EMPLOYEE LIFE INSURANCE PROGRAM 401k Plan overview

EMPLOYEE LIFE INSURANCE PROGRAM Benefits

401k Sponsoring company profile

Company Name:	SUSQUEHANNA NURSING AND REHABILITATION, LLC
Employer identification number (EIN):	810663761
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2013-01-01	BERNADETTE BRINSKO
503	2012-01-01	BERNADETTE BRINSKO
503	2011-01-01	BERNADETTE BRINSKO

Plan Statistics for EMPLOYEE LIFE INSURANCE PROGRAM

Measure	Date	Value
2013: EMPLOYEE LIFE INSURANCE PROGRAM 2013 401k membership
Total participants, beginning-of-year	2013-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	154
Total of all active and inactive participants	2013-01-01	154
Total participants	2013-01-01	154
2012: EMPLOYEE LIFE INSURANCE PROGRAM 2012 401k membership
Total participants, beginning-of-year	2012-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	126
Total of all active and inactive participants	2012-01-01	126
Total participants	2012-01-01	126
2011: EMPLOYEE LIFE INSURANCE PROGRAM 2011 401k membership
Total participants, beginning-of-year	2011-01-01	80
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	80
Total of all active and inactive participants	2011-01-01	80
Total participants	2011-01-01	80

Form 5500 Responses for EMPLOYEE LIFE INSURANCE PROGRAM

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