401k Plan data: GRACE HEALTHCARE SERVICES, LLC 401K PLAN plan

GRACE HEALTHCARE SERVICES, LLC 401K PLAN 401k Plan overview

Plan Name	GRACE HEALTHCARE SERVICES, LLC 401K PLAN
Plan identification number	001

GRACE HEALTHCARE SERVICES, LLC 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.

401k Sponsoring company profile

GRACE HEALTHCARE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: GRACE HEALTHCARE SERVICES, LLC

Employer identification number (EIN): 203513374

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRACE HEALTHCARE SERVICES, LLC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JILL LEVINE
001 2016-01-01 JILL LEVINE
001 2015-01-01 JILL LEVINE
001 2014-01-01 JILL LEVINE
001 2013-01-01 JILL LEVINE
001 2012-01-01 JILL LEVINE
001 2011-01-01 JILL LEVINE
001 2009-01-01 JILL LEVINE

Plan Statistics for GRACE HEALTHCARE SERVICES, LLC 401K PLAN

401k plan membership statisitcs for GRACE HEALTHCARE SERVICES, LLC 401K PLAN

Measure Date Value
2022: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 412
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 324
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 84
Total of all active and inactive participants 2022-01-01 408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 408
Number of participants with account balances 2022-01-01 237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 16
2021: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 367
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 283
Number of retired or separated participants receiving benefits 2021-01-01 10
Number of other retired or separated participants entitled to future benefits 2021-01-01 64
Total of all active and inactive participants 2021-01-01 357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 357
Number of participants with account balances 2021-01-01 228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 17
2020: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 430
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 296
Number of retired or separated participants receiving benefits 2020-01-01 6
Number of other retired or separated participants entitled to future benefits 2020-01-01 54
Total of all active and inactive participants 2020-01-01 356
Total participants 2020-01-01 356
Number of participants with account balances 2020-01-01 220
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 26
2019: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 429
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 374
Number of retired or separated participants receiving benefits 2019-01-01 3
Number of other retired or separated participants entitled to future benefits 2019-01-01 20
Total of all active and inactive participants 2019-01-01 397
Total participants 2019-01-01 397
Number of participants with account balances 2019-01-01 206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 17
2018: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 397
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 378
Number of retired or separated participants receiving benefits 2018-01-01 9
Number of other retired or separated participants entitled to future benefits 2018-01-01 40
Total of all active and inactive participants 2018-01-01 427
Total participants 2018-01-01 427
Number of participants with account balances 2018-01-01 202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 4
2017: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 377
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 326
Number of other retired or separated participants entitled to future benefits 2017-01-01 50
Total of all active and inactive participants 2017-01-01 376
Total participants 2017-01-01 376
Number of participants with account balances 2017-01-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 7
2016: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 273
Number of other retired or separated participants entitled to future benefits 2016-01-01 33
Total of all active and inactive participants 2016-01-01 306
Total participants 2016-01-01 306
Number of participants with account balances 2016-01-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 12
2015: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 240
Number of other retired or separated participants entitled to future benefits 2015-01-01 42
Total of all active and inactive participants 2015-01-01 282
Total participants 2015-01-01 282
Number of participants with account balances 2015-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 266
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 233
Number of other retired or separated participants entitled to future benefits 2014-01-01 33
Total of all active and inactive participants 2014-01-01 266
Total participants 2014-01-01 266
Number of participants with account balances 2014-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 12
2013: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 220
Number of other retired or separated participants entitled to future benefits 2013-01-01 17
Total of all active and inactive participants 2013-01-01 237
Total participants 2013-01-01 237
Number of participants with account balances 2013-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 197
Number of other retired or separated participants entitled to future benefits 2012-01-01 16
Total of all active and inactive participants 2012-01-01 213
Total participants 2012-01-01 213
Number of participants with account balances 2012-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 7
2011: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 241
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 193
Number of other retired or separated participants entitled to future benefits 2011-01-01 9
Total of all active and inactive participants 2011-01-01 202
Total participants 2011-01-01 202
Number of participants with account balances 2011-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2009: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 165
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 168
Number of participants with account balances 2009-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2022: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	412
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	324
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	84
Total of all active and inactive participants	2022-01-01	408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	408
Number of participants with account balances	2022-01-01	237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	16
2021: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	367
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	283
Number of retired or separated participants receiving benefits	2021-01-01	10
Number of other retired or separated participants entitled to future benefits	2021-01-01	64
Total of all active and inactive participants	2021-01-01	357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	357
Number of participants with account balances	2021-01-01	228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	17
2020: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	430
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	296
Number of retired or separated participants receiving benefits	2020-01-01	6
Number of other retired or separated participants entitled to future benefits	2020-01-01	54
Total of all active and inactive participants	2020-01-01	356
Total participants	2020-01-01	356
Number of participants with account balances	2020-01-01	220
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	26
2019: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	429
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	374
Number of retired or separated participants receiving benefits	2019-01-01	3
Number of other retired or separated participants entitled to future benefits	2019-01-01	20
Total of all active and inactive participants	2019-01-01	397
Total participants	2019-01-01	397
Number of participants with account balances	2019-01-01	206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	17
2018: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	397
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	378
Number of retired or separated participants receiving benefits	2018-01-01	9
Number of other retired or separated participants entitled to future benefits	2018-01-01	40
Total of all active and inactive participants	2018-01-01	427
Total participants	2018-01-01	427
Number of participants with account balances	2018-01-01	202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	4
2017: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	377
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	326
Number of other retired or separated participants entitled to future benefits	2017-01-01	50
Total of all active and inactive participants	2017-01-01	376
Total participants	2017-01-01	376
Number of participants with account balances	2017-01-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	7
2016: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	273
Number of other retired or separated participants entitled to future benefits	2016-01-01	33
Total of all active and inactive participants	2016-01-01	306
Total participants	2016-01-01	306
Number of participants with account balances	2016-01-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	12
2015: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	240
Number of other retired or separated participants entitled to future benefits	2015-01-01	42
Total of all active and inactive participants	2015-01-01	282
Total participants	2015-01-01	282
Number of participants with account balances	2015-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	266
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	233
Number of other retired or separated participants entitled to future benefits	2014-01-01	33
Total of all active and inactive participants	2014-01-01	266
Total participants	2014-01-01	266
Number of participants with account balances	2014-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	12
2013: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	220
Number of other retired or separated participants entitled to future benefits	2013-01-01	17
Total of all active and inactive participants	2013-01-01	237
Total participants	2013-01-01	237
Number of participants with account balances	2013-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	197
Number of other retired or separated participants entitled to future benefits	2012-01-01	16
Total of all active and inactive participants	2012-01-01	213
Total participants	2012-01-01	213
Number of participants with account balances	2012-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	7
2011: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	241
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	193
Number of other retired or separated participants entitled to future benefits	2011-01-01	9
Total of all active and inactive participants	2011-01-01	202
Total participants	2011-01-01	202
Number of participants with account balances	2011-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2009: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	165
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	168
Number of participants with account balances	2009-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on GRACE HEALTHCARE SERVICES, LLC 401K PLAN

Measure	Date	Value
2022 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-125,690
Total of all expenses incurred	2022-12-31	$475,827
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$465,091
Expenses. Certain deemed distributions of participant loans	2022-12-31	$10,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$818,347
Value of total assets at end of year	2022-12-31	$4,803,801
Value of total assets at beginning of year	2022-12-31	$5,405,318
Total interest from all sources	2022-12-31	$4,482
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$509,873
Participant contributions at end of year	2022-12-31	$112,719
Participant contributions at beginning of year	2022-12-31	$45,816
Participant contributions at end of year	2022-12-31	$20,052
Participant contributions at beginning of year	2022-12-31	$18,105
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$100,636
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$31
Total non interest bearing cash at beginning of year	2022-12-31	$79
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-601,517
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,803,801
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,405,318
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,103,923
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,104,715
Interest on participant loans	2022-12-31	$4,482
Value of interest in common/collective trusts at end of year	2022-12-31	$2,332,946
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$26,292
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$33,836
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-948,519
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$207,838
Employer contributions (assets) at end of year	2022-12-31	$207,838
Employer contributions (assets) at beginning of year	2022-12-31	$202,767
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$465,091
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	SCHULTHEIS & PANETTIERI, LLP
Accountancy firm EIN	2022-12-31	131577780
2021 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$1,353,162
Total of all expenses incurred	2021-12-31	$482,887
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$451,328
Expenses. Certain deemed distributions of participant loans	2021-12-31	$8,161
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$798,091
Value of total assets at end of year	2021-12-31	$5,405,318
Value of total assets at beginning of year	2021-12-31	$4,535,043
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$23,398
Total interest from all sources	2021-12-31	$2,895
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$496,374
Participant contributions at end of year	2021-12-31	$45,816
Participant contributions at beginning of year	2021-12-31	$68,102
Participant contributions at end of year	2021-12-31	$18,105
Participant contributions at beginning of year	2021-12-31	$17,307
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$98,950
Total non interest bearing cash at end of year	2021-12-31	$79
Total non interest bearing cash at beginning of year	2021-12-31	$136
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$870,275
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,405,318
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,535,043
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$23,398
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,104,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,186,082
Interest on participant loans	2021-12-31	$2,895
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$33,836
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$39,485
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$552,176
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$202,767
Employer contributions (assets) at end of year	2021-12-31	$202,767
Employer contributions (assets) at beginning of year	2021-12-31	$223,931
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$451,328
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	SCHULTHEIS@PANETTIERI, LLP
Accountancy firm EIN	2021-12-31	131577780
2020 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,389,178
Total of all expenses incurred	2020-12-31	$334,168
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$315,987
Expenses. Certain deemed distributions of participant loans	2020-12-31	$3,216
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$756,384
Value of total assets at end of year	2020-12-31	$4,535,043
Value of total assets at beginning of year	2020-12-31	$3,480,033
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,965
Total interest from all sources	2020-12-31	$3,711
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$499,070
Participant contributions at end of year	2020-12-31	$68,102
Participant contributions at beginning of year	2020-12-31	$64,102
Participant contributions at end of year	2020-12-31	$17,307
Participant contributions at beginning of year	2020-12-31	$19,306
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$33,383
Total non interest bearing cash at end of year	2020-12-31	$136
Total non interest bearing cash at beginning of year	2020-12-31	$180
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,055,010
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,535,043
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,480,033
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$14,965
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,186,082
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,134,065
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$3,711
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$39,485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$65,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$629,083
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$223,931
Employer contributions (assets) at end of year	2020-12-31	$223,931
Employer contributions (assets) at beginning of year	2020-12-31	$196,770
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$315,987
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	SCHULTHEIS@PANETTIERI, LLP
Accountancy firm EIN	2020-12-31	131577780
2019 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$1,204,249
Total of all expenses incurred	2019-12-31	$429,877
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$422,182
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$697,769
Value of total assets at end of year	2019-12-31	$3,480,033
Value of total assets at beginning of year	2019-12-31	$2,705,661
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,622
Total interest from all sources	2019-12-31	$2,521
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$275,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$478,701
Participant contributions at end of year	2019-12-31	$64,102
Participant contributions at beginning of year	2019-12-31	$37,717
Participant contributions at end of year	2019-12-31	$19,306
Participant contributions at beginning of year	2019-12-31	$157
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$22,298
Total non interest bearing cash at end of year	2019-12-31	$180
Total non interest bearing cash at beginning of year	2019-12-31	$224
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$774,372
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,480,033
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,705,661
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$5,622
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,134,065
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$2,408,181
Interest on participant loans	2019-12-31	$2,521
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$65,610
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$96,065
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$65,439
Net investment gain/loss from pooled separate accounts	2019-12-31	$438,520
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$196,770
Employer contributions (assets) at end of year	2019-12-31	$196,770
Employer contributions (assets) at beginning of year	2019-12-31	$163,317
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$422,182
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	SCHULTHEIS& PANETTIERI, LLP
Accountancy firm EIN	2019-12-31	131577780
2018 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$363,887
Total of all expenses incurred	2018-12-31	$85,554
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$76,645
Expenses. Certain deemed distributions of participant loans	2018-12-31	$6,193
Value of total corrective distributions	2018-12-31	$115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$494,946
Value of total assets at end of year	2018-12-31	$2,705,661
Value of total assets at beginning of year	2018-12-31	$2,427,328
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,601
Total interest from all sources	2018-12-31	$1,929
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$275,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$322,216
Participant contributions at end of year	2018-12-31	$37,717
Participant contributions at beginning of year	2018-12-31	$40,821
Participant contributions at end of year	2018-12-31	$157
Participant contributions at beginning of year	2018-12-31	$9,538
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$9,413
Total non interest bearing cash at end of year	2018-12-31	$224
Total non interest bearing cash at beginning of year	2018-12-31	$292
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$278,333
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,705,661
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,427,328
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$2,601
Value of interest in pooled separate accounts at end of year	2018-12-31	$2,408,181
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$2,175,789
Interest on participant loans	2018-12-31	$1,929
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$96,065
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$82,702
Net investment gain/loss from pooled separate accounts	2018-12-31	$-132,988
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$163,317
Employer contributions (assets) at end of year	2018-12-31	$163,317
Employer contributions (assets) at beginning of year	2018-12-31	$118,186
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$76,645
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	SCHULTHEIS & PANATTIERI, LLP
Accountancy firm EIN	2018-12-31	131577780
2017 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$649,554
Total of all expenses incurred	2017-12-31	$113,424
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$108,515
Expenses. Certain deemed distributions of participant loans	2017-12-31	$2,518
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$370,283
Value of total assets at end of year	2017-12-31	$2,427,328
Value of total assets at beginning of year	2017-12-31	$1,891,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,391
Total interest from all sources	2017-12-31	$1,522
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$275,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$248,489
Participant contributions at end of year	2017-12-31	$40,821
Participant contributions at beginning of year	2017-12-31	$31,386
Participant contributions at end of year	2017-12-31	$9,538
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$3,608
Total non interest bearing cash at end of year	2017-12-31	$292
Total non interest bearing cash at beginning of year	2017-12-31	$384
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$536,130
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,427,328
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,891,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$2,391
Value of interest in pooled separate accounts at end of year	2017-12-31	$2,175,789
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,676,565
Interest on participant loans	2017-12-31	$1,522
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$82,702
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$77,599
Net investment gain/loss from pooled separate accounts	2017-12-31	$277,749
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$118,186
Employer contributions (assets) at end of year	2017-12-31	$118,186
Employer contributions (assets) at beginning of year	2017-12-31	$105,264
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$108,515
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	SCHULTHEIS & PANETTIERI, LLP
Accountancy firm EIN	2017-12-31	131577780
2016 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$425,248
Total of all expenses incurred	2016-12-31	$139,525
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$134,261
Expenses. Certain deemed distributions of participant loans	2016-12-31	$2,911
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$339,125
Value of total assets at end of year	2016-12-31	$1,891,198
Value of total assets at beginning of year	2016-12-31	$1,605,475
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,353
Total interest from all sources	2016-12-31	$1,440
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$180,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$232,885
Participant contributions at end of year	2016-12-31	$31,386
Participant contributions at beginning of year	2016-12-31	$39,625
Participant contributions at beginning of year	2016-12-31	$7,383
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$976
Total non interest bearing cash at end of year	2016-12-31	$384
Total non interest bearing cash at beginning of year	2016-12-31	$428
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	$285,723
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,891,198
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,605,475
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
Investment advisory and management fees	2016-12-31	$2,353
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,676,565
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,407,249
Interest on participant loans	2016-12-31	$1,440
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$77,599
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$44,664
Net investment gain/loss from pooled separate accounts	2016-12-31	$84,683
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	$105,264
Employer contributions (assets) at end of year	2016-12-31	$105,264
Employer contributions (assets) at beginning of year	2016-12-31	$106,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$134,261
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	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	SCHULTHEIS & PANETTIERI, LLP
Accountancy firm EIN	2016-12-31	131577780
2015 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$274,889
Total of all expenses incurred	2015-12-31	$191,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$186,540
Expenses. Certain deemed distributions of participant loans	2015-12-31	$2,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$279,613
Value of total assets at end of year	2015-12-31	$1,605,475
Value of total assets at beginning of year	2015-12-31	$1,522,224
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,831
Total interest from all sources	2015-12-31	$796
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	$180,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$215,487
Participant contributions at end of year	2015-12-31	$39,625
Participant contributions at beginning of year	2015-12-31	$13,633
Participant contributions at end of year	2015-12-31	$7,383
Total non interest bearing cash at end of year	2015-12-31	$428
Total non interest bearing cash at beginning of year	2015-12-31	$492
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	$83,251
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,605,475
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,522,224
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
Investment advisory and management fees	2015-12-31	$2,831
Value of interest in pooled separate accounts at end of year	2015-12-31	$1,407,249
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,357,736
Interest on participant loans	2015-12-31	$796
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$44,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$67,519
Net investment gain/loss from pooled separate accounts	2015-12-31	$-5,520
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	$64,126
Employer contributions (assets) at end of year	2015-12-31	$106,126
Employer contributions (assets) at beginning of year	2015-12-31	$82,844
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$186,540
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	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	SCHULTHEIS & PANETTIERI, LLP
Accountancy firm EIN	2015-12-31	131577780
2014 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$340,672
Total of all expenses incurred	2014-12-31	$161,872
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$138,418
Expenses. Certain deemed distributions of participant loans	2014-12-31	$23,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$282,262
Value of total assets at end of year	2014-12-31	$1,522,224
Value of total assets at beginning of year	2014-12-31	$1,343,424
Total interest from all sources	2014-12-31	$501
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	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$192,161
Participant contributions at end of year	2014-12-31	$13,633
Participant contributions at beginning of year	2014-12-31	$12,428
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$1,247,400
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$7,257
Total non interest bearing cash at end of year	2014-12-31	$492
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	$178,800
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,522,224
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,343,424
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 pooled separate accounts at end of year	2014-12-31	$1,357,736
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$501
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$67,519
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$57,909
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	$82,844
Employer contributions (assets) at end of year	2014-12-31	$82,844
Employer contributions (assets) at beginning of year	2014-12-31	$83,596
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$138,418
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	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	SCHULTHEIS & PANETTIERI, LLP
Accountancy firm EIN	2014-12-31	131577780
2013 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$435,026
Total of all expenses incurred	2013-12-31	$70,606
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$69,653
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$298,244
Value of total assets at end of year	2013-12-31	$1,343,424
Value of total assets at beginning of year	2013-12-31	$979,004
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$953
Total interest from all sources	2013-12-31	$655
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$150,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$208,365
Participant contributions at end of year	2013-12-31	$12,428
Participant contributions at beginning of year	2013-12-31	$16,848
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$1,247,400
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$6,283
Other income not declared elsewhere	2013-12-31	$1,418
Administrative expenses (other) incurred	2013-12-31	$179
Total non interest bearing cash at beginning of year	2013-12-31	$500
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	$364,420
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,343,424
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$979,004
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
Interest on participant loans	2013-12-31	$655
Value of interest in common/collective trusts at beginning of year	2013-12-31	$888,067
Net gain/loss from 103.12 investment entities	2013-12-31	$134,709
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	$83,596
Employer contributions (assets) at end of year	2013-12-31	$83,596
Employer contributions (assets) at beginning of year	2013-12-31	$73,589
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$69,653
Contract administrator fees	2013-12-31	$774
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	Yes
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	SPIRE GROUP, PC
Accountancy firm EIN	2013-12-31	455221053
2012 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$344,941
Total of all expenses incurred	2012-12-31	$51,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$50,919
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$273,667
Value of total assets at end of year	2012-12-31	$979,004
Value of total assets at beginning of year	2012-12-31	$685,148
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$166
Total interest from all sources	2012-12-31	$526
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$56
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
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	$198,731
Participant contributions at end of year	2012-12-31	$16,848
Participant contributions at beginning of year	2012-12-31	$10,703
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,347
Administrative expenses (other) incurred	2012-12-31	$110
Total non interest bearing cash at end of year	2012-12-31	$500
Total non interest bearing cash at beginning of year	2012-12-31	$500
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	$293,856
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$979,004
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$685,148
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
Interest on participant loans	2012-12-31	$526
Value of interest in common/collective trusts at end of year	2012-12-31	$888,067
Value of interest in common/collective trusts at beginning of year	2012-12-31	$604,215
Net investment gain or loss from common/collective trusts	2012-12-31	$70,748
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	$73,589
Employer contributions (assets) at end of year	2012-12-31	$73,589
Employer contributions (assets) at beginning of year	2012-12-31	$69,730
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$50,919
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	SPIRE GROUP, PC
Accountancy firm EIN	2012-12-31	455221053
2011 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$230,450
Total of all expenses incurred	2011-12-31	$16,983
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$16,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$250,809
Value of total assets at end of year	2011-12-31	$685,148
Value of total assets at beginning of year	2011-12-31	$471,681
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$115
Total interest from all sources	2011-12-31	$336
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	$250,000
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	$177,023
Participant contributions at end of year	2011-12-31	$10,703
Participant contributions at beginning of year	2011-12-31	$857
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$4,056
Total non interest bearing cash at end of year	2011-12-31	$500
Total non interest bearing cash at beginning of year	2011-12-31	$500
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	$213,467
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$685,148
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$471,681
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
Investment advisory and management fees	2011-12-31	$115
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$384,242
Interest on participant loans	2011-12-31	$336
Value of interest in common/collective trusts at end of year	2011-12-31	$604,215
Value of interest in common/collective trusts at beginning of year	2011-12-31	$30,177
Net investment gain/loss from pooled separate accounts	2011-12-31	$-20,695
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	$69,730
Employer contributions (assets) at end of year	2011-12-31	$69,730
Employer contributions (assets) at beginning of year	2011-12-31	$55,905
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$16,983
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	SPIRE GROUP PC
Accountancy firm EIN	2011-12-31	455221053
2010 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2010 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$412
Total income from all sources (including contributions)	2010-12-31	$227,477
Total of all expenses incurred	2010-12-31	$25,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$25,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$199,851
Value of total assets at end of year	2010-12-31	$471,681
Value of total assets at beginning of year	2010-12-31	$270,082
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$12
Total interest from all sources	2010-12-31	$31
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	Yes
Value of fidelity bond cover	2010-12-31	$250,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$143,503
Participant contributions at end of year	2010-12-31	$857
Participant contributions at beginning of year	2010-12-31	$830
Other income not declared elsewhere	2010-12-31	$616
Administrative expenses (other) incurred	2010-12-31	$12
Total non interest bearing cash at end of year	2010-12-31	$500
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	$202,011
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$471,681
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$269,670
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	$384,242
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$222,800
Interest on participant loans	2010-12-31	$31
Value of interest in common/collective trusts at end of year	2010-12-31	$30,177
Value of interest in common/collective trusts at beginning of year	2010-12-31	$18,642
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$27,225
Net investment gain or loss from common/collective trusts	2010-12-31	$-246
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	$56,348
Employer contributions (assets) at end of year	2010-12-31	$55,905
Employer contributions (assets) at beginning of year	2010-12-31	$27,810
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$25,454
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$412
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	CARR, DALEY, SULLIVAN & WEIR PC
Accountancy firm EIN	2010-12-31	223021956
2009 : GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for GRACE HEALTHCARE SERVICES, LLC 401K PLAN

2022: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: GRACE HEALTHCARE SERVICES, LLC 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

35080757

Policy instance

Insurance contract or identification number	35080757
Number of Individuals Covered	260
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

35080757

Policy instance

Insurance contract or identification number	35080757
Number of Individuals Covered	228
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

35080757

Policy instance

Insurance contract or identification number	35080757
Number of Individuals Covered	220
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

35080757

Policy instance

Insurance contract or identification number	35080757
Number of Individuals Covered	205
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $8,377
Total amount of fees paid to insurance company	USD $1,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,377
Insurance broker organization code?	3
Amount paid for insurance broker fees	1326

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $7,148
Total amount of fees paid to insurance company	USD $1,239
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,148
Insurance broker organization code?	3
Amount paid for insurance broker fees	1239

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,847
Total amount of fees paid to insurance company	USD $1,011
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,055
Insurance broker organization code?	3
Amount paid for insurance broker fees	1011
Insurance broker name	UBS FINANCIAL SERVICES INS AGENCY

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,221
Total amount of fees paid to insurance company	USD $638
Commission paid to Insurance Broker	USD $4,221
Insurance broker organization code?	3
Amount paid for insurance broker fees	638
Insurance broker name	INTAC ACTUARIAL SERVICES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Number of Individuals Covered	115
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,780
Total amount of fees paid to insurance company	USD $2,002
Commission paid to Insurance Broker	USD $3,780
Insurance broker organization code?	3
Amount paid for insurance broker fees	2002
Insurance broker name	INTAC ACTUARIAL SERVICES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

804706

Policy instance

Insurance contract or identification number	804706
Number of Individuals Covered	85
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11,232
Commission paid to Insurance Broker	USD $11,232
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES INS. AGENCY

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

Policy contract number

GA-801442

Policy instance

Insurance contract or identification number	GA-801442
Number of Individuals Covered	54
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,102
Total amount of fees paid to insurance company	USD $344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,102
Insurance broker organization code?	3
Amount paid for insurance broker fees	344
Insurance broker name	INTAC ACTUARIAL SERVICES, INC.

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

Policy contract number

GA-801442

Policy instance

Insurance contract or identification number	GA-801442
Number of Individuals Covered	54
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,078
Total amount of fees paid to insurance company	USD $237
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

GA-801442

Policy instance

Insurance contract or identification number	GA-801442
Number of Individuals Covered	49
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	GRACE HEALTHCARE SERVICES, LLC
Employer identification number (EIN):	203513374
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities