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JEWISH SENIOR LIFE WRAP BENEFIT PLAN 401k Plan overview

Plan NameJEWISH SENIOR LIFE WRAP BENEFIT PLAN
Plan identification number 502

JEWISH SENIOR LIFE WRAP BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

JEWISH SENIOR LIFE has sponsored the creation of one or more 401k plans.

Company Name:JEWISH SENIOR LIFE
Employer identification number (EIN):160743058
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about JEWISH SENIOR LIFE

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1920-03-15
Company Identification Number: 15667
Legal Registered Office Address: 2021 WINTON ROAD SOUTH
Monroe
ROCHESTER
United States of America (USA)
14618

More information about JEWISH SENIOR LIFE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JEWISH SENIOR LIFE WRAP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01KIM OLIVER2024-07-23
5022022-01-01KIM OLIVER2024-04-30
5022021-01-01KIM OLIVER2024-04-30
5022020-01-01KIM OLIVER2024-04-30
5022019-01-01ERIN REECE2020-09-08
5022018-01-01ERIN REECE2018-07-29
5022017-01-01
5022016-01-01
5022015-01-01
5022014-01-01ERIN REECE
5022013-01-01ERIN REECE
5022012-01-01ERIN REECE

Plan Statistics for JEWISH SENIOR LIFE WRAP BENEFIT PLAN

401k plan membership statisitcs for JEWISH SENIOR LIFE WRAP BENEFIT PLAN

Measure Date Value
2023: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01195
Total number of active participants reported on line 7a of the Form 55002023-01-01195
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01195
Number of employers contributing to the scheme2023-01-010
2022: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01182
Total number of active participants reported on line 7a of the Form 55002022-01-01195
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01195
Number of employers contributing to the scheme2022-01-010
2021: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01200
Total number of active participants reported on line 7a of the Form 55002021-01-01182
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01182
Number of employers contributing to the scheme2021-01-010
2020: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01535
Total number of active participants reported on line 7a of the Form 55002020-01-01200
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01200
Number of employers contributing to the scheme2020-01-010
2019: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01520
Total number of active participants reported on line 7a of the Form 55002019-01-01529
Number of retired or separated participants receiving benefits2019-01-016
Total of all active and inactive participants2019-01-01535
2018: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01544
Total number of active participants reported on line 7a of the Form 55002018-01-01508
Number of retired or separated participants receiving benefits2018-01-018
Total of all active and inactive participants2018-01-01516
2017: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01527
Total number of active participants reported on line 7a of the Form 55002017-01-01522
Total of all active and inactive participants2017-01-01522
2016: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01536
Total number of active participants reported on line 7a of the Form 55002016-01-01520
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01520
2015: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01419
Total number of active participants reported on line 7a of the Form 55002015-01-01472
Number of retired or separated participants receiving benefits2015-01-019
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01481
Total participants2015-01-01481
2014: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01489
Total number of active participants reported on line 7a of the Form 55002014-01-01463
Number of retired or separated participants receiving benefits2014-01-0112
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01475
Total participants2014-01-01475
2013: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01470
Total number of active participants reported on line 7a of the Form 55002013-01-01463
Number of retired or separated participants receiving benefits2013-01-0112
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01475
Total participants2013-01-01475
2012: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01441
Total number of active participants reported on line 7a of the Form 55002012-01-01443
Number of retired or separated participants receiving benefits2012-01-0112
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01455
Total participants2012-01-01455

Form 5500 Responses for JEWISH SENIOR LIFE WRAP BENEFIT PLAN

2023: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: JEWISH SENIOR LIFE WRAP BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberVDY0003007
Policy instance 4
Insurance contract or identification numberVDY0003007
Number of Individuals Covered195
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $3,408
Total amount of fees paid to insurance companyUSD $551
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
METROPOLITAN GENERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 39950 )
Policy contract number6500010
Policy instance 3
Insurance contract or identification number6500010
Number of Individuals Covered34
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $996
Total amount of fees paid to insurance companyUSD $74
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $9,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number163748
Policy instance 2
Insurance contract or identification number163748
Number of Individuals Covered459
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,752
Total amount of fees paid to insurance companyUSD $1,001
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $67,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number98455611001
Policy instance 1
Insurance contract or identification number98455611001
Number of Individuals Covered275
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $761
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberLTD128379
Policy instance 5
Insurance contract or identification numberLTD128379
Number of Individuals Covered29
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,123
Total amount of fees paid to insurance companyUSD $1,896
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $21,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberLTD128379
Policy instance 3
Insurance contract or identification numberLTD128379
Number of Individuals Covered27
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,368
Total amount of fees paid to insurance companyUSD $1,550
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $13,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,368
Amount paid for insurance broker fees1550
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number163748
Policy instance 2
Insurance contract or identification number163748
Number of Individuals Covered459
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,432
Total amount of fees paid to insurance companyUSD $1,175
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,432
Amount paid for insurance broker fees1171
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION, SUPPPLEMENTAL COMPENSATION
Insurance broker organization code?3
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number98455611001
Policy instance 1
Insurance contract or identification number98455611001
Number of Individuals Covered243
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $936
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $936
Amount paid for insurance broker fees0
Insurance broker organization code?3
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number98455611001
Policy instance 1
Insurance contract or identification number98455611001
Number of Individuals Covered296
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,872
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,872
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number163748
Policy instance 2
Insurance contract or identification number163748
Number of Individuals Covered427
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,563
Total amount of fees paid to insurance companyUSD $1,031
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $60,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,563
Amount paid for insurance broker fees1029
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberLTD128379
Policy instance 3
Insurance contract or identification numberLTD128379
Number of Individuals Covered39
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,975
Total amount of fees paid to insurance companyUSD $1,879
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $19,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,975
Amount paid for insurance broker fees1879
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 78697 )
Policy contract number98455611001
Policy instance 1
Insurance contract or identification number98455611001
Number of Individuals Covered291
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,301
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number163748
Policy instance 2
Insurance contract or identification number163748
Number of Individuals Covered470
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,352
Total amount of fees paid to insurance companyUSD $996
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $62,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberLTD128379
Policy instance 3
Insurance contract or identification numberLTD128379
Number of Individuals Covered26
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,655
Total amount of fees paid to insurance companyUSD $1,695
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $16,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0163748
Policy instance 1
Insurance contract or identification number0163748
Number of Individuals Covered540
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,284
Total amount of fees paid to insurance companyUSD $849
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $63,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,284
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0163748
Policy instance 1
Insurance contract or identification number0163748
Number of Individuals Covered545
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,918
Total amount of fees paid to insurance companyUSD $844
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $60,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,918
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0163748
Policy instance 1
Insurance contract or identification number0163748
Number of Individuals Covered545
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,460
Total amount of fees paid to insurance companyUSD $935
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $54,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,460
Amount paid for insurance broker fees64
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC

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