401k Plan data: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN plan

CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	CEDAR LAKE 401K RETIREMENT SAVINGS PLAN
Plan identification number	001

CEDAR LAKE 401K RETIREMENT SAVINGS 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

CEDAR LAKE WORKFORCE, LLC has sponsored the creation of one or more 401k plans.

Company Name: CEDAR LAKE WORKFORCE, LLC

Employer identification number (EIN): 364702958

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CEDAR LAKE 401K RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 MARGE WAUGH 2023-07-28
001 2021-01-01 MARGARET WAUGH 2022-07-26
001 2020-01-01 MARGARET WAUGH 2021-10-06
001 2019-01-01
001 2018-01-01
001 2017-01-01 CASSANDRA TEMBO
001 2016-01-01 CASSANDRA TEMBO
001 2015-01-01 CASSANDRA TEMBO
001 2014-01-01 CASSANDRA TEMBO
001 2013-01-01 CLYDE D. LANG
001 2012-01-01 CLYDE D. LANG
001 2011-01-01 GREGORY D. SIMPSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	MARGE WAUGH	2023-07-28
001	2021-01-01	MARGARET WAUGH	2022-07-26
001	2020-01-01	MARGARET WAUGH	2021-10-06
001	2019-01-01
001	2018-01-01
001	2017-01-01	CASSANDRA TEMBO
001	2016-01-01	CASSANDRA TEMBO
001	2015-01-01	CASSANDRA TEMBO
001	2014-01-01	CASSANDRA TEMBO
001	2013-01-01	CLYDE D. LANG
001	2012-01-01	CLYDE D. LANG
001	2011-01-01	GREGORY D. SIMPSON

Plan Statistics for CEDAR LAKE 401K RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for CEDAR LAKE 401K RETIREMENT SAVINGS PLAN

Measure Date Value
2022: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 414
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 323
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 81
Total of all active and inactive participants 2022-01-01 405
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 405
Number of participants with account balances 2022-01-01 351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 23
2021: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 430
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 336
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 71
Total of all active and inactive participants 2021-01-01 407
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 407
Number of participants with account balances 2021-01-01 351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 14
2020: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 438
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 341
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 70
Total of all active and inactive participants 2020-01-01 412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 412
Number of participants with account balances 2020-01-01 321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 9
2019: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 485
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 331
Number of other retired or separated participants entitled to future benefits 2019-01-01 90
Total of all active and inactive participants 2019-01-01 421
Total participants 2019-01-01 421
Number of participants with account balances 2019-01-01 367
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 494
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 328
Number of other retired or separated participants entitled to future benefits 2018-01-01 157
Total of all active and inactive participants 2018-01-01 485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 485
Number of participants with account balances 2018-01-01 446
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 10
2017: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 499
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 350
Number of retired or separated participants receiving benefits 2017-01-01 144
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 494
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 494
Number of participants with account balances 2017-01-01 447
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 10
2016: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 453
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 321
Number of retired or separated participants receiving benefits 2016-01-01 178
Total of all active and inactive participants 2016-01-01 499
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 499
Number of participants with account balances 2016-01-01 473
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 7
2015: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 434
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 303
Number of other retired or separated participants entitled to future benefits 2015-01-01 150
Total of all active and inactive participants 2015-01-01 453
Total participants 2015-01-01 453
Number of participants with account balances 2015-01-01 442
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 50
2014: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 371
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 298
Number of other retired or separated participants entitled to future benefits 2014-01-01 118
Total of all active and inactive participants 2014-01-01 416
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 417
Number of participants with account balances 2014-01-01 413
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 26
2013: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 386
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 295
Number of retired or separated participants receiving benefits 2013-01-01 3
Number of other retired or separated participants entitled to future benefits 2013-01-01 72
Total of all active and inactive participants 2013-01-01 370
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 371
Number of participants with account balances 2013-01-01 365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 32
2012: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 355
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 285
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 55
Total of all active and inactive participants 2012-01-01 340
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 341
Number of participants with account balances 2012-01-01 320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 311
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 242
Number of other retired or separated participants entitled to future benefits 2011-01-01 80
Total of all active and inactive participants 2011-01-01 322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 323
Number of participants with account balances 2011-01-01 321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 16

Measure	Date	Value
2022: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	414
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	323
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	81
Total of all active and inactive participants	2022-01-01	405
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	405
Number of participants with account balances	2022-01-01	351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	23
2021: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	430
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	336
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	71
Total of all active and inactive participants	2021-01-01	407
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	407
Number of participants with account balances	2021-01-01	351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	14
2020: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	438
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	341
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	70
Total of all active and inactive participants	2020-01-01	412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	412
Number of participants with account balances	2020-01-01	321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	9
2019: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	485
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	331
Number of other retired or separated participants entitled to future benefits	2019-01-01	90
Total of all active and inactive participants	2019-01-01	421
Total participants	2019-01-01	421
Number of participants with account balances	2019-01-01	367
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	494
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	328
Number of other retired or separated participants entitled to future benefits	2018-01-01	157
Total of all active and inactive participants	2018-01-01	485
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	485
Number of participants with account balances	2018-01-01	446
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	10
2017: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	499
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	350
Number of retired or separated participants receiving benefits	2017-01-01	144
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	494
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	494
Number of participants with account balances	2017-01-01	447
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	10
2016: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	453
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	321
Number of retired or separated participants receiving benefits	2016-01-01	178
Total of all active and inactive participants	2016-01-01	499
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	499
Number of participants with account balances	2016-01-01	473
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	7
2015: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	434
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	303
Number of other retired or separated participants entitled to future benefits	2015-01-01	150
Total of all active and inactive participants	2015-01-01	453
Total participants	2015-01-01	453
Number of participants with account balances	2015-01-01	442
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	50
2014: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	371
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	298
Number of other retired or separated participants entitled to future benefits	2014-01-01	118
Total of all active and inactive participants	2014-01-01	416
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	417
Number of participants with account balances	2014-01-01	413
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	26
2013: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	386
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	295
Number of retired or separated participants receiving benefits	2013-01-01	3
Number of other retired or separated participants entitled to future benefits	2013-01-01	72
Total of all active and inactive participants	2013-01-01	370
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	371
Number of participants with account balances	2013-01-01	365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	32
2012: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	355
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	285
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	55
Total of all active and inactive participants	2012-01-01	340
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	341
Number of participants with account balances	2012-01-01	320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	311
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	242
Number of other retired or separated participants entitled to future benefits	2011-01-01	80
Total of all active and inactive participants	2011-01-01	322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	323
Number of participants with account balances	2011-01-01	321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	16

Financial Data on CEDAR LAKE 401K RETIREMENT SAVINGS PLAN

Measure	Date	Value
2022 : CEDAR LAKE 401K RETIREMENT SAVINGS 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-959,252
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,222,251
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,210,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,036,325
Value of total assets at end of year	2022-12-31	$10,082,832
Value of total assets at beginning of year	2022-12-31	$12,264,335
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$12,100
Total interest from all sources	2022-12-31	$19,279
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
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	$675,575
Participant contributions at end of year	2022-12-31	$25
Participant contributions at beginning of year	2022-12-31	$431
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	$-2,181,503
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$10,082,832
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$12,264,335
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 pooled separate accounts at end of year	2022-12-31	$8,940,083
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$11,389,631
Interest earned on other investments	2022-12-31	$19,279
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,142,680
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$873,999
Net investment gain/loss from pooled separate accounts	2022-12-31	$-2,014,856
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	$360,750
Employer contributions (assets) at end of year	2022-12-31	$44
Employer contributions (assets) at beginning of year	2022-12-31	$274
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,210,151
Contract administrator fees	2022-12-31	$12,100
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	DEMING MALONE LIVESAY OSTROFF
Accountancy firm EIN	2022-12-31	611064249
2021 : CEDAR LAKE 401K RETIREMENT SAVINGS 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	$0
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	$2,632,075
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,537,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,525,489
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,067,222
Value of total assets at end of year	2021-12-31	$12,264,335
Value of total assets at beginning of year	2021-12-31	$11,169,525
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$11,776
Total interest from all sources	2021-12-31	$22,814
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
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	$680,246
Participant contributions at end of year	2021-12-31	$431
Participant contributions at beginning of year	2021-12-31	$25
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$7,612
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	$1,094,810
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$12,264,335
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,169,525
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 pooled separate accounts at end of year	2021-12-31	$11,389,631
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$10,144,749
Interest earned on other investments	2021-12-31	$22,814
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$873,999
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,023,289
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,542,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$379,364
Employer contributions (assets) at end of year	2021-12-31	$274
Employer contributions (assets) at beginning of year	2021-12-31	$1,462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,525,489
Contract administrator fees	2021-12-31	$11,776
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	DEMING MALONE LIVESAY OSTROFF
Accountancy firm EIN	2021-12-31	611064249
2020 : CEDAR LAKE 401K RETIREMENT SAVINGS 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	$3,664
Total income from all sources (including contributions)	2020-12-31	$2,602,669
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$921,278
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$911,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,134,669
Value of total assets at end of year	2020-12-31	$11,169,525
Value of total assets at beginning of year	2020-12-31	$9,491,798
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$9,580
Total interest from all sources	2020-12-31	$17,073
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	No
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	$704,888
Participant contributions at end of year	2020-12-31	$25
Participant contributions at beginning of year	2020-12-31	$12
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,681,391
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,169,525
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,488,134
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$10,144,749
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$8,631,390
Interest earned on other investments	2020-12-31	$17,073
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,023,289
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$860,384
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,450,927
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	$429,781
Employer contributions (assets) at end of year	2020-12-31	$1,462
Employer contributions (assets) at beginning of year	2020-12-31	$12
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$911,698
Contract administrator fees	2020-12-31	$9,580
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$3,664
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	DEMING MALONE LIVESAY OSTROFF
Accountancy firm EIN	2020-12-31	611064249
2019 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$3,664
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$6,590
Total income from all sources (including contributions)	2019-12-31	$2,996,898
Total of all expenses incurred	2019-12-31	$1,895,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,886,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,235,688
Value of total assets at end of year	2019-12-31	$9,491,798
Value of total assets at beginning of year	2019-12-31	$8,392,856
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,610
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$680,227
Participant contributions at end of year	2019-12-31	$12
Participant contributions at beginning of year	2019-12-31	$24,535
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$22,187
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	$1,101,868
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,488,134
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,386,266
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$8,631,390
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$6,735,300
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$860,384
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,612,430
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,761,210
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$533,274
Employer contributions (assets) at end of year	2019-12-31	$12
Employer contributions (assets) at beginning of year	2019-12-31	$20,591
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,886,420
Contract administrator fees	2019-12-31	$8,610
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$3,664
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$6,590
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	DEMING MALONE LIVESAY OSTROFF
Accountancy firm EIN	2019-12-31	611064249
2018 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$6,590
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$1,706
Total income from all sources (including contributions)	2018-12-31	$709,375
Total of all expenses incurred	2018-12-31	$1,514,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,507,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,195,849
Value of total assets at end of year	2018-12-31	$8,392,856
Value of total assets at beginning of year	2018-12-31	$9,193,204
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$6,841
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	$647,733
Participant contributions at end of year	2018-12-31	$24,535
Participant contributions at beginning of year	2018-12-31	$20,761
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$3,924
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	$-805,232
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$8,386,266
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,191,498
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 pooled separate accounts at end of year	2018-12-31	$6,735,300
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$7,323,587
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,612,430
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,572,551
Net investment gain/loss from pooled separate accounts	2018-12-31	$-486,474
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	$548,116
Employer contributions (assets) at end of year	2018-12-31	$20,591
Employer contributions (assets) at beginning of year	2018-12-31	$272,381
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,507,766
Contract administrator fees	2018-12-31	$6,841
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$6,590
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$1,706
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	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2018-12-31	611064249
2017 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,706
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$16,661
Total income from all sources (including contributions)	2017-12-31	$2,587,985
Total of all expenses incurred	2017-12-31	$623,796
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$618,589
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,417,037
Value of total assets at end of year	2017-12-31	$9,193,204
Value of total assets at beginning of year	2017-12-31	$7,243,970
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,207
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$541,163
Participant contributions at end of year	2017-12-31	$20,761
Participant contributions at beginning of year	2017-12-31	$16,361
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$199,426
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$1,188
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$3,924
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	$1,964,189
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,191,498
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$7,227,309
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 pooled separate accounts at end of year	2017-12-31	$7,323,587
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$5,702,188
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,572,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,280,048
Net investment gain/loss from pooled separate accounts	2017-12-31	$1,170,948
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	$676,448
Employer contributions (assets) at end of year	2017-12-31	$272,381
Employer contributions (assets) at beginning of year	2017-12-31	$245,373
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$617,401
Contract administrator fees	2017-12-31	$5,207
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$1,706
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$16,661
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	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2017-12-31	611064249
2016 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$16,661
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$6,158
Total income from all sources (including contributions)	2016-12-31	$1,629,926
Total of all expenses incurred	2016-12-31	$785,951
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$774,273
Value of total corrective distributions	2016-12-31	$6,158
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,188,759
Value of total assets at end of year	2016-12-31	$7,243,970
Value of total assets at beginning of year	2016-12-31	$6,389,492
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$5,520
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$396,896
Participant contributions at end of year	2016-12-31	$16,361
Participant contributions at beginning of year	2016-12-31	$12,582
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$251,227
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$20,647
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	$843,975
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$7,227,309
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$6,383,334
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 pooled separate accounts at end of year	2016-12-31	$5,702,188
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$5,085,050
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,280,048
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,059,711
Net investment gain/loss from pooled separate accounts	2016-12-31	$441,167
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	$540,636
Employer contributions (assets) at end of year	2016-12-31	$245,373
Employer contributions (assets) at beginning of year	2016-12-31	$211,502
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$774,273
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$16,661
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$6,158
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	DEMING MALONG LIVESAY & OSTROFF
Accountancy firm EIN	2016-12-31	611064249
2015 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$6,158
Total income from all sources (including contributions)	2015-12-31	$1,016,140
Total of all expenses incurred	2015-12-31	$346,218
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$342,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,137,226
Value of total assets at end of year	2015-12-31	$6,389,492
Value of total assets at beginning of year	2015-12-31	$5,713,412
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,117
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$4,117
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$3,000,000
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
Contributions received from participants	2015-12-31	$336,835
Participant contributions at end of year	2015-12-31	$12,582
Participant contributions at beginning of year	2015-12-31	$57
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$40,484
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$20,647
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$55,127
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	$669,922
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$6,383,334
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,713,412
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 pooled separate accounts at end of year	2015-12-31	$5,085,050
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$4,665,804
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,059,711
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$992,424
Net investment gain/loss from pooled separate accounts	2015-12-31	$-121,086
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	Yes
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	$759,907
Employer contributions (assets) at end of year	2015-12-31	$211,502
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$342,101
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$6,158
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	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2015-12-31	611064249
2014 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,166,314
Total of all expenses incurred	2014-12-31	$564,381
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$559,672
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$881,526
Value of total assets at end of year	2014-12-31	$5,713,412
Value of total assets at beginning of year	2014-12-31	$5,111,479
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,709
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$4,709
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$235,230
Participant contributions at end of year	2014-12-31	$57
Participant contributions at beginning of year	2014-12-31	$57
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$61,826
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$55,127
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	$601,933
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,713,412
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,111,479
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$4,665,804
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$4,166,753
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$992,424
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$934,512
Net investment gain/loss from pooled separate accounts	2014-12-31	$284,788
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	Yes
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	$584,470
Employer contributions (assets) at beginning of year	2014-12-31	$10,157
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$559,672
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	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2014-12-31	611064249
2013 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$1,715,443
Total of all expenses incurred	2013-12-31	$481,055
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$478,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$826,376
Value of total assets at end of year	2013-12-31	$5,111,479
Value of total assets at beginning of year	2013-12-31	$3,877,091
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$2,944
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$2,944
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$3,000,000
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
Contributions received from participants	2013-12-31	$209,012
Participant contributions at end of year	2013-12-31	$57
Participant contributions at beginning of year	2013-12-31	$3,148
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$84,101
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	$1,234,388
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,111,479
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,877,091
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 pooled separate accounts at end of year	2013-12-31	$4,166,753
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$3,043,909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$934,512
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$805,453
Net investment gain/loss from pooled separate accounts	2013-12-31	$889,067
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$533,263
Employer contributions (assets) at end of year	2013-12-31	$10,157
Employer contributions (assets) at beginning of year	2013-12-31	$24,581
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$478,111
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2013-12-31	611064249
2012 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$1,071,275
Total of all expenses incurred	2012-12-31	$305,195
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$302,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$700,023
Value of total assets at end of year	2012-12-31	$3,877,091
Value of total assets at beginning of year	2012-12-31	$3,111,011
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,434
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$2,434
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$181,100
Participant contributions at end of year	2012-12-31	$3,148
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$20,109
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$70
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$766,080
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,877,091
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,111,011
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$3,043,909
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$2,381,484
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$805,453
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$728,815
Net investment gain/loss from pooled separate accounts	2012-12-31	$371,252
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$498,814
Employer contributions (assets) at end of year	2012-12-31	$24,581
Employer contributions (assets) at beginning of year	2012-12-31	$642
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$302,761
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2012-12-31	611064249
2011 : CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$707,803
Total of all expenses incurred	2011-12-31	$374,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$370,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$785,620
Value of total assets at end of year	2011-12-31	$3,111,011
Value of total assets at beginning of year	2011-12-31	$2,777,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$3,386
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$3,386
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$189,976
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$8,117
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$70
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$345
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$333,606
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,111,011
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,777,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$2,381,484
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,113,420
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$728,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$638,515
Net investment gain/loss from pooled separate accounts	2011-12-31	$-77,817
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$587,527
Employer contributions (assets) at end of year	2011-12-31	$642
Employer contributions (assets) at beginning of year	2011-12-31	$25,125
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$370,811
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2011-12-31	611064249

Form 5500 Responses for CEDAR LAKE 401K RETIREMENT SAVINGS PLAN

2022: CEDAR LAKE 401K RETIREMENT SAVINGS 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: CEDAR LAKE 401K RETIREMENT SAVINGS 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: CEDAR LAKE 401K RETIREMENT SAVINGS 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: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CEDAR LAKE 401K RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Number of Individuals Covered	405
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $34,171
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,171
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Number of Individuals Covered	407
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $41,327
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,327
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Number of Individuals Covered	412
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $33,815
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,815
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $31,566
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,566
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $31,606
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,197
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

802660

Policy instance

Insurance contract or identification number	802660
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $34,109
Contracts With Unallocated Funds Deposit Administration	1
Commission paid to Insurance Broker	USD $34,109
Insurance broker organization code?	1
Insurance broker name	STOCK YARDS BANK & TRUST CO.

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Company Name:	CEDAR LAKE WORKFORCE, LLC
Employer identification number (EIN):	364702958
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities