account balances	2022-01-01	1,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	847
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	794
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	151
Total of all active and inactive participants	2021-01-01	946
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	946
Number of participants with account balances	2021-01-01	946
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	766
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	740
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	106
Total of all active and inactive participants	2020-01-01	847
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	847
Number of participants with account balances	2020-01-01	847
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	631
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	683
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	82
Total of all active and inactive participants	2019-01-01	766
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	766
Number of participants with account balances	2019-01-01	766
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	541
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	541
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	88
Total of all active and inactive participants	2018-01-01	631
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	631
Number of participants with account balances	2018-01-01	631
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	514
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	496
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	80
Total of all active and inactive participants	2017-01-01	578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	578
Number of participants with account balances	2017-01-01	578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	481
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	456
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	56
Total of all active and inactive participants	2016-01-01	514
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	514
Number of participants with account balances	2016-01-01	514
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	400
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	419
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	60
Total of all active and inactive participants	2015-01-01	481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	481
Number of participants with account balances	2015-01-01	481
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	338
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	355
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	43
Total of all active and inactive participants	2014-01-01	400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	400
Number of participants with account balances	2014-01-01	400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	289
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	306
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	31
Total of all active and inactive participants	2013-01-01	338
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	338
Number of participants with account balances	2013-01-01	338
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	268
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	20
Total of all active and inactive participants	2012-01-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	289
Number of participants with account balances	2012-01-01	289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	215
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	12
Total of all active and inactive participants	2011-01-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	228
Number of participants with account balances	2011-01-01	228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	161
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	17
Total of all active and inactive participants	2009-01-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	179
Number of participants with account balances	2009-01-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on GENESIS HEALTHCARE SYSTEM 401(K) PLAN

Measure	Date	Value
2023 : GENESIS HEALTHCARE SYSTEM 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	$29,954,217
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$3,965,000
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$3,801,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$24,670,139
Value of total assets at end of year	2023-12-31	$51,728,506
Value of total assets at beginning of year	2023-12-31	$25,739,289
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$163,626
Total interest from all sources	2023-12-31	$810,952
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	$2,000,000
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	$14,254,527
Participant contributions at end of year	2023-12-31	$559,868
Participant contributions at beginning of year	2023-12-31	$364,635
Participant contributions at end of year	2023-12-31	$0
Participant contributions at beginning of year	2023-12-31	$98,110
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$7,177,716
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	$25,989,217
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$51,728,506
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$25,739,289
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$29,667,809
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$14,259,425
Value of interest in pooled separate accounts at end of year	2023-12-31	$3,973,870
Value of interest in pooled separate accounts at beginning of year	2023-12-31	$2,223,852
Interest on participant loans	2023-12-31	$29,677
Interest earned on other investments	2023-12-31	$781,275
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$17,526,959
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$8,772,137
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$4,139,183
Net investment gain/loss from pooled separate accounts	2023-12-31	$333,943
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	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$3,237,896
Employer contributions (assets) at end of year	2023-12-31	$0
Employer contributions (assets) at beginning of year	2023-12-31	$21,130
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$3,801,374
Contract administrator fees	2023-12-31	$163,626
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	REA & ASSOCIATES
Accountancy firm EIN	2023-12-31	341310124
2022 : GENESIS HEALTHCARE SYSTEM 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	$490,843
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,197,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,083,586
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$3,853,062
Value of total assets at end of year	2022-12-31	$25,739,289
Value of total assets at beginning of year	2022-12-31	$26,445,504
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$113,472
Total interest from all sources	2022-12-31	$419,126
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	$2,000,000
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	$2,911,121
Participant contributions at end of year	2022-12-31	$364,635
Participant contributions at beginning of year	2022-12-31	$230,138
Participant contributions at end of year	2022-12-31	$98,110
Participant contributions at beginning of year	2022-12-31	$89,086
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$366,505
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	$-706,215
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$25,739,289
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$26,445,504
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 registered invesment companies (eg mutual funds) at end of year	2022-12-31	$14,259,425
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$15,414,735
Value of interest in pooled separate accounts at end of year	2022-12-31	$2,223,852
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$2,027,174
Interest on participant loans	2022-12-31	$12,834
Interest earned on other investments	2022-12-31	$406,292
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$8,772,137
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$8,665,112
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,538,674
Net investment gain/loss from pooled separate accounts	2022-12-31	$-242,671
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
Contributions received in cash from employer	2022-12-31	$575,436
Employer contributions (assets) at end of year	2022-12-31	$21,130
Employer contributions (assets) at beginning of year	2022-12-31	$19,259
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,083,586
Contract administrator fees	2022-12-31	$113,472
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	REA & ASSOCIATES
Accountancy firm EIN	2022-12-31	341310124
2021 : GENESIS HEALTHCARE SYSTEM 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	$6,006,228
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$945,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$838,900
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$3,397,977
Value of total assets at end of year	2021-12-31	$26,445,504
Value of total assets at beginning of year	2021-12-31	$21,384,311
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$106,135
Total interest from all sources	2021-12-31	$373,442
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	$2,000,000
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	$2,607,261
Participant contributions at end of year	2021-12-31	$230,138
Participant contributions at beginning of year	2021-12-31	$280,214
Participant contributions at end of year	2021-12-31	$89,086
Participant contributions at beginning of year	2021-12-31	$84,171
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$272,289
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	$5,061,193
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$26,445,504
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$21,384,311
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 registered invesment companies (eg mutual funds) at end of year	2021-12-31	$15,414,735
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$12,106,659
Value of interest in pooled separate accounts at end of year	2021-12-31	$2,027,174
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,423,210
Interest on participant loans	2021-12-31	$10,624
Interest earned on other investments	2021-12-31	$362,818
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$8,665,112
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$7,472,080
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,030,872
Net investment gain/loss from pooled separate accounts	2021-12-31	$203,937
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
Contributions received in cash from employer	2021-12-31	$518,427
Employer contributions (assets) at end of year	2021-12-31	$19,259
Employer contributions (assets) at beginning of year	2021-12-31	$17,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$838,900
Contract administrator fees	2021-12-31	$106,135
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	Unqualified
Accountancy firm name	2021-12-31	REA & ASSOCIATES
Accountancy firm EIN	2021-12-31	341310124
2020 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$5,972,637
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$859,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$782,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$3,064,129
Value of total assets at end of year	2020-12-31	$21,384,311
Value of total assets at beginning of year	2020-12-31	$16,271,195
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$77,045
Total interest from all sources	2020-12-31	$303,668
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$2,263,682
Participant contributions at end of year	2020-12-31	$280,214
Participant contributions at beginning of year	2020-12-31	$264,689
Participant contributions at end of year	2020-12-31	$84,171
Participant contributions at beginning of year	2020-12-31	$80,089
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$351,190
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$5,113,116
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$21,384,311
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$16,271,195
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$12,106,659
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,939,403
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,423,210
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$952,275
Interest on participant loans	2020-12-31	$13,976
Interest earned on other investments	2020-12-31	$289,692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$7,472,080
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$6,019,405
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,469,983
Net investment gain/loss from pooled separate accounts	2020-12-31	$134,857
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$449,257
Employer contributions (assets) at end of year	2020-12-31	$17,977
Employer contributions (assets) at beginning of year	2020-12-31	$15,334
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$782,476
Contract administrator fees	2020-12-31	$77,045
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	REA & ASSOCIATES
Accountancy firm EIN	2020-12-31	341310124
2019 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$4,605,302
Total income from all sources (including contributions)	2019-12-31	$4,605,302
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$610,971
Total of all expenses incurred	2019-12-31	$610,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$547,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$547,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,373,319
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,373,319
Value of total assets at end of year	2019-12-31	$16,271,195
Value of total assets at end of year	2019-12-31	$16,271,195
Value of total assets at beginning of year	2019-12-31	$12,276,864
Value of total assets at beginning of year	2019-12-31	$12,276,864
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$63,934
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$63,934
Total interest from all sources	2019-12-31	$259,583
Total interest from all sources	2019-12-31	$259,583
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$2,000,000
Value of fidelity bond cover	2019-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,860,739
Contributions received from participants	2019-12-31	$1,860,739
Participant contributions at end of year	2019-12-31	$264,689
Participant contributions at end of year	2019-12-31	$264,689
Participant contributions at beginning of year	2019-12-31	$227,286
Participant contributions at beginning of year	2019-12-31	$227,286
Participant contributions at end of year	2019-12-31	$80,089
Participant contributions at end of year	2019-12-31	$80,089
Participant contributions at beginning of year	2019-12-31	$13,245
Participant contributions at beginning of year	2019-12-31	$13,245
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$141,384
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$141,384
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$3,994,331
Value of net income/loss	2019-12-31	$3,994,331
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$16,271,195
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$16,271,195
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$12,276,864
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$12,276,864
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,939,403
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,939,403
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,737,328
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,737,328
Value of interest in pooled separate accounts at end of year	2019-12-31	$952,275
Value of interest in pooled separate accounts at end of year	2019-12-31	$952,275
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$559,622
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$559,622
Interest on participant loans	2019-12-31	$14,004
Interest on participant loans	2019-12-31	$14,004
Interest earned on other investments	2019-12-31	$245,579
Interest earned on other investments	2019-12-31	$245,579
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$6,019,405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$6,019,405
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$4,679,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$4,679,589
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,880,179
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,880,179
Net investment gain/loss from pooled separate accounts	2019-12-31	$92,221
Net investment gain/loss from pooled separate accounts	2019-12-31	$92,221
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$371,196
Contributions received in cash from employer	2019-12-31	$371,196
Employer contributions (assets) at end of year	2019-12-31	$15,334
Employer contributions (assets) at end of year	2019-12-31	$15,334
Employer contributions (assets) at beginning of year	2019-12-31	$59,794
Employer contributions (assets) at beginning of year	2019-12-31	$59,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$547,037
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$547,037
Contract administrator fees	2019-12-31	$63,934
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	REA & ASSOCIATES
Accountancy firm name	2019-12-31	REA & ASSOCIATES
Accountancy firm EIN	2019-12-31	341310124
Accountancy firm EIN	2019-12-31	341310124
2018 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$1,283,865
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,180,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,177,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,844,301
Value of total assets at end of year	2018-12-31	$12,276,864
Value of total assets at beginning of year	2018-12-31	$12,173,744
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$3,211
Total interest from all sources	2018-12-31	$219,974
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,428,528
Participant contributions at end of year	2018-12-31	$227,286
Participant contributions at beginning of year	2018-12-31	$123,234
Participant contributions at end of year	2018-12-31	$13,245
Participant contributions at beginning of year	2018-12-31	$10,835
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$95,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$103,120
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$12,276,864
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$12,173,744
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,737,328
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,574,279
Value of interest in pooled separate accounts at end of year	2018-12-31	$559,622
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$483,388
Interest on participant loans	2018-12-31	$8,121
Interest earned on other investments	2018-12-31	$211,853
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$4,679,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$4,934,569
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-753,329
Net investment gain/loss from pooled separate accounts	2018-12-31	$-27,081
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$320,076
Employer contributions (assets) at end of year	2018-12-31	$59,794
Employer contributions (assets) at beginning of year	2018-12-31	$47,439
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,177,534
Contract administrator fees	2018-12-31	$3,211
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	REA & ASSOCIATES
Accountancy firm EIN	2018-12-31	341310124
2017 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$2,976,610
Total of all expenses incurred	2017-12-31	$1,058,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,055,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,572,512
Value of total assets at end of year	2017-12-31	$12,173,744
Value of total assets at beginning of year	2017-12-31	$10,255,204
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,227
Total interest from all sources	2017-12-31	$140,813
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$58,655
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$58,655
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$2,000,000
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	$1,182,060
Participant contributions at end of year	2017-12-31	$123,234
Participant contributions at beginning of year	2017-12-31	$138,383
Participant contributions at end of year	2017-12-31	$10,835
Participant contributions at beginning of year	2017-12-31	$9,213
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$116,375
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	$1,918,540
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$12,173,744
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$10,255,204
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$6,574,279
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$5,472,631
Value of interest in pooled separate accounts at end of year	2017-12-31	$483,388
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$397,111
Interest on participant loans	2017-12-31	$5,882
Interest earned on other investments	2017-12-31	$134,931
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$4,934,569
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$4,196,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,148,317
Net investment gain/loss from pooled separate accounts	2017-12-31	$56,313
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	No
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	$274,077
Employer contributions (assets) at end of year	2017-12-31	$47,439
Employer contributions (assets) at beginning of year	2017-12-31	$41,728
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,055,843
Contract administrator fees	2017-12-31	$2,227
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2017-12-31	311038077
2016 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,991,860
Total of all expenses incurred	2016-12-31	$454,579
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$452,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,368,748
Value of total assets at end of year	2016-12-31	$10,255,204
Value of total assets at beginning of year	2016-12-31	$8,717,923
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,121
Total interest from all sources	2016-12-31	$121,271
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$50,612
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$50,612
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$2,000,000
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	$1,030,933
Participant contributions at end of year	2016-12-31	$138,383
Participant contributions at beginning of year	2016-12-31	$120,976
Participant contributions at end of year	2016-12-31	$9,213
Participant contributions at beginning of year	2016-12-31	$8,019
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$108,933
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	$1,537,281
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$10,255,204
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,717,923
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$5,472,631
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,541,427
Value of interest in pooled separate accounts at end of year	2016-12-31	$397,111
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$336,575
Interest on participant loans	2016-12-31	$5,169
Interest earned on other investments	2016-12-31	$116,102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$4,196,138
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$3,676,549
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$436,468
Net investment gain/loss from pooled separate accounts	2016-12-31	$14,761
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	$228,882
Employer contributions (assets) at end of year	2016-12-31	$41,728
Employer contributions (assets) at beginning of year	2016-12-31	$34,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$452,458
Contract administrator fees	2016-12-31	$2,121
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2016-12-31	311038077
2015 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$894
Total income from all sources (including contributions)	2015-12-31	$1,383,011
Total of all expenses incurred	2015-12-31	$340,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$338,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,169,079
Value of total assets at end of year	2015-12-31	$8,717,923
Value of total assets at beginning of year	2015-12-31	$7,675,895
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,715
Total interest from all sources	2015-12-31	$107,870
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$54,127
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$54,127
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$886,458
Participant contributions at end of year	2015-12-31	$120,976
Participant contributions at beginning of year	2015-12-31	$121,451
Participant contributions at end of year	2015-12-31	$8,019
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$83,471
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$894
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	$1,042,922
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,717,923
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,675,001
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$4,541,427
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$3,915,384
Value of interest in pooled separate accounts at end of year	2015-12-31	$336,575
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$321,843
Interest on participant loans	2015-12-31	$4,870
Interest earned on other investments	2015-12-31	$103,000
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,676,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$3,317,217
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$58,310
Net investment gain/loss from pooled separate accounts	2015-12-31	$-6,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
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	$199,150
Employer contributions (assets) at end of year	2015-12-31	$34,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$338,374
Contract administrator fees	2015-12-31	$1,715
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2015-12-31	311038077
2014 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$894
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$9,906
Total income from all sources (including contributions)	2014-12-31	$1,308,717
Total of all expenses incurred	2014-12-31	$774,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$772,592
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$966,460
Value of total assets at end of year	2014-12-31	$7,675,895
Value of total assets at beginning of year	2014-12-31	$7,150,424
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,642
Total interest from all sources	2014-12-31	$96,695
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$38,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$38,634
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$689,164
Participant contributions at end of year	2014-12-31	$121,451
Participant contributions at beginning of year	2014-12-31	$125,560
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$109,121
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$894
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$9,906
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	$534,483
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$7,675,001
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,140,518
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$3,915,384
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$3,782,630
Value of interest in pooled separate accounts at end of year	2014-12-31	$321,843
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$273,171
Interest on participant loans	2014-12-31	$5,419
Interest earned on other investments	2014-12-31	$91,276
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$3,317,217
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,969,063
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$196,784
Net investment gain/loss from pooled separate accounts	2014-12-31	$10,144
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	$168,175
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$772,592
Contract administrator fees	2014-12-31	$1,642
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2014-12-31	311038077
2013 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$9,906
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$5,718
Total income from all sources (including contributions)	2013-12-31	$1,831,448
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$160,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$159,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$902,405
Value of total assets at end of year	2013-12-31	$7,150,424
Value of total assets at beginning of year	2013-12-31	$5,475,747
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,888
Total interest from all sources	2013-12-31	$85,682
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$31,665
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$31,665
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$630,115
Participant contributions at end of year	2013-12-31	$125,560
Participant contributions at beginning of year	2013-12-31	$95,059
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$135,751
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$9,906
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$5,718
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	$1,670,489
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,140,518
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,470,029
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 registered invesment companies (eg mutual funds) at end of year	2013-12-31	$3,782,630
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,627,460
Value of interest in pooled separate accounts at end of year	2013-12-31	$273,171
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$198,646
Interest on participant loans	2013-12-31	$4,582
Interest earned on other investments	2013-12-31	$81,100
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,969,063
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,554,582
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$795,889
Net investment gain/loss from pooled separate accounts	2013-12-31	$15,807
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	$136,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$159,071
Contract administrator fees	2013-12-31	$1,888
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2013-12-31	311038077
2012 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$5,718
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,146,438
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$80,049
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$78,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$751,948
Value of total assets at end of year	2012-12-31	$5,475,747
Value of total assets at beginning of year	2012-12-31	$4,403,640
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,398
Total interest from all sources	2012-12-31	$75,602
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$27,825
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$27,825
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$464,670
Participant contributions at end of year	2012-12-31	$95,059
Participant contributions at beginning of year	2012-12-31	$103,859
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$186,448
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$5,718
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$279,837
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	$1,066,389
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,470,029
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,403,640
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,627,460
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,020,748
Value of interest in pooled separate accounts at end of year	2012-12-31	$198,646
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$94,079
Interest on participant loans	2012-12-31	$5,012
Interest earned on other investments	2012-12-31	$70,590
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,554,582
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,184,954
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$11,226
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	$100,830
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$78,651
Contract administrator fees	2012-12-31	$1,398
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	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2012-12-31	311038077
2011 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$473,374
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$319,260
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$318,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$448,352
Value of total assets at end of year	2011-12-31	$4,403,640
Value of total assets at beginning of year	2011-12-31	$4,249,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$641
Total interest from all sources	2011-12-31	$69,221
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$21,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$21,634
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$357,832
Participant contributions at end of year	2011-12-31	$103,859
Participant contributions at beginning of year	2011-12-31	$87,936
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$2,044
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$154,114
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,403,640
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,249,526
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$2,020,748
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,952,533
Value of interest in pooled separate accounts at end of year	2011-12-31	$94,079
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$66,750
Interest on participant loans	2011-12-31	$4,604
Interest earned on other investments	2011-12-31	$64,617
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,184,954
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,142,307
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-67,266
Net investment gain/loss from pooled separate accounts	2011-12-31	$1,433
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$88,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$318,619
Contract administrator fees	2011-12-31	$641
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2011-12-31	311038077
2010 : GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$929,406
Total loss/gain on sale of assets	2010-12-31	$17,893
Total of all expenses incurred	2010-12-31	$252,461
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$251,412
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$637,717
Value of total assets at end of year	2010-12-31	$4,249,526
Value of total assets at beginning of year	2010-12-31	$3,572,581
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,049
Total interest from all sources	2010-12-31	$66,824
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$20,044
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$321,347
Participant contributions at end of year	2010-12-31	$87,936
Participant contributions at beginning of year	2010-12-31	$87,415
Participant contributions at beginning of year	2010-12-31	$3,120
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$235,630
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$676,945
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,249,526
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,572,581
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,952,533
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,466,115
Value of interest in pooled separate accounts at end of year	2010-12-31	$66,750
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$90,531
Interest on participant loans	2010-12-31	$4,595
Interest earned on other investments	2010-12-31	$62,229
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,142,307
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,915,101
Net investment gain/loss from pooled separate accounts	2010-12-31	$186,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$80,740
Employer contributions (assets) at beginning of year	2010-12-31	$10,299
Income. Dividends from common stock	2010-12-31	$20,044
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$251,412
Contract administrator fees	2010-12-31	$1,049
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Aggregate proceeds on sale of assets	2010-12-31	$17,893
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MCLAIN HILL RUGG & ASSOCIATES
Accountancy firm EIN	2010-12-31	311038077

Form 5500 Responses for GENESIS HEALTHCARE SYSTEM 401(K) PLAN

2023: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single 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	No
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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single 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: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single 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
2020: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: GENESIS HEALTHCARE SYSTEM 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
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: GENESIS HEALTHCARE SYSTEM 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	1
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	4
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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	4188
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?	No
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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	1007
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	5
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	1
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	1
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	6
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	946
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	No
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	847
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	6
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	1
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	6
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	766
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	6
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	626
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	6
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	578
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	419
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $7,001
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
Amount paid for insurance broker fees	7001
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PROVIDER
Insurance broker organization code?	3
Insurance broker name	UBS FININCIAL SRVCS INS AGENCY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	8
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	419
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	290
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PLAN
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SRVCS INS AGENCY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	355
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $6,205
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
Amount paid for insurance broker fees	6205
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PROVIDER
Insurance broker organization code?	3
Insurance broker name	UBS FININCIAL SRVCS INS AGENCY INC

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	306
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $5,673
Are there contracts with allocated funds for individual policies?	No
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
Amount paid for insurance broker fees	5673
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PROVIDER
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SRVCS INS AGENCY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	8
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
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?	No
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	268
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,881
Are there contracts with allocated funds for individual policies?	No
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
Amount paid for insurance broker fees	4881
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PROVIDER
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SRVCS INS AGENCY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	9
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	No
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?	No
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	215
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,415
Are there contracts with allocated funds for individual policies?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	9
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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?	No
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?	No
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

BETH00OH00K1

Policy instance

Insurance contract or identification number	BETH00OH00K1
Number of Individuals Covered	3
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	No
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?	No
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

007600

Policy instance

Insurance contract or identification number	007600
Number of Individuals Covered	166
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,248
Are there contracts with allocated funds for individual policies?	No
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
Amount paid for insurance broker fees	4248
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PLAN
Insurance broker organization code?	0
Insurance broker name	UBS FINANCIAL SRVCS INS AGENCY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05581

Policy instance

Insurance contract or identification number	G05581
Number of Individuals Covered	9
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	No
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:	GENESIS HEALTHCARE SYSTEM
Employer identification number (EIN):	311480941
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1996-09-20
Company Identification Number:	953587
Legal Registered Office Address:	2951 MAPLE AVE - ZANESVILLE United States of America (USA) 43701