401k Plan data: JOPAL BRONX, LLC UNION 401(K) PLAN plan

JOPAL BRONX, LLC UNION 401(K) PLAN 401k Plan overview

Plan Name	JOPAL BRONX, LLC UNION 401(K) PLAN
Plan identification number	003

JOPAL BRONX, LLC UNION 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.
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

JOPAL BRONX, LLC has sponsored the creation of one or more 401k plans.

Company Name: JOPAL BRONX, LLC

Employer identification number (EIN): 274158722

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

Additional information about JOPAL BRONX, LLC

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 2010-10-28

Company Identification Number: 4012688

Legal Registered Office Address: 225 CROSSWAYS PARK DRIVE
Suffolk
WOODBURY
United States of America (USA)
11797

More information about JOPAL BRONX, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOPAL BRONX, LLC UNION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2016-01-01 SOLOMAN RUTENBERG 2017-10-09
003 2015-01-01 SOLOMAN RUTENBERG
003 2014-01-01 SOLOMAN RUTENBERG
003 2013-10-01 SOLOMAN RUTENBERG

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
003	2016-01-01	SOLOMAN RUTENBERG	2017-10-09
003	2015-01-01	SOLOMAN RUTENBERG
003	2014-01-01	SOLOMAN RUTENBERG
003	2013-10-01	SOLOMAN RUTENBERG

Plan Statistics for JOPAL BRONX, LLC UNION 401(K) PLAN

401k plan membership statisitcs for JOPAL BRONX, LLC UNION 401(K) PLAN

Measure Date Value
2015: JOPAL BRONX, LLC UNION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 323
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 307
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 307
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 307
Number of participants with account balances 2015-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JOPAL BRONX, LLC UNION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 281
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 0
Total of all active and inactive participants 2014-01-01 281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 281
Number of participants with account balances 2014-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: JOPAL BRONX, LLC UNION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 474
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 377
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 377
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 377
Number of participants with account balances 2013-10-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0

Measure	Date	Value
2015: JOPAL BRONX, LLC UNION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	323
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	307
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	307
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	307
Number of participants with account balances	2015-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JOPAL BRONX, LLC UNION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	281
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	0
Total of all active and inactive participants	2014-01-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	281
Number of participants with account balances	2014-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: JOPAL BRONX, LLC UNION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	474
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	377
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	377
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	377
Number of participants with account balances	2013-10-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0

Financial Data on JOPAL BRONX, LLC UNION 401(K) PLAN

Measure	Date	Value
2015 : JOPAL BRONX, LLC UNION 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	$119
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$531
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$700
Value of total assets at end of year	2015-12-31	$41,358
Value of total assets at beginning of year	2015-12-31	$41,770
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$531
Total interest from all sources	2015-12-31	$18
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Participant contributions at end of year	2015-12-31	$1,094
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$700
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	$-412
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$41,358
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$41,770
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,406
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,403
Value of interest in pooled separate accounts at end of year	2015-12-31	$38,858
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$40,367
Interest earned on other investments	2015-12-31	$18
Net investment gain/loss from pooled separate accounts	2015-12-31	$-599
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
Contract administrator fees	2015-12-31	$531
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	HMM, CPAS LLP
Accountancy firm EIN	2015-12-31	465416249
2014 : JOPAL BRONX, LLC UNION 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	$9,562
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$4,076
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,605
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$7,494
Value of total assets at end of year	2014-12-31	$41,770
Value of total assets at beginning of year	2014-12-31	$36,284
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$471
Total interest from all sources	2014-12-31	$14
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$9
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$9
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$800,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$7,494
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	$5,486
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$41,770
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$36,284
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	$1,403
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,804
Value of interest in pooled separate accounts at end of year	2014-12-31	$40,367
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$33,480
Interest earned on other investments	2014-12-31	$14
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$118
Net investment gain/loss from pooled separate accounts	2014-12-31	$1,927
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,605
Contract administrator fees	2014-12-31	$471
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	HMM, CPAS LLP
Accountancy firm EIN	2014-12-31	465416249
2013 : JOPAL BRONX, LLC UNION 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$36,326
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$42
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$35,699
Value of total assets at end of year	2013-12-31	$36,284
Value of total assets at beginning of year	2013-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$42
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$9
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$9
Was this plan covered by a fidelity bond	2013-12-31	No
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$35,699
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$36,284
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$36,284
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,804
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$33,480
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$110
Net investment gain/loss from pooled separate accounts	2013-12-31	$508
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contract administrator fees	2013-12-31	$42
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer

Form 5500 Responses for JOPAL BRONX, LLC UNION 401(K) PLAN

2015: JOPAL BRONX, LLC UNION 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JOPAL BRONX, LLC UNION 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JOPAL BRONX, LLC UNION 401(K) PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	First time form 5500 has been submitted	Yes
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

460281

Policy instance

Insurance contract or identification number	460281
Number of Individuals Covered	114
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $200
Total amount of fees paid to insurance company	USD $20
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 $200
Insurance broker organization code?	3
Amount paid for insurance broker fees	20
Additional information about fees paid to insurance broker	REFERRAL / SERVICE FEE
Insurance broker name	ASSOCIATED PENSION CONSULTANTS, INC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	114
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7
Total amount of fees paid to insurance company	USD $1
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 $7
Insurance broker organization code?	3
Amount paid for insurance broker fees	1
Additional information about fees paid to insurance broker	REFERRAL / SERVICE FEE
Insurance broker name	ASSOCIATED PENSION CONSULTANTS, INC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

460281

Policy instance

Insurance contract or identification number	460281
Number of Individuals Covered	114
Insurance policy start date	2014-10-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4
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 $4
Insurance broker organization code?	3
Insurance broker name	SAGEPOINT FINANCIAL INC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

460281

Policy instance

Insurance contract or identification number	460281
Number of Individuals Covered	104
Insurance policy start date	2013-10-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	JOPAL BRONX, LLC
Employer identification number (EIN):	274158722
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	2010-10-28
Company Identification Number:	4012688
Legal Registered Office Address:	225 CROSSWAYS PARK DRIVE Suffolk WOODBURY United States of America (USA) 11797