401k Plan data: CASTLE SENIOR LIVING 401K PLAN plan

CASTLE SENIOR LIVING 401K PLAN 401k Plan overview

Plan Name	CASTLE SENIOR LIVING 401K PLAN
Plan identification number	001

CASTLE SENIOR LIVING 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.
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

MIDWAY AL LLC DBA CASTLE SENIOR LIVING has sponsored the creation of one or more 401k plans.

Company Name: MIDWAY AL LLC DBA CASTLE SENIOR LIVING

Employer identification number (EIN): 260630878

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASTLE SENIOR LIVING 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 BRUCE OSTERHOUDT 2022-09-07
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01
001 2017-03-01 BRUCE OSTERHOUDT

Plan Statistics for CASTLE SENIOR LIVING 401K PLAN

401k plan membership statisitcs for CASTLE SENIOR LIVING 401K PLAN

Measure Date Value
2020: CASTLE SENIOR LIVING 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 112
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 9
Total of all active and inactive participants 2020-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 122
Number of participants with account balances 2020-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: CASTLE SENIOR LIVING 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 112
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 9
Total of all active and inactive participants 2019-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 122
Number of participants with account balances 2019-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: CASTLE SENIOR LIVING 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 122
Number of retired or separated participants receiving benefits 2018-01-01 4
Number of other retired or separated participants entitled to future benefits 2018-01-01 5
Total of all active and inactive participants 2018-01-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 132
Number of participants with account balances 2018-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 3
2017: CASTLE SENIOR LIVING 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-03-01 120
Total number of active participants reported on line 7a of the Form 5500 2017-03-01 117
Number of retired or separated participants receiving benefits 2017-03-01 0
Number of other retired or separated participants entitled to future benefits 2017-03-01 5
Total of all active and inactive participants 2017-03-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-03-01 1
Total participants 2017-03-01 123
Number of participants with account balances 2017-03-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-03-01 0

Measure	Date	Value
2020: CASTLE SENIOR LIVING 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	112
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	9
Total of all active and inactive participants	2020-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	122
Number of participants with account balances	2020-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: CASTLE SENIOR LIVING 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	112
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	9
Total of all active and inactive participants	2019-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	122
Number of participants with account balances	2019-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: CASTLE SENIOR LIVING 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	122
Number of retired or separated participants receiving benefits	2018-01-01	4
Number of other retired or separated participants entitled to future benefits	2018-01-01	5
Total of all active and inactive participants	2018-01-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	132
Number of participants with account balances	2018-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	3
2017: CASTLE SENIOR LIVING 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-03-01	120
Total number of active participants reported on line 7a of the Form 5500	2017-03-01	117
Number of retired or separated participants receiving benefits	2017-03-01	0
Number of other retired or separated participants entitled to future benefits	2017-03-01	5
Total of all active and inactive participants	2017-03-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-03-01	1
Total participants	2017-03-01	123
Number of participants with account balances	2017-03-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-03-01	0

Financial Data on CASTLE SENIOR LIVING 401K PLAN

Measure	Date	Value
2020 : CASTLE SENIOR LIVING 401K PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$363,945
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$168,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$150,206
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$154,283
Value of total assets at end of year	2020-12-31	$1,582,192
Value of total assets at beginning of year	2020-12-31	$1,387,219
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$18,766
Total interest from all sources	2020-12-31	$7,438
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$545
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$150,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$133,450
Participant contributions at end of year	2020-12-31	$138,729
Participant contributions at beginning of year	2020-12-31	$162,758
Total non interest bearing cash at end of year	2020-12-31	$1,503
Total non interest bearing cash at beginning of year	2020-12-31	$596
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	$194,973
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,582,192
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,387,219
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
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,441,960
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,223,865
Interest on participant loans	2020-12-31	$7,438
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$202,224
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	$20,833
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$150,206
Contract administrator fees	2020-12-31	$18,221
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	Disclaimer
Accountancy firm name	2020-12-31	DAVIS, WARD & HOCHMAN, LLP
Accountancy firm EIN	2020-12-31	200494412
2019 : CASTLE SENIOR LIVING 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$342,082
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$18,186
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,064
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$136,268
Value of total assets at end of year	2019-12-31	$1,387,219
Value of total assets at beginning of year	2019-12-31	$1,063,323
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$16,122
Total interest from all sources	2019-12-31	$7,875
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$15,501
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$150,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$117,994
Participant contributions at end of year	2019-12-31	$162,758
Participant contributions at beginning of year	2019-12-31	$120,056
Total non interest bearing cash at end of year	2019-12-31	$596
Total non interest bearing cash at beginning of year	2019-12-31	$18,476
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	$323,896
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,387,219
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,063,323
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	$211
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,223,865
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$924,791
Income. Interest from loans (other than to participants)	2019-12-31	$7,875
Net investment gain/loss from pooled separate accounts	2019-12-31	$197,939
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	$18,274
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,064
Contract administrator fees	2019-12-31	$410
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	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	DAVIS, WARD & HOCHMAN, LLP
Accountancy firm EIN	2019-12-31	200494412
2018 : CASTLE SENIOR LIVING 401K PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$220,301
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$17,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$3,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$263,686
Value of total assets at end of year	2018-12-31	$1,063,323
Value of total assets at beginning of year	2018-12-31	$860,706
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$13,701
Total interest from all sources	2018-12-31	$4,600
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$13,115
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$150,000
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	$107,299
Participant contributions at end of year	2018-12-31	$120,056
Participant contributions at beginning of year	2018-12-31	$86,080
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$140,670
Total non interest bearing cash at end of year	2018-12-31	$18,476
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$202,617
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,063,323
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$860,706
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	$171
Value of interest in pooled separate accounts at end of year	2018-12-31	$924,791
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$774,626
Interest on participant loans	2018-12-31	$4,600
Net investment gain/loss from pooled separate accounts	2018-12-31	$-47,985
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	Yes
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	$15,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$3,983
Contract administrator fees	2018-12-31	$415
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	2018-12-31	No
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	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	DAVIS, WARD & HOCHMAN, LLP
Accountancy firm EIN	2018-12-31	200494412
2017 : CASTLE SENIOR LIVING 401K PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$935,609
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$74,903
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$65,861
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$886,618
Value of total assets at end of year	2017-12-31	$860,706
Value of total assets at beginning of year	2017-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$9,042
Total interest from all sources	2017-12-31	$1,174
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$8,236
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$25,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$92,835
Participant contributions at end of year	2017-12-31	$86,080
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$779,945
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	$860,706
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$860,706
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$0
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	$86
Value of interest in pooled separate accounts at end of year	2017-12-31	$774,626
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$1,174
Net investment gain/loss from pooled separate accounts	2017-12-31	$47,817
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	Yes
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	$13,838
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$65,861
Contract administrator fees	2017-12-31	$720
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	2017-12-31	No
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	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	DAVIS, WARD & HOCHMAN, LLP
Accountancy firm EIN	2017-12-31	200494412

Form 5500 Responses for CASTLE SENIOR LIVING 401K PLAN

2020: CASTLE SENIOR LIVING 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CASTLE SENIOR LIVING 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CASTLE SENIOR LIVING 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CASTLE SENIOR LIVING 401K PLAN 2017 form 5500 responses
2017-03-01	Type of plan entity	Single employer plan
2017-03-01	First time form 5500 has been submitted	Yes
2017-03-01	Submission has been amended	No
2017-03-01	This submission is the final filing	No
2017-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-03-01	Plan is a collectively bargained plan	No
2017-03-01	Plan funding arrangement – Insurance	Yes
2017-03-01	Plan funding arrangement – Trust	Yes
2017-03-01	Plan benefit arrangement – Insurance	Yes
2017-03-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

801555

Policy instance

Insurance contract or identification number	801555
Number of Individuals Covered	67
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $9,522
Total amount of fees paid to insurance company	USD $1,259
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,522
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

801555

Policy instance

Insurance contract or identification number	801555
Number of Individuals Covered	67
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7,882
Total amount of fees paid to insurance company	USD $1,018
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,882
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

801555

Policy instance

Insurance contract or identification number	801555
Number of Individuals Covered	57
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $6,453
Total amount of fees paid to insurance company	USD $1,379
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,453
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

801555

Policy instance

Insurance contract or identification number	801555
Number of Individuals Covered	58
Insurance policy start date	2017-03-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,626
Total amount of fees paid to insurance company	USD $3,392
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	3392
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5
Insurance broker name	CETERA FINANCIAL SPECIALISTS LLC

Potentially related plans

CASTLE SENIOR LIVING 401(K) RETIREMENT PLAN [EIN = 320255210]

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Company Name:	MIDWAY AL LLC DBA CASTLE SENIOR LIVING
Employer identification number (EIN):	260630878
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01	BRUCE OSTERHOUDT	2022-09-07
001	2020-01-01
001	2019-01-01
001	2019-01-01
001	2018-01-01
001	2017-03-01	BRUCE OSTERHOUDT