401k Plan data: ICARE SERVICES 401(K) PLAN plan

ICARE SERVICES 401(K) PLAN 401k Plan overview

Plan Name	ICARE SERVICES 401(K) PLAN
Plan identification number	001

ICARE SERVICES 401(K) 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ICARE FINANCIAL SERVICES has sponsored the creation of one or more 401k plans.

Company Name: ICARE FINANCIAL SERVICES

Employer identification number (EIN): 272323090

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ICARE SERVICES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 KEVIN CHANKIN 2023-10-12
001 2021-01-01 KEVIN CHANKIN 2022-10-07
001 2020-01-01 KEVIN CHANKIN 2021-10-07
001 2019-01-01 KEVIN CHANKIN 2020-10-15
001 2019-01-01 KEVIN CHANKIN 2021-01-18
001 2018-01-01 KEVIN CHANKIN 2019-10-07
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 KEVIN CHANKIN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	KEVIN CHANKIN	2023-10-12
001	2021-01-01	KEVIN CHANKIN	2022-10-07
001	2020-01-01	KEVIN CHANKIN	2021-10-07
001	2019-01-01	KEVIN CHANKIN	2020-10-15
001	2019-01-01	KEVIN CHANKIN	2021-01-18
001	2018-01-01	KEVIN CHANKIN	2019-10-07
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	KEVIN CHANKIN

Plan Statistics for ICARE SERVICES 401(K) PLAN

401k plan membership statisitcs for ICARE SERVICES 401(K) PLAN

Measure Date Value
2022: ICARE SERVICES 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 613
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 786
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 22
Total of all active and inactive participants 2022-01-01 808
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 808
Number of participants with account balances 2022-01-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: ICARE SERVICES 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 543
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 497
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 16
Total of all active and inactive participants 2021-01-01 513
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 513
Number of participants with account balances 2021-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 9
2020: ICARE SERVICES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 696
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 527
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 16
Total of all active and inactive participants 2020-01-01 543
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 543
Number of participants with account balances 2020-01-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 25
2019: ICARE SERVICES 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 583
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 683
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 13
Total of all active and inactive participants 2019-01-01 696
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 696
Number of participants with account balances 2019-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 29
2018: ICARE SERVICES 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 683
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 570
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 13
Total of all active and inactive participants 2018-01-01 583
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 583
Number of participants with account balances 2018-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 5
2017: ICARE SERVICES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,089
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 597
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 599
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 599
Number of participants with account balances 2017-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 8
2016: ICARE SERVICES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,033
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 26
Total of all active and inactive participants 2016-01-01 1,059
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1,059
Number of participants with account balances 2016-01-01 96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 10
2015: ICARE SERVICES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,065
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,144
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 29
Total of all active and inactive participants 2015-01-01 1,173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1,173
Number of participants with account balances 2015-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 9
2014: ICARE SERVICES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 548
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 470
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 7
Total of all active and inactive participants 2014-01-01 477
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 477
Number of participants with account balances 2014-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7

Measure	Date	Value
2022: ICARE SERVICES 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	613
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	786
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	22
Total of all active and inactive participants	2022-01-01	808
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	808
Number of participants with account balances	2022-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: ICARE SERVICES 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	543
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	497
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	16
Total of all active and inactive participants	2021-01-01	513
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	513
Number of participants with account balances	2021-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	9
2020: ICARE SERVICES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	696
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	527
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	16
Total of all active and inactive participants	2020-01-01	543
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	543
Number of participants with account balances	2020-01-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	25
2019: ICARE SERVICES 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	583
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	683
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	13
Total of all active and inactive participants	2019-01-01	696
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	696
Number of participants with account balances	2019-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	29
2018: ICARE SERVICES 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	683
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	570
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	13
Total of all active and inactive participants	2018-01-01	583
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	583
Number of participants with account balances	2018-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	5
2017: ICARE SERVICES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,089
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	597
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	599
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	599
Number of participants with account balances	2017-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	8
2016: ICARE SERVICES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,033
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	26
Total of all active and inactive participants	2016-01-01	1,059
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,059
Number of participants with account balances	2016-01-01	96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	10
2015: ICARE SERVICES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,065
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,144
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	29
Total of all active and inactive participants	2015-01-01	1,173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,173
Number of participants with account balances	2015-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	9
2014: ICARE SERVICES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	548
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	470
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	7
Total of all active and inactive participants	2014-01-01	477
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	477
Number of participants with account balances	2014-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7

Financial Data on ICARE SERVICES 401(K) PLAN

Measure	Date	Value
2022 : ICARE SERVICES 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$581
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$2,182
Total income from all sources (including contributions)	2022-12-31	$64,171
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$197,040
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$171,999
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$417,856
Value of total assets at end of year	2022-12-31	$2,129,523
Value of total assets at beginning of year	2022-12-31	$2,263,993
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$25,041
Total interest from all sources	2022-12-31	$1,471
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$9,996
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	$9,996
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	$354,124
Participant contributions at end of year	2022-12-31	$38,110
Participant contributions at beginning of year	2022-12-31	$38,613
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$80
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$18,044
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$581
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$2,182
Other income not declared elsewhere	2022-12-31	$373
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$1,810
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	$-132,869
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,128,942
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,261,811
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	$198,273
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$308,650
Interest on participant loans	2022-12-31	$1,471
Value of interest in common/collective trusts at end of year	2022-12-31	$1,804,238
Value of interest in common/collective trusts at beginning of year	2022-12-31	$1,835,945
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$43,586
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$38,323
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-48,545
Net investment gain or loss from common/collective trusts	2022-12-31	$-316,980
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	$45,688
Employer contributions (assets) at end of year	2022-12-31	$45,316
Employer contributions (assets) at beginning of year	2022-12-31	$40,572
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$171,999
Contract administrator fees	2022-12-31	$25,041
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	CRAY, KAISER LTD.
Accountancy firm EIN	2022-12-31	362746886
2021 : ICARE SERVICES 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$2,182
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$774,892
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$102,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$73,130
Expenses. Certain deemed distributions of participant loans	2021-12-31	$3,600
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$543,991
Value of total assets at end of year	2021-12-31	$2,263,993
Value of total assets at beginning of year	2021-12-31	$1,589,401
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$25,752
Total interest from all sources	2021-12-31	$1,827
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$15,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$15,601
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$279,861
Participant contributions at end of year	2021-12-31	$38,613
Participant contributions at beginning of year	2021-12-31	$36,707
Participant contributions at end of year	2021-12-31	$80
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$223,930
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$2,182
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$319
Total non interest bearing cash at end of year	2021-12-31	$1,810
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$672,410
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,261,811
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,589,401
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$308,650
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$192,536
Interest on participant loans	2021-12-31	$1,827
Value of interest in common/collective trusts at end of year	2021-12-31	$1,835,945
Value of interest in common/collective trusts at beginning of year	2021-12-31	$1,289,712
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$38,323
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$34,058
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$20,990
Net investment gain or loss from common/collective trusts	2021-12-31	$192,164
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	Yes
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	$40,200
Employer contributions (assets) at end of year	2021-12-31	$40,572
Employer contributions (assets) at beginning of year	2021-12-31	$36,388
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$73,130
Contract administrator fees	2021-12-31	$25,752
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	CRAY, KAISER LTD.
Accountancy firm EIN	2021-12-31	362746886
2020 : ICARE SERVICES 401(K) 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	$461,815
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$102,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$84,814
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$284,533
Value of total assets at end of year	2020-12-31	$1,589,401
Value of total assets at beginning of year	2020-12-31	$1,229,797
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$17,397
Total interest from all sources	2020-12-31	$1,853
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$3,469
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$3,469
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
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	$245,592
Participant contributions at end of year	2020-12-31	$36,707
Participant contributions at beginning of year	2020-12-31	$27,652
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$635
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$2,668
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$359,604
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,589,401
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,229,797
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 registered invesment companies (eg mutual funds) at end of year	2020-12-31	$192,536
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,392
Interest on participant loans	2020-12-31	$1,520
Interest earned on other investments	2020-12-31	$333
Value of interest in common/collective trusts at end of year	2020-12-31	$1,289,712
Value of interest in common/collective trusts at beginning of year	2020-12-31	$1,134,475
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$34,058
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$30,693
Net investment gain or loss from common/collective trusts	2020-12-31	$171,960
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	$36,273
Employer contributions (assets) at end of year	2020-12-31	$36,388
Employer contributions (assets) at beginning of year	2020-12-31	$34,950
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$84,814
Contract administrator fees	2020-12-31	$17,397
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	CRAY, KAISER LTD.
Accountancy firm EIN	2020-12-31	362746886
2019 : ICARE SERVICES 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$218,017
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	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 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	$406,331
Total income from all sources (including contributions)	2019-12-31	$406,331
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$261,857
Total of all expenses incurred	2019-12-31	$261,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$241,936
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$241,936
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,926
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,926
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$232,604
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$232,604
Value of total assets at end of year	2019-12-31	$1,194,212
Value of total assets at end of year	2019-12-31	$1,194,212
Value of total assets at beginning of year	2019-12-31	$1,049,738
Value of total assets at beginning of year	2019-12-31	$1,049,738
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$16,995
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$16,995
Total interest from all sources	2019-12-31	$1,899
Total interest from all sources	2019-12-31	$1,899
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$472
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$472
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$472
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$472
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$205,795
Contributions received from participants	2019-12-31	$205,795
Participant contributions at end of year	2019-12-31	$27,652
Participant contributions at end of year	2019-12-31	$27,652
Participant contributions at beginning of year	2019-12-31	$46,121
Participant contributions at beginning of year	2019-12-31	$46,121
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$26,809
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$26,809
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$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	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$144,474
Value of net income/loss	2019-12-31	$144,474
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,194,212
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,194,212
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,049,738
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,049,738
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,395
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$140,174
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$140,174
Interest on participant loans	2019-12-31	$1,899
Interest on participant loans	2019-12-31	$1,899
Interest earned on other investments	2019-12-31	$435
Value of interest in common/collective trusts at end of year	2019-12-31	$1,134,475
Value of interest in common/collective trusts at end of year	2019-12-31	$1,134,475
Value of interest in common/collective trusts at beginning of year	2019-12-31	$788,394
Value of interest in common/collective trusts at beginning of year	2019-12-31	$788,394
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$30,690
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$30,690
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$42,293
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$42,293
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$380
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$380
Net investment gain/loss from pooled separate accounts	2019-12-31	$170,976
Net investment gain/loss from pooled separate accounts	2019-12-31	$170,976
Net investment gain or loss from common/collective trusts	2019-12-31	$174,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$34,857
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$32,756
Employer contributions (assets) at beginning of year	2019-12-31	$32,756
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$241,936
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$241,936
Contract administrator fees	2019-12-31	$16,995
Contract administrator fees	2019-12-31	$16,995
Did the plan have assets held for investment	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
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
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CRAY, KAISER LTD.
Accountancy firm name	2019-12-31	CRAY, KAISER LTD.
Accountancy firm EIN	2019-12-31	362746886
Accountancy firm EIN	2019-12-31	362746886
2018 : ICARE SERVICES 401(K) 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	$152,093
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$65,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$51,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$234,014
Value of total assets at end of year	2018-12-31	$1,049,738
Value of total assets at beginning of year	2018-12-31	$962,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$13,395
Total interest from all sources	2018-12-31	$2,279
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
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
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	$189,013
Participant contributions at end of year	2018-12-31	$46,121
Participant contributions at beginning of year	2018-12-31	$42,265
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$1,113
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$12,245
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$26,806
Other income not declared elsewhere	2018-12-31	$2,111
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	$86,827
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,049,738
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$962,911
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$140,174
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$113,460
Interest on participant loans	2018-12-31	$2,279
Value of interest in common/collective trusts at end of year	2018-12-31	$788,394
Value of interest in common/collective trusts at beginning of year	2018-12-31	$742,690
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$42,293
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,828
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$9,304
Net investment gain/loss from pooled separate accounts	2018-12-31	$-21,251
Net investment gain or loss from common/collective trusts	2018-12-31	$-74,364
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	$32,756
Employer contributions (assets) at end of year	2018-12-31	$32,756
Employer contributions (assets) at beginning of year	2018-12-31	$32,749
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$51,871
Contract administrator fees	2018-12-31	$13,395
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	CUKIERSKI & COCHRANE, LLC
Accountancy firm EIN	2018-12-31	364239322
2017 : ICARE SERVICES 401(K) 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	$410,189
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$145,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$133,616
Expenses. Certain deemed distributions of participant loans	2017-12-31	$1,064
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$293,991
Value of total assets at end of year	2017-12-31	$962,911
Value of total assets at beginning of year	2017-12-31	$697,731
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,329
Total interest from all sources	2017-12-31	$2,192
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$4,954
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$4,954
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
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	$197,689
Participant contributions at end of year	2017-12-31	$42,265
Participant contributions at beginning of year	2017-12-31	$54,835
Participant contributions at end of year	2017-12-31	$1,113
Participant contributions at beginning of year	2017-12-31	$540
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$63,553
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$26,806
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$265,180
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$962,911
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$697,731
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$113,460
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$77,169
Interest on participant loans	2017-12-31	$2,192
Value of interest in common/collective trusts at end of year	2017-12-31	$742,690
Value of interest in common/collective trusts at beginning of year	2017-12-31	$535,392
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$3,828
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,332
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$12,092
Net investment gain or loss from common/collective trusts	2017-12-31	$96,960
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	$32,749
Employer contributions (assets) at end of year	2017-12-31	$32,749
Employer contributions (assets) at beginning of year	2017-12-31	$27,463
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$133,616
Contract administrator fees	2017-12-31	$10,329
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	MOWERY & SCHOENFELD, LLC
Accountancy firm EIN	2017-12-31	364111140
2016 : ICARE SERVICES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$400,053
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$141,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$131,673
Expenses. Certain deemed distributions of participant loans	2016-12-31	$1,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$346,551
Value of total assets at end of year	2016-12-31	$697,731
Value of total assets at beginning of year	2016-12-31	$439,112
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$7,833
Total interest from all sources	2016-12-31	$1,687
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$21,694
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$21,694
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$208,308
Participant contributions at end of year	2016-12-31	$54,835
Participant contributions at beginning of year	2016-12-31	$7,124
Participant contributions at end of year	2016-12-31	$540
Participant contributions at beginning of year	2016-12-31	$2,419
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$110,780
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	$258,619
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$697,731
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$439,112
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$77,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$402,454
Interest on participant loans	2016-12-31	$1,687
Value of interest in common/collective trusts at end of year	2016-12-31	$535,392
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,332
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$11,477
Net investment gain or loss from common/collective trusts	2016-12-31	$18,644
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	Yes
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	$27,463
Employer contributions (assets) at end of year	2016-12-31	$27,463
Employer contributions (assets) at beginning of year	2016-12-31	$27,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$131,673
Contract administrator fees	2016-12-31	$7,833
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MOWERY & SCHOENFELD, LLC
Accountancy firm EIN	2016-12-31	364111140
2015 : ICARE SERVICES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$298,685
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$70,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$65,781
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$305,744
Value of total assets at end of year	2015-12-31	$439,112
Value of total assets at beginning of year	2015-12-31	$211,023
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,815
Total interest from all sources	2015-12-31	$134
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$29,922
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$29,922
Was this plan covered by a fidelity bond	2015-12-31	No
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$218,312
Participant contributions at end of year	2015-12-31	$7,124
Participant contributions at beginning of year	2015-12-31	$1,294
Participant contributions at end of year	2015-12-31	$2,419
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$60,317
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	$228,089
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$439,112
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$211,023
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$402,454
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$187,625
Interest on participant loans	2015-12-31	$128
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$6
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-37,115
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	$27,115
Employer contributions (assets) at end of year	2015-12-31	$27,115
Employer contributions (assets) at beginning of year	2015-12-31	$22,104
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$65,781
Contract administrator fees	2015-12-31	$4,815
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MOWERY & SCHOENFELD, LLC
Accountancy firm EIN	2015-12-31	364111140
2014 : ICARE SERVICES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$212,797
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$711
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$210,037
Value of total assets at end of year	2014-12-31	$211,023
Value of total assets at beginning of year	2014-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,063
Total interest from all sources	2014-12-31	$7
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	No
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$143,443
Participant contributions at end of year	2014-12-31	$1,294
Participant contributions at beginning of year	2014-12-31	$0
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$44,490
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	$211,023
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$211,023
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$187,625
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$7
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$2,753
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	$22,104
Employer contributions (assets) at end of year	2014-12-31	$22,104
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$711
Contract administrator fees	2014-12-31	$1,063
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BERNARD ROBINSON & COMPANY, LLP
Accountancy firm EIN	2014-12-31	560571159

Form 5500 Responses for ICARE SERVICES 401(K) PLAN

2022: ICARE SERVICES 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
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: ICARE SERVICES 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
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: ICARE SERVICES 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Mulitple 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 - Trust	Yes
2019: ICARE SERVICES 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Mulitple employer plan
2019-01-01	Submission has been amended	No
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 - Trust	Yes
2018: ICARE SERVICES 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple 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 - Trust	Yes
2017: ICARE SERVICES 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
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: ICARE SERVICES 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ICARE SERVICES 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ICARE SERVICES 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	2
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	Yes
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
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	2
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	Yes
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
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	1
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $110
Total amount of fees paid to insurance company	USD $0
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?	Yes
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 $110
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	89
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $136
Total amount of fees paid to insurance company	USD $0
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?	Yes
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 $136
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	88
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $210
Total amount of fees paid to insurance company	USD $0
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?	Yes
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 $210
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $16
Total amount of fees paid to insurance company	USD $0
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?	Yes
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 $16
Insurance broker organization code?	3
Insurance broker name	ROBERT GREULICH

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	92
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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 $2
Insurance broker organization code?	3
Insurance broker name	ROBERT GREULICH

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

336850-01

Policy instance

Insurance contract or identification number	336850-01
Number of Individuals Covered	70
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $32
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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 $32
Insurance broker organization code?	3
Insurance broker name	ROBERT GREULICH

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Company Name:	ICARE FINANCIAL SERVICES
Employer identification number (EIN):	272323090
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities