401k Plan data: IDEAL REHABILITATION 401(K) PLAN plan

IDEAL REHABILITATION 401(K) PLAN 401k Plan overview

Plan Name	IDEAL REHABILITATION 401(K) PLAN
Plan identification number	001

IDEAL REHABILITATION 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

IDEAL REHABILITATION, LLC has sponsored the creation of one or more 401k plans.

Company Name: IDEAL REHABILITATION, LLC

Employer identification number (EIN): 134304642

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IDEAL REHABILITATION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 LISA HOKANSON
001 2015-01-01 LISA HOKANSON
001 2014-01-01 LISA HOKANSON
001 2014-01-01 LISA HOKANSON LISA HOKANSON 2015-10-13
001 2013-01-01 LISA HOKANSON 2016-01-16
001 2012-01-01 MARCUS CADELL 2013-09-21 MARCUS CADELL 2013-09-21
001 2011-01-01 MARCUS CADELL 2012-10-10 MARCUS CADELL 2012-10-10
001 2010-01-01 MARCUS CADELL 2011-10-14 MARCUS CADELL 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	LISA HOKANSON
001	2015-01-01	LISA HOKANSON
001	2014-01-01	LISA HOKANSON
001	2014-01-01	LISA HOKANSON		LISA HOKANSON	2015-10-13
001	2013-01-01	LISA HOKANSON	2016-01-16
001	2012-01-01	MARCUS CADELL	2013-09-21	MARCUS CADELL	2013-09-21
001	2011-01-01	MARCUS CADELL	2012-10-10	MARCUS CADELL	2012-10-10
001	2010-01-01	MARCUS CADELL	2011-10-14	MARCUS CADELL	2011-10-14

Plan Statistics for IDEAL REHABILITATION 401(K) PLAN

401k plan membership statisitcs for IDEAL REHABILITATION 401(K) PLAN

Measure Date Value
2016: IDEAL REHABILITATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: IDEAL REHABILITATION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 204
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 0
Total of all active and inactive participants 2015-01-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 204
Number of participants with account balances 2015-01-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: IDEAL REHABILITATION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 51
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 14
Total of all active and inactive participants 2014-01-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 65
Number of participants with account balances 2014-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7

Measure	Date	Value
2016: IDEAL REHABILITATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: IDEAL REHABILITATION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	204
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	0
Total of all active and inactive participants	2015-01-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	204
Number of participants with account balances	2015-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: IDEAL REHABILITATION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	51
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	14
Total of all active and inactive participants	2014-01-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	65
Number of participants with account balances	2014-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7

Financial Data on IDEAL REHABILITATION 401(K) PLAN

Measure	Date	Value
2016 : IDEAL REHABILITATION 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-04-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-04-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-04-30	$0
Total income from all sources (including contributions)	2016-04-30	$780
Total loss/gain on sale of assets	2016-04-30	$0
Total of all expenses incurred	2016-04-30	$1,486,278
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-04-30	$1,479,362
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-04-30	$0
Value of total assets at end of year	2016-04-30	$0
Value of total assets at beginning of year	2016-04-30	$1,485,498
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-04-30	$6,916
Total interest from all sources	2016-04-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-04-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-04-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-04-30	$0
Administrative expenses professional fees incurred	2016-04-30	$6,916
Was this plan covered by a fidelity bond	2016-04-30	Yes
Value of fidelity bond cover	2016-04-30	$150,000
If this is an individual account plan, was there a blackout period	2016-04-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-04-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-04-30	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	2016-04-30	No
Value of net income/loss	2016-04-30	$-1,485,498
Value of net assets at end of year (total assets less liabilities)	2016-04-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-04-30	$1,485,498
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-04-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-04-30	No
Were any leases to which the plan was party in default or uncollectible	2016-04-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-04-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-04-30	$1,431,962
Value of interest in common/collective trusts at end of year	2016-04-30	$0
Value of interest in common/collective trusts at beginning of year	2016-04-30	$48,235
Net investment gain/loss from pooled separate accounts	2016-04-30	$780
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-04-30	No
Was there a failure to transmit to the plan any participant contributions	2016-04-30	No
Has the plan failed to provide any benefit when due under the plan	2016-04-30	No
Employer contributions (assets) at end of year	2016-04-30	$0
Employer contributions (assets) at beginning of year	2016-04-30	$5,301
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-04-30	$1,479,362
Did the plan have assets held for investment	2016-04-30	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	2016-04-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-04-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-04-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-04-30	Disclaimer
Accountancy firm name	2016-04-30	EIDE BAILLY LLP
Accountancy firm EIN	2016-04-30	450250958
2015 : IDEAL REHABILITATION 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	$724,588
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$53,624
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$52,894
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$784,957
Value of total assets at end of year	2015-12-31	$1,485,498
Value of total assets at beginning of year	2015-12-31	$814,534
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$730
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	$100,000
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	$497,919
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$12,611
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$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	2015-12-31	No
Value of net income/loss	2015-12-31	$670,964
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,485,498
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$814,534
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	$1,431,962
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$788,723
Value of interest in common/collective trusts at end of year	2015-12-31	$48,235
Value of interest in common/collective trusts at beginning of year	2015-12-31	$19,481
Net investment gain/loss from pooled separate accounts	2015-12-31	$-60,369
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	$274,427
Employer contributions (assets) at end of year	2015-12-31	$5,301
Employer contributions (assets) at beginning of year	2015-12-31	$6,330
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$52,894
Contract administrator fees	2015-12-31	$730
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	EIDE BAILLY LLP
Accountancy firm EIN	2015-12-31	450250958
2014 : IDEAL REHABILITATION 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	$0
Total income from all sources (including contributions)	2014-12-31	$325,448
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$49,852
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$48,152
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$307,895
Value of total assets at end of year	2014-12-31	$808,204
Value of total assets at beginning of year	2014-12-31	$532,608
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,700
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	$222,363
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$1,274
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$21,447
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	$275,596
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$808,204
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$532,608
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	$788,723
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$515,832
Value of interest in common/collective trusts at end of year	2014-12-31	$19,481
Value of interest in common/collective trusts at beginning of year	2014-12-31	$16,776
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$15,471
Net investment gain/loss from pooled separate accounts	2014-12-31	$17,553
Net investment gain or loss from common/collective trusts	2014-12-31	$2,082
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	Yes
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	$64,085
Employer contributions (assets) at end of year	2014-12-31	$6,330
Employer contributions (assets) at beginning of year	2014-12-31	$12
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$48,152
Contract administrator fees	2014-12-31	$1,700
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	EIDE BAILLY LLP
Accountancy firm EIN	2014-12-31	450250958

Form 5500 Responses for IDEAL REHABILITATION 401(K) PLAN

2016: IDEAL REHABILITATION 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	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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 - Trust	Yes
2015: IDEAL REHABILITATION 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 - Trust	Yes
2014: IDEAL REHABILITATION 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	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 - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

812862

Policy instance

Insurance contract or identification number	812862
Number of Individuals Covered	0
Insurance policy start date	2016-01-01
Insurance policy end date	2016-04-30
Total amount of commissions paid to insurance broker	USD $1,736
Total amount of fees paid to insurance company	USD $172
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 $1,736
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	RECORDKEEPING
Insurance broker organization code?	3
Insurance broker name	SUNWET PENSIONS

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

Policy contract number

812862

Policy instance

Insurance contract or identification number	812862
Number of Individuals Covered	125
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $10,112
Total amount of fees paid to insurance company	USD $477
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 $10,112
Insurance broker organization code?	3
Amount paid for insurance broker fees	477
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker name	SUNWEST PENSIONS

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

Policy contract number

812862

Policy instance

Insurance contract or identification number	812862
Number of Individuals Covered	65
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,642
Total amount of fees paid to insurance company	USD $301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
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
Commission paid to Insurance Broker	USD $4,642
Insurance broker organization code?	3
Amount paid for insurance broker fees	301
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker name	SUNWEST PENSIONS

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Company Name:	IDEAL REHABILITATION, LLC
Employer identification number (EIN):	134304642
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists