401k Plan data: HEARTFELT CARE RETIREMENT PLAN plan

HEARTFELT CARE RETIREMENT PLAN 401k Plan overview

Plan Name	HEARTFELT CARE RETIREMENT PLAN
Plan identification number	001

HEARTFELT CARE RETIREMENT 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

HEARTFELT CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEARTFELT CARE, INC.

Employer identification number (EIN): 275278945

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about HEARTFELT CARE, INC.

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2011-03-01

Company Identification Number: 20111126034

Legal Registered Office Address: 700 Kimbark St

Longmont
United States of America (USA)
80501

More information about HEARTFELT CARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEARTFELT CARE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 ARTHUR SANCHEZ
001 2016-01-01 ARTHUR SANCHEZ ARTHUR SANCHEZ 2017-10-10
001 2015-01-01 2016-07-28
001 2015-01-01 2016-07-28
001 2015-01-01 ARTHUR SANCHEZ ARTHUR SANCHEZ 2016-07-28
001 2014-01-01 ARTHUR SANCHEZ ARTHUR SANCHEZ 2015-06-08
001 2013-01-01 ARTHUR SANCHEZ ARTHUR SANCHEZ 2014-09-11
001 2012-01-01 ARTHUR SANCHEZ ARTHUR SANCHEZ 2013-06-13
001 2011-03-02 ARTHUR SANCHEZ ARTHUR SANCHEZ 2012-05-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	ARTHUR SANCHEZ
001	2016-01-01	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2017-10-10
001	2015-01-01		2016-07-28
001	2015-01-01		2016-07-28
001	2015-01-01	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2016-07-28
001	2014-01-01	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2015-06-08
001	2013-01-01	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2014-09-11
001	2012-01-01	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2013-06-13
001	2011-03-02	ARTHUR SANCHEZ		ARTHUR SANCHEZ	2012-05-31

Plan Statistics for HEARTFELT CARE RETIREMENT PLAN

401k plan membership statisitcs for HEARTFELT CARE RETIREMENT PLAN

Measure Date Value
2022: HEARTFELT CARE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 25
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 8
Total of all active and inactive participants 2022-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 33
Number of participants with account balances 2022-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: HEARTFELT CARE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 16
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 1
Total of all active and inactive participants 2021-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 17
Number of participants with account balances 2021-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: HEARTFELT CARE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 14
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 1
Total of all active and inactive participants 2020-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 15
Number of participants with account balances 2020-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: HEARTFELT CARE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 14
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 0
Total of all active and inactive participants 2019-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 14
Number of participants with account balances 2019-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: HEARTFELT CARE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 13
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 0
Total of all active and inactive participants 2018-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 13
Number of participants with account balances 2018-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: HEARTFELT CARE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 10
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 0
Total of all active and inactive participants 2017-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 10
Number of participants with account balances 2017-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: HEARTFELT CARE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 5
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 1
Total of all active and inactive participants 2016-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 6
Number of participants with account balances 2016-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: HEARTFELT CARE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 5
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 2
Total of all active and inactive participants 2015-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 7
Number of participants with account balances 2015-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: HEARTFELT CARE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 6
Number of participants with account balances 2014-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: HEARTFELT CARE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: HEARTFELT CARE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: HEARTFELT CARE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-03-02 2
Total number of active participants reported on line 7a of the Form 5500 2011-03-02 2
Number of retired or separated participants receiving benefits 2011-03-02 0
Number of other retired or separated participants entitled to future benefits 2011-03-02 0
Total of all active and inactive participants 2011-03-02 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-03-02 0
Total participants 2011-03-02 2
Number of participants with account balances 2011-03-02 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-03-02 0

Measure	Date	Value
2022: HEARTFELT CARE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	25
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	8
Total of all active and inactive participants	2022-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	33
Number of participants with account balances	2022-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: HEARTFELT CARE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	16
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	1
Total of all active and inactive participants	2021-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	17
Number of participants with account balances	2021-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: HEARTFELT CARE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	14
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	1
Total of all active and inactive participants	2020-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	15
Number of participants with account balances	2020-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: HEARTFELT CARE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	14
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	0
Total of all active and inactive participants	2019-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	14
Number of participants with account balances	2019-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: HEARTFELT CARE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	13
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	0
Total of all active and inactive participants	2018-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	13
Number of participants with account balances	2018-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: HEARTFELT CARE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	10
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	0
Total of all active and inactive participants	2017-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	10
Number of participants with account balances	2017-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: HEARTFELT CARE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	5
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	1
Total of all active and inactive participants	2016-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	6
Number of participants with account balances	2016-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: HEARTFELT CARE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	5
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	2
Total of all active and inactive participants	2015-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	7
Number of participants with account balances	2015-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: HEARTFELT CARE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	6
Number of participants with account balances	2014-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: HEARTFELT CARE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: HEARTFELT CARE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: HEARTFELT CARE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-03-02	2
Total number of active participants reported on line 7a of the Form 5500	2011-03-02	2
Number of retired or separated participants receiving benefits	2011-03-02	0
Number of other retired or separated participants entitled to future benefits	2011-03-02	0
Total of all active and inactive participants	2011-03-02	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-03-02	0
Total participants	2011-03-02	2
Number of participants with account balances	2011-03-02	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-03-02	0

Financial Data on HEARTFELT CARE RETIREMENT PLAN

Measure	Date	Value
2022 : HEARTFELT CARE RETIREMENT PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$97,705
Total income from all sources	2022-12-31	$6,421
Expenses. Total of all expenses incurred	2022-12-31	$4,076
Benefits paid (including direct rollovers)	2022-12-31	$3,719
Total plan assets at end of year	2022-12-31	$493,880
Total plan assets at beginning of year	2022-12-31	$393,830
Value of fidelity bond covering the plan	2022-12-31	$50,000
Total contributions received or receivable from participants	2022-12-31	$20,085
Other income received	2022-12-31	$-22,811
Net income (gross income less expenses)	2022-12-31	$2,345
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$493,880
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$393,830
Assets. Value of employer securities	2022-12-31	$325,000
Total contributions received or receivable from employer(s)	2022-12-31	$9,147
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$357
2021 : HEARTFELT CARE RETIREMENT PLAN 2021 401k financial data
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$109
Total income from all sources	2021-12-31	$248,207
Expenses. Total of all expenses incurred	2021-12-31	$615
Total plan assets at end of year	2021-12-31	$393,830
Total plan assets at beginning of year	2021-12-31	$146,347
Value of fidelity bond covering the plan	2021-12-31	$50,000
Total contributions received or receivable from participants	2021-12-31	$8,457
Other income received	2021-12-31	$234,923
Net income (gross income less expenses)	2021-12-31	$247,592
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$393,830
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$146,238
Assets. Value of employer securities	2021-12-31	$325,000
Total contributions received or receivable from employer(s)	2021-12-31	$4,827
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$615
2020 : HEARTFELT CARE RETIREMENT PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-12-31	$109
Total plan liabilities at beginning of year	2020-12-31	$52
Total income from all sources	2020-12-31	$16,075
Expenses. Total of all expenses incurred	2020-12-31	$329
Total plan assets at end of year	2020-12-31	$146,347
Total plan assets at beginning of year	2020-12-31	$130,544
Value of fidelity bond covering the plan	2020-12-31	$50,000
Total contributions received or receivable from participants	2020-12-31	$4,704
Other income received	2020-12-31	$7,564
Net income (gross income less expenses)	2020-12-31	$15,746
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$146,238
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$130,492
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2020-12-31	$1,493
Assets. Value of employer securities	2020-12-31	$97,000
Total contributions received or receivable from employer(s)	2020-12-31	$3,807
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$329
2019 : HEARTFELT CARE RETIREMENT PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-12-31	$52
Total plan liabilities at beginning of year	2019-12-31	$22
Total income from all sources	2019-12-31	$33,950
Expenses. Total of all expenses incurred	2019-12-31	$249
Total plan assets at end of year	2019-12-31	$130,544
Total plan assets at beginning of year	2019-12-31	$96,813
Value of fidelity bond covering the plan	2019-12-31	$50,000
Total contributions received or receivable from participants	2019-12-31	$11,139
Other income received	2019-12-31	$20,652
Net income (gross income less expenses)	2019-12-31	$33,701
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$130,492
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$96,791
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2019-12-31	$1,370
Assets. Value of employer securities	2019-12-31	$95,000
Total contributions received or receivable from employer(s)	2019-12-31	$2,159
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$249
2018 : HEARTFELT CARE RETIREMENT PLAN 2018 401k financial data
Total plan liabilities at end of year	2018-12-31	$22
Total plan liabilities at beginning of year	2018-12-31	$67
Total income from all sources	2018-12-31	$3,151
Expenses. Total of all expenses incurred	2018-12-31	$170
Total plan assets at end of year	2018-12-31	$96,813
Total plan assets at beginning of year	2018-12-31	$93,877
Value of fidelity bond covering the plan	2018-12-31	$50,000
Total contributions received or receivable from participants	2018-12-31	$870
Other income received	2018-12-31	$1,411
Net income (gross income less expenses)	2018-12-31	$2,981
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$96,791
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$93,810
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2018-12-31	$120
Assets. Value of employer securities	2018-12-31	$77,000
Total contributions received or receivable from employer(s)	2018-12-31	$870
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$170
2017 : HEARTFELT CARE RETIREMENT PLAN 2017 401k financial data
Total plan liabilities at end of year	2017-12-31	$67
Total plan liabilities at beginning of year	2017-12-31	$67
Total income from all sources	2017-12-31	$-5,164
Expenses. Total of all expenses incurred	2017-12-31	$2,876
Benefits paid (including direct rollovers)	2017-12-31	$2,680
Total plan assets at end of year	2017-12-31	$93,877
Total plan assets at beginning of year	2017-12-31	$101,917
Value of fidelity bond covering the plan	2017-12-31	$20,000
Total contributions received or receivable from participants	2017-12-31	$480
Other income received	2017-12-31	$-6,124
Net income (gross income less expenses)	2017-12-31	$-8,040
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$93,810
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$101,850
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2017-12-31	$60
Assets. Value of employer securities	2017-12-31	$75,000
Total contributions received or receivable from employer(s)	2017-12-31	$480
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$196
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : HEARTFELT CARE RETIREMENT PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-12-31	$67
Total plan liabilities at beginning of year	2016-12-31	$79
Total income from all sources	2016-12-31	$-29,980
Expenses. Total of all expenses incurred	2016-12-31	$1,478
Benefits paid (including direct rollovers)	2016-12-31	$1,197
Total plan assets at end of year	2016-12-31	$101,917
Total plan assets at beginning of year	2016-12-31	$133,387
Value of fidelity bond covering the plan	2016-12-31	$20,000
Total contributions received or receivable from participants	2016-12-31	$1,578
Other income received	2016-12-31	$-33,089
Net income (gross income less expenses)	2016-12-31	$-31,458
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$101,850
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$133,308
Assets. Value of participant loans	2016-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2016-12-31	$60
Assets. Value of employer securities	2016-12-31	$82,325
Total contributions received or receivable from employer(s)	2016-12-31	$1,531
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$281
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : HEARTFELT CARE RETIREMENT PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$79
Total income from all sources	2015-12-31	$5,087
Expenses. Total of all expenses incurred	2015-12-31	$269
Total plan assets at end of year	2015-12-31	$133,387
Total plan assets at beginning of year	2015-12-31	$128,490
Value of fidelity bond covering the plan	2015-12-31	$20,000
Total contributions received or receivable from participants	2015-12-31	$2,320
Expenses. Other expenses not covered elsewhere	2015-12-31	$60
Other income received	2015-12-31	$447
Net income (gross income less expenses)	2015-12-31	$4,818
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$133,308
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$128,490
Assets. Value of participant loans	2015-12-31	$450
Assets. Value of employer securities	2015-12-31	$115,950
Total contributions received or receivable from employer(s)	2015-12-31	$2,320
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$209
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : HEARTFELT CARE RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$-282
Expenses. Total of all expenses incurred	2014-12-31	$240
Total plan assets at end of year	2014-12-31	$128,490
Total plan assets at beginning of year	2014-12-31	$129,012
Value of fidelity bond covering the plan	2014-12-31	$20,000
Expenses. Other expenses not covered elsewhere	2014-12-31	$240
Other income received	2014-12-31	$-282
Net income (gross income less expenses)	2014-12-31	$-522
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$128,490
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$129,012
Assets. Value of participant loans	2014-12-31	$1,831
Assets. Value of employer securities	2014-12-31	$115,500
2013 : HEARTFELT CARE RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$-573
Expenses. Total of all expenses incurred	2013-12-31	$240
Total plan assets at end of year	2013-12-31	$129,012
Total plan assets at beginning of year	2013-12-31	$129,825
Expenses. Other expenses not covered elsewhere	2013-12-31	$240
Other income received	2013-12-31	$-573
Net income (gross income less expenses)	2013-12-31	$-813
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$129,012
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$129,825
Assets. Value of participant loans	2013-12-31	$5,352
Assets. Value of employer securities	2013-12-31	$116,100
2012 : HEARTFELT CARE RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$21,224
Expenses. Total of all expenses incurred	2012-12-31	$240
Total plan assets at end of year	2012-12-31	$129,825
Total plan assets at beginning of year	2012-12-31	$108,841
Expenses. Other expenses not covered elsewhere	2012-12-31	$240
Other income received	2012-12-31	$21,224
Net income (gross income less expenses)	2012-12-31	$20,984
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$129,825
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$108,841
Assets. Value of employer securities	2012-12-31	$117,000
2011 : HEARTFELT CARE RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$109,011
Expenses. Total of all expenses incurred	2011-12-31	$170
Total plan assets at end of year	2011-12-31	$108,841
Expenses. Other expenses not covered elsewhere	2011-12-31	$170
Contributions received from other sources (not participants or employers)	2011-12-31	$110,333
Other income received	2011-12-31	$-1,322
Net income (gross income less expenses)	2011-12-31	$108,841
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$108,841
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$0
Assets. Value of participant loans	2011-12-31	$6,562
Assets. Value of employer securities	2011-12-31	$96,030

Form 5500 Responses for HEARTFELT CARE RETIREMENT PLAN

2022: HEARTFELT CARE RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single 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 – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: HEARTFELT CARE RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single 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 – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: HEARTFELT CARE RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: HEARTFELT CARE RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single 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 – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: HEARTFELT CARE RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: HEARTFELT CARE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single 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 – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: HEARTFELT CARE RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single 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 – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HEARTFELT CARE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
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: HEARTFELT CARE RETIREMENT 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: HEARTFELT CARE RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HEARTFELT CARE RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: HEARTFELT CARE RETIREMENT PLAN 2011 form 5500 responses
2011-03-02	Type of plan entity	Single employer plan
2011-03-02	First time form 5500 has been submitted	Yes
2011-03-02	Submission has been amended	No
2011-03-02	This submission is the final filing	No
2011-03-02	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-03-02	Plan is a collectively bargained plan	No
2011-03-02	Plan funding arrangement – Trust	Yes
2011-03-02	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	3
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $17
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 $17
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	3
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $50
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 $50
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	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 $32
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	2
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $15
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 $15
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	2
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $8
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 $8
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $8
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 $8
Insurance broker organization code?	3
Insurance broker name	LORENZ SEAN MICHAEL

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

690983

Policy instance

Insurance contract or identification number	690983
Number of Individuals Covered	5
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $30
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 $30
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LORENZ SEAN MICHAEL

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Company Name:	HEARTFELT CARE, INC.
Employer identification number (EIN):	275278945
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2011-03-01
Company Identification Number:	20111126034
Legal Registered Office Address:	700 Kimbark St Longmont United States of America (USA) 80501