401k Plan data: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN plan

PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 401k Plan overview

Plan Name	PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN
Plan identification number	001

PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PARK LANE CARE AND REHABILITATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: PARK LANE CARE AND REHABILITATION CENTER, INC.

Employer identification number (EIN): 043749240

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 KURT LEUTZINGER 2018-01-11
001 2016-01-01 KURT LEUTZINGER
001 2015-01-01 JOAN RIEGERT
001 2014-01-01 JOAN RIEGERT
001 2013-01-01 JOAN RIEGERT
001 2012-01-01 JOAN RIEGERT
001 2011-01-01 JOAN RIEGERT
001 2010-01-01 JEANNIE BOLTZ

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01	KURT LEUTZINGER	2018-01-11
001	2016-01-01	KURT LEUTZINGER
001	2015-01-01	JOAN RIEGERT
001	2014-01-01	JOAN RIEGERT
001	2013-01-01	JOAN RIEGERT
001	2012-01-01	JOAN RIEGERT
001	2011-01-01	JOAN RIEGERT
001	2010-01-01	JEANNIE BOLTZ

Plan Statistics for PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN

401k plan membership statisitcs for PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN

Measure Date Value
2016: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 41
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 12
Total of all active and inactive participants 2016-01-01 53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 53
Number of participants with account balances 2016-01-01 53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 158
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 9
Total of all active and inactive participants 2015-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 167
Number of participants with account balances 2015-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 163
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 6
Total of all active and inactive participants 2014-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 169
Number of participants with account balances 2014-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 163
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 5
Total of all active and inactive participants 2013-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 168
Number of participants with account balances 2013-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 166
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 8
Total of all active and inactive participants 2012-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 174
Number of participants with account balances 2012-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 165
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 3
Total of all active and inactive participants 2011-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 168
Number of participants with account balances 2011-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 149
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 2
Total of all active and inactive participants 2010-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 151
Number of participants with account balances 2010-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2016: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	41
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	12
Total of all active and inactive participants	2016-01-01	53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	53
Number of participants with account balances	2016-01-01	53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	158
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	9
Total of all active and inactive participants	2015-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	167
Number of participants with account balances	2015-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	163
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	6
Total of all active and inactive participants	2014-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	169
Number of participants with account balances	2014-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	163
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	5
Total of all active and inactive participants	2013-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	168
Number of participants with account balances	2013-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	166
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	8
Total of all active and inactive participants	2012-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	174
Number of participants with account balances	2012-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	165
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	3
Total of all active and inactive participants	2011-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	168
Number of participants with account balances	2011-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	149
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	2
Total of all active and inactive participants	2010-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	151
Number of participants with account balances	2010-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN

Measure	Date	Value
2016 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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	$262,224
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$246,530
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$241,015
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$197,273
Value of total assets at end of year	2016-12-31	$861,478
Value of total assets at beginning of year	2016-12-31	$845,784
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,515
Total interest from all sources	2016-12-31	$0
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$20,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$126,978
Participant contributions at end of year	2016-12-31	$16
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$958
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	$15,694
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$861,478
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$845,784
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	$861,462
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$845,784
Net investment gain or loss from common/collective trusts	2016-12-31	$64,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$69,337
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$241,015
Contract administrator fees	2016-12-31	$5,515
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CONNER ASH P.C.
Accountancy firm EIN	2016-12-31	431012822
2015 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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	$162,336
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$50,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$49,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$192,415
Value of total assets at end of year	2015-12-31	$845,784
Value of total assets at beginning of year	2015-12-31	$733,456
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$225
Total interest from all sources	2015-12-31	$0
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	$20,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$124,681
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$31
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,185
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	$112,328
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$845,784
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$733,456
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	$845,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$733,410
Net investment gain or loss from common/collective trusts	2015-12-31	$-30,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$66,549
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$15
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$49,783
Contract administrator fees	2015-12-31	$225
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CONNER ASH P.C.
Accountancy firm EIN	2015-12-31	431012822
2014 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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	$8,128
Total income from all sources (including contributions)	2014-12-31	$215,796
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$69,147
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$69,022
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$188,525
Value of total assets at end of year	2014-12-31	$733,456
Value of total assets at beginning of year	2014-12-31	$594,935
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$125
Total interest from all sources	2014-12-31	$0
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	$20,000
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	$125,508
Participant contributions at end of year	2014-12-31	$31
Participant contributions at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$146,649
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$733,456
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$586,807
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	$733,410
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$594,935
Net investment gain or loss from common/collective trusts	2014-12-31	$27,271
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	$63,017
Employer contributions (assets) at end of year	2014-12-31	$15
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$69,022
Contract administrator fees	2014-12-31	$125
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$8,128
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	MUELLER PROST PC
Accountancy firm EIN	2014-12-31	431594752
2013 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$8,128
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	$224,825
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$25,737
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$17,432
Value of total corrective distributions	2013-12-31	$8,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$180,954
Value of total assets at end of year	2013-12-31	$594,935
Value of total assets at beginning of year	2013-12-31	$387,719
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$177
Total interest from all sources	2013-12-31	$0
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	$20,000
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	$122,947
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$37,800
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	$199,088
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$586,807
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$387,719
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	$594,935
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$340,754
Net investment gain or loss from common/collective trusts	2013-12-31	$43,871
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	$58,007
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$9,165
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$17,432
Contract administrator fees	2013-12-31	$177
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$8,128
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
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	MUELLER PROST PC
Accountancy firm EIN	2013-12-31	431594752
2012 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$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	$211,402
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$26,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$26,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$186,161
Value of total assets at end of year	2012-12-31	$387,719
Value of total assets at beginning of year	2012-12-31	$202,600
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$150
Total interest from all sources	2012-12-31	$0
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	$20,000
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	$114,771
Participant contributions at end of year	2012-12-31	$37,800
Participant contributions at beginning of year	2012-12-31	$36,800
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	$185,119
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$387,719
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$202,600
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	$340,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$164,247
Net investment gain/loss from pooled separate accounts	2012-12-31	$25,241
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	$71,390
Employer contributions (assets) at end of year	2012-12-31	$9,165
Employer contributions (assets) at beginning of year	2012-12-31	$1,553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$26,133
Contract administrator fees	2012-12-31	$150
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	MUELLER PROST PC
Accountancy firm EIN	2012-12-31	431594752
2011 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$177,525
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$7,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$7,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$183,093
Value of total assets at end of year	2011-12-31	$202,600
Value of total assets at beginning of year	2011-12-31	$32,310
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$75
Total interest from all sources	2011-12-31	$0
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	$20,000
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	$116,746
Participant contributions at end of year	2011-12-31	$36,800
Participant contributions at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$170,290
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$202,600
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$32,310
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	$164,247
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$32,310
Net investment gain/loss from pooled separate accounts	2011-12-31	$-5,568
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$66,347
Employer contributions (assets) at end of year	2011-12-31	$1,553
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$7,160
Contract administrator fees	2011-12-31	$75
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	MUELLER PROST PC
Accountancy firm EIN	2011-12-31	431594752
2010 : PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$32,310
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$31,651
Value of total assets at end of year	2010-12-31	$32,310
Value of total assets at beginning of year	2010-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$15,446
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$3,809
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$32,310
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$32,310
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$32,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$659
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$12,396
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MUELLER PROST PC
Accountancy firm EIN	2010-12-31	431594752

Form 5500 Responses for PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN

2016: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) 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: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PARKLANE CARE AND REHABILITATION CENTER, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	48
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,765
Total amount of fees paid to insurance company	USD $376
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,765
Insurance broker organization code?	3
Amount paid for insurance broker fees	376
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	BENEFITS OF MISSOURI, INC.

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	45
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,167
Total amount of fees paid to insurance company	USD $317
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,167
Insurance broker organization code?	3
Amount paid for insurance broker fees	317
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	BENEFITS OF MISSOURI, INC.

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	40
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,938
Total amount of fees paid to insurance company	USD $194
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,938
Insurance broker organization code?	3
Amount paid for insurance broker fees	194
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	BENEFITS OF MISSOURI, INC.

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	41
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,312
Total amount of fees paid to insurance company	USD $136
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,066
Insurance broker organization code?	3
Amount paid for insurance broker fees	119
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	43
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $887
Total amount of fees paid to insurance company	USD $33
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

823580

Policy instance

Insurance contract or identification number	823580
Number of Individuals Covered	39
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $158
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $158
Insurance broker organization code?	3
Insurance broker name	ENTERPRISE GENERAL INS AGENCY

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	PARK LANE CARE AND REHABILITATION CENTER, INC.
Employer identification number (EIN):	043749240
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities