401k Plan data: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN plan

GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 401k Plan overview

Plan Name	GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN
Plan identification number	001

GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

GEORGE ADE MEMORIAL HEALTHCARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: GEORGE ADE MEMORIAL HEALTHCARE CENTER

Employer identification number (EIN): 351842438

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 ANTHONY WARREN 2024-06-18
001 2022-01-01 ANTHONY WARREN 2023-07-20
001 2021-01-01
001 2021-01-01 ANTHONY WARREN 2023-07-19
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 SCOTT JAMES
001 2016-01-01
001 2015-01-01 SCOTT JAMES
001 2014-01-01 SCOTT JAMES
001 2013-01-01 SCOTT JAMES
001 2012-01-01 SCOTT JAMES
001 2011-01-01 SCOTT JAMES
001 2010-01-01 SCOTT JAMES 2011-07-25 SCOTT JAMES 2011-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	ANTHONY WARREN	2024-06-18
001	2022-01-01	ANTHONY WARREN	2023-07-20
001	2021-01-01
001	2021-01-01	ANTHONY WARREN	2023-07-19
001	2020-01-01
001	2019-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	SCOTT JAMES
001	2016-01-01
001	2015-01-01	SCOTT JAMES
001	2014-01-01	SCOTT JAMES
001	2013-01-01	SCOTT JAMES
001	2012-01-01	SCOTT JAMES
001	2011-01-01	SCOTT JAMES
001	2010-01-01	SCOTT JAMES	2011-07-25	SCOTT JAMES	2011-07-25

Plan Statistics for GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN

401k plan membership statisitcs for GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN

Measure Date Value
2021: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 96
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 83
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 10
Total of all active and inactive participants 2021-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 93
Number of participants with account balances 2021-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 3
2020: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 90
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 83
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 10
Total of all active and inactive participants 2020-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 93
Number of participants with account balances 2020-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 79
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 6
Total of all active and inactive participants 2019-01-01 85
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 85
Number of participants with account balances 2019-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 80
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 28
Total of all active and inactive participants 2018-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 108
Number of participants with account balances 2018-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 81
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 29
Total of all active and inactive participants 2017-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 110
Number of participants with account balances 2017-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 81
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 28
Total of all active and inactive participants 2016-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 109
Number of participants with account balances 2016-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 90
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 23
Total of all active and inactive participants 2015-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 113
Number of participants with account balances 2015-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 95
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 17
Total of all active and inactive participants 2014-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 112
Number of participants with account balances 2014-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 98
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 32
Total of all active and inactive participants 2013-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 130
Number of participants with account balances 2013-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 102
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 35
Total of all active and inactive participants 2012-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 137
Number of participants with account balances 2012-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 95
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 46
Total of all active and inactive participants 2011-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 141
Number of participants with account balances 2011-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2021: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	96
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	83
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	10
Total of all active and inactive participants	2021-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	93
Number of participants with account balances	2021-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	3
2020: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	90
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	83
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	10
Total of all active and inactive participants	2020-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	93
Number of participants with account balances	2020-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	79
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	6
Total of all active and inactive participants	2019-01-01	85
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	85
Number of participants with account balances	2019-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	80
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	28
Total of all active and inactive participants	2018-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	108
Number of participants with account balances	2018-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	81
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	29
Total of all active and inactive participants	2017-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	110
Number of participants with account balances	2017-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	81
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	28
Total of all active and inactive participants	2016-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	109
Number of participants with account balances	2016-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	90
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	23
Total of all active and inactive participants	2015-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	113
Number of participants with account balances	2015-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	95
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	17
Total of all active and inactive participants	2014-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	112
Number of participants with account balances	2014-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	98
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	32
Total of all active and inactive participants	2013-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	130
Number of participants with account balances	2013-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	102
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	35
Total of all active and inactive participants	2012-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	137
Number of participants with account balances	2012-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	95
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	46
Total of all active and inactive participants	2011-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	141
Number of participants with account balances	2011-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN

Measure	Date	Value
2021 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$241,021
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$402,872
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$401,932
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$79,074
Value of total assets at end of year	2021-12-31	$1,639,110
Value of total assets at beginning of year	2021-12-31	$1,800,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$940
Total interest from all sources	2021-12-31	$297
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$77,131
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$77,131
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$250,000
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	$50,662
Participant contributions at end of year	2021-12-31	$9,163
Participant contributions at beginning of year	2021-12-31	$6,278
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	$-161,851
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,639,110
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,800,961
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	$1,629,947
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,794,683
Interest on participant loans	2021-12-31	$297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$84,519
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	$28,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$401,932
Contract administrator fees	2021-12-31	$940
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	HUTH THOMPSON LLP
Accountancy firm EIN	2021-12-31	352055043
2020 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$236,721
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$8,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$8,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$104,324
Value of total assets at end of year	2020-12-31	$1,800,961
Value of total assets at beginning of year	2020-12-31	$1,572,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$420
Total interest from all sources	2020-12-31	$405
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$44,382
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$44,382
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
If this is an individual account plan, was there a blackout period	2020-12-31	Yes
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	$65,757
Participant contributions at end of year	2020-12-31	$6,278
Participant contributions at beginning of year	2020-12-31	$25,377
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	$228,000
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,800,961
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,572,961
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	$1,794,683
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,535,421
Interest on participant loans	2020-12-31	$405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$12,163
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$87,610
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	$38,567
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$8,301
Contract administrator fees	2020-12-31	$420
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2020-12-31	Yes
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	Disclaimer
Accountancy firm name	2020-12-31	HUTH THOMPSON LLP
Accountancy firm EIN	2020-12-31	352055043
2019 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
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	$283,556
Total income from all sources (including contributions)	2019-12-31	$283,556
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	$308,145
Total of all expenses incurred	2019-12-31	$308,145
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$305,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$305,445
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$104,849
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$104,849
Value of total assets at end of year	2019-12-31	$1,572,961
Value of total assets at end of year	2019-12-31	$1,572,961
Value of total assets at beginning of year	2019-12-31	$1,597,550
Value of total assets at beginning of year	2019-12-31	$1,597,550
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,700
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,700
Total interest from all sources	2019-12-31	$15,933
Total interest from all sources	2019-12-31	$15,933
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$38,785
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$38,785
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$38,785
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$38,785
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
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	$65,031
Contributions received from participants	2019-12-31	$65,031
Participant contributions at end of year	2019-12-31	$25,377
Participant contributions at end of year	2019-12-31	$25,377
Participant contributions at beginning of year	2019-12-31	$32,947
Participant contributions at beginning of year	2019-12-31	$32,947
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$21,403
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$21,403
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	$-24,589
Value of net income/loss	2019-12-31	$-24,589
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,572,961
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,572,961
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,597,550
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,597,550
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 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
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	$1,535,421
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,535,421
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$490,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$490,496
Interest on participant loans	2019-12-31	$568
Interest on participant loans	2019-12-31	$568
Interest earned on other investments	2019-12-31	$15,365
Interest earned on other investments	2019-12-31	$15,365
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$12,163
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$12,163
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,074,107
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,074,107
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$123,989
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$123,989
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
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	$18,415
Contributions received in cash from employer	2019-12-31	$18,415
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$305,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$305,445
Contract administrator fees	2019-12-31	$2,700
Contract administrator fees	2019-12-31	$2,700
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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	HUTH THOMPSON LLP
Accountancy firm name	2019-12-31	HUTH THOMPSON LLP
Accountancy firm EIN	2019-12-31	352055043
Accountancy firm EIN	2019-12-31	352055043
2018 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$72,889
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$213,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$213,039
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$58,271
Value of total assets at end of year	2018-12-31	$1,597,550
Value of total assets at beginning of year	2018-12-31	$1,738,194
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$494
Total interest from all sources	2018-12-31	$40,179
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	$250,000
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	$58,271
Participant contributions at end of year	2018-12-31	$32,947
Participant contributions at beginning of year	2018-12-31	$39,983
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	$-140,644
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,597,550
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,738,194
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	$490,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$532,476
Interest earned on other investments	2018-12-31	$40,179
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,074,107
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,165,735
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-25,561
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$213,039
Contract administrator fees	2018-12-31	$494
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
2017 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$187,923
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$50,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$50,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$56,957
Value of total assets at end of year	2017-12-31	$1,738,194
Value of total assets at beginning of year	2017-12-31	$1,600,969
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$42,308
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$250,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$56,957
Participant contributions at end of year	2017-12-31	$39,983
Participant contributions at beginning of year	2017-12-31	$21,814
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	$137,225
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,738,194
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,600,969
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	$532,476
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$452,895
Interest earned on other investments	2017-12-31	$42,308
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,165,735
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,126,260
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$88,658
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$50,698
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
2016 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$164,376
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$79,662
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$79,612
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$95,673
Value of total assets at end of year	2016-12-31	$1,600,969
Value of total assets at beginning of year	2016-12-31	$1,516,255
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$50
Total interest from all sources	2016-12-31	$38,134
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$250,000
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	$60,574
Participant contributions at end of year	2016-12-31	$21,814
Participant contributions at beginning of year	2016-12-31	$22,416
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$35,099
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	$84,714
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,600,969
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,516,255
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	$452,895
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$425,949
Interest earned on other investments	2016-12-31	$38,134
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,126,260
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,067,890
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$30,569
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$79,612
Contract administrator fees	2016-12-31	$50
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
2015 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
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	$0
Total income from all sources (including contributions)	2015-12-31	$92,674
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$134,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$134,018
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$60,876
Value of total assets at end of year	2015-12-31	$1,516,255
Value of total assets at beginning of year	2015-12-31	$1,557,730
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$131
Total interest from all sources	2015-12-31	$35,524
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$250,000
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	$60,876
Participant contributions at end of year	2015-12-31	$22,416
Participant contributions at beginning of year	2015-12-31	$27,067
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	$-41,475
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,516,255
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,557,730
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	$425,949
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$470,529
Interest earned on other investments	2015-12-31	$35,524
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,067,890
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,060,134
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-3,726
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$134,018
Contract administrator fees	2015-12-31	$131
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
2014 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$158,313
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$47,494
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$47,494
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$85,545
Value of total assets at end of year	2014-12-31	$1,557,730
Value of total assets at beginning of year	2014-12-31	$1,446,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$0
Total interest from all sources	2014-12-31	$35,712
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$250,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$65,358
Participant contributions at end of year	2014-12-31	$27,067
Participant contributions at beginning of year	2014-12-31	$20,096
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$9,351
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	$110,819
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,557,730
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,446,911
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	$470,529
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$442,540
Interest on participant loans	2014-12-31	$682
Interest earned on other investments	2014-12-31	$35,030
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,060,134
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$984,275
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$37,056
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	$10,836
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$47,494
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	HORIZON CPA SERVICES, INC.
Accountancy firm EIN	2014-12-31	204287594
2013 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$222,507
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$40,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$40,965
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$98,664
Value of total assets at end of year	2013-12-31	$1,446,911
Value of total assets at beginning of year	2013-12-31	$1,265,396
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$27
Total interest from all sources	2013-12-31	$32,940
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$50,000
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	$52,050
Participant contributions at end of year	2013-12-31	$20,096
Participant contributions at beginning of year	2013-12-31	$23,601
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$13,019
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	$181,515
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,446,911
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,265,396
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	$442,540
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$324,434
Interest earned on other investments	2013-12-31	$32,940
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$984,275
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$917,361
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$90,903
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	$33,595
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$40,965
Contract administrator fees	2013-12-31	$27
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	HORIZON CPA SERVICES, INC.
Accountancy firm EIN	2013-12-31	204287594
2012 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$0
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	$171,524
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$42,890
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$42,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$104,298
Value of total assets at end of year	2012-12-31	$1,265,396
Value of total assets at beginning of year	2012-12-31	$1,136,762
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$80
Total interest from all sources	2012-12-31	$30,891
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$50,000
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	$49,047
Participant contributions at end of year	2012-12-31	$23,601
Participant contributions at beginning of year	2012-12-31	$17,614
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$13,781
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	$128,634
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,265,396
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,136,762
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	$324,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$260,784
Interest on participant loans	2012-12-31	$726
Interest earned on other investments	2012-12-31	$30,891
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$917,361
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$858,364
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$36,335
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	$41,470
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$42,810
Contract administrator fees	2012-12-31	$80
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	HORIZON CPA SERVICES, INC.
Accountancy firm EIN	2012-12-31	204287594
2011 : GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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	$115,052
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$125,457
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$125,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$86,399
Value of total assets at end of year	2011-12-31	$1,136,762
Value of total assets at beginning of year	2011-12-31	$1,147,167
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$29,753
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$50,000
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	$56,783
Participant contributions at end of year	2011-12-31	$17,614
Participant contributions at beginning of year	2011-12-31	$17,783
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$1,977
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	$-10,405
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,136,762
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,147,167
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	$260,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$299,184
Interest on participant loans	2011-12-31	$560
Interest earned on other investments	2011-12-31	$29,193
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$858,364
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$830,200
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,100
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
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	$27,639
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$125,457
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	HORIZON CPA SERVICES, INC.
Accountancy firm EIN	2011-12-31	204287594

Form 5500 Responses for GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN

2021: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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 benefit arrangement – Insurance	Yes
2011: GEORGE ADE MEMORIAL HEALTHCARE CENTER MATCHING 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-06-09
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	6
Insurance policy start date	2019-01-01
Insurance policy end date	2019-06-09
Total amount of commissions paid to insurance broker	USD $1,858
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Commission paid to Insurance Broker	USD $1,858
Insurance broker organization code?	4

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	46
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $9,271
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,271
Insurance broker organization code?	4

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	50
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,658
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,658
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	54
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,010
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
Commission paid to Insurance Broker	USD $6,010
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	71
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,560
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
Commission paid to Insurance Broker	USD $5,560
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	65
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $6,280
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
Commission paid to Insurance Broker	USD $6,280
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR31810

Policy instance

Insurance contract or identification number	CR31810
Number of Individuals Covered	69
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,633
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:	GEORGE ADE MEMORIAL HEALTHCARE CENTER
Employer identification number (EIN):	351842438
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities