401k Plan data: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN plan

HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

HIAWATHA HOMES, INC. has sponsored the creation of one or more 401k plans.

Company Name: HIAWATHA HOMES, INC.

Employer identification number (EIN): 411278404

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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 CINDY OSTROWSKI CINDY OSTROWSKI 2019-06-28
001 2017-01-01 CINDY OSTROWSKI CINDY OSTROWSKI 2018-07-11
001 2016-01-01 CINDY OSTROWSKI
001 2015-01-01 CINDY OSTROWSKI
001 2014-01-01 CINDY OSTROWSKI
001 2013-01-01 CINDY OSTROWSKI
001 2012-01-01 CINDY OSTROWSKI CINDY OSTROWSKI 2013-10-04
001 2011-01-01 CINDY OSTROWSKI
001 2010-01-01 CINDY OSTROWSKI
001 2009-01-01 CINDY OSTROWSKI

Plan id#	Filing Submission Date	Name of Administrator	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	CINDY OSTROWSKI	CINDY OSTROWSKI	2019-06-28
001	2017-01-01	CINDY OSTROWSKI	CINDY OSTROWSKI	2018-07-11
001	2016-01-01	CINDY OSTROWSKI
001	2015-01-01	CINDY OSTROWSKI
001	2014-01-01	CINDY OSTROWSKI
001	2013-01-01	CINDY OSTROWSKI
001	2012-01-01	CINDY OSTROWSKI	CINDY OSTROWSKI	2013-10-04
001	2011-01-01	CINDY OSTROWSKI
001	2010-01-01	CINDY OSTROWSKI
001	2009-01-01	CINDY OSTROWSKI

Plan Statistics for HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 187
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 36
Total of all active and inactive participants 2022-01-01 223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 223
Number of participants with account balances 2022-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 3
2021: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 234
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 183
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 34
Total of all active and inactive participants 2021-01-01 217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 217
Number of participants with account balances 2021-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 203
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 39
Total of all active and inactive participants 2020-01-01 242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 242
Number of participants with account balances 2020-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 260
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 222
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 33
Total of all active and inactive participants 2019-01-01 255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 255
Number of participants with account balances 2019-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 3
2018: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 281
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 235
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 34
Total of all active and inactive participants 2018-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 269
Number of participants with account balances 2018-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 7
2017: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 291
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 237
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 28
Total of all active and inactive participants 2017-01-01 265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 265
Number of participants with account balances 2017-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 254
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 25
Total of all active and inactive participants 2016-01-01 279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 279
Number of participants with account balances 2016-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 264
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 24
Total of all active and inactive participants 2015-01-01 288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 288
Number of participants with account balances 2015-01-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 284
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 242
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 26
Total of all active and inactive participants 2014-01-01 268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 268
Number of participants with account balances 2014-01-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 303
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 271
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 22
Total of all active and inactive participants 2013-01-01 293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 293
Number of participants with account balances 2013-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 251
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 25
Total of all active and inactive participants 2012-01-01 276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 276
Number of participants with account balances 2012-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 265
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 285
Number of participants with account balances 2011-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2
2010: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 325
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 266
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 22
Total of all active and inactive participants 2010-01-01 288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 288
Number of participants with account balances 2010-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 3
2009: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 290
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 274
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 19
Total of all active and inactive participants 2009-01-01 293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 293
Number of participants with account balances 2009-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2022: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	187
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	36
Total of all active and inactive participants	2022-01-01	223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	223
Number of participants with account balances	2022-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	3
2021: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	234
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	183
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	34
Total of all active and inactive participants	2021-01-01	217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	217
Number of participants with account balances	2021-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	203
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	39
Total of all active and inactive participants	2020-01-01	242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	242
Number of participants with account balances	2020-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	260
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	222
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	33
Total of all active and inactive participants	2019-01-01	255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	255
Number of participants with account balances	2019-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	3
2018: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	281
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	235
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	34
Total of all active and inactive participants	2018-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	269
Number of participants with account balances	2018-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	7
2017: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	291
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	237
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	28
Total of all active and inactive participants	2017-01-01	265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	265
Number of participants with account balances	2017-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	254
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	25
Total of all active and inactive participants	2016-01-01	279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	279
Number of participants with account balances	2016-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	264
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	24
Total of all active and inactive participants	2015-01-01	288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	288
Number of participants with account balances	2015-01-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	284
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	242
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	26
Total of all active and inactive participants	2014-01-01	268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	268
Number of participants with account balances	2014-01-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	303
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	271
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	22
Total of all active and inactive participants	2013-01-01	293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	293
Number of participants with account balances	2013-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	251
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	25
Total of all active and inactive participants	2012-01-01	276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	276
Number of participants with account balances	2012-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	265
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	285
Number of participants with account balances	2011-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2
2010: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	325
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	266
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	22
Total of all active and inactive participants	2010-01-01	288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	288
Number of participants with account balances	2010-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	3
2009: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	290
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	274
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	19
Total of all active and inactive participants	2009-01-01	293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	293
Number of participants with account balances	2009-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2022 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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	$-291,461
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$671,616
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$669,272
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$223,595
Value of total assets at end of year	2022-12-31	$3,316,038
Value of total assets at beginning of year	2022-12-31	$4,279,115
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,344
Total interest from all sources	2022-12-31	$19,499
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	$331,604
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	$170,331
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$460
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	$-963,077
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,316,038
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,279,115
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	$2,471,056
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$3,392,507
Interest earned on other investments	2022-12-31	$19,499
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$844,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$886,608
Net investment gain/loss from pooled separate accounts	2022-12-31	$-534,555
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	$52,804
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$669,272
Contract administrator fees	2022-12-31	$2,344
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	SMITH SCHAFER AND ASSOCIATES
Accountancy firm EIN	2022-12-31	411489071
2021 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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	$816,770
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$535,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$527,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$259,945
Value of total assets at end of year	2021-12-31	$4,279,115
Value of total assets at beginning of year	2021-12-31	$3,997,724
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$8,266
Total interest from all sources	2021-12-31	$19,117
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	$399,772
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	$198,709
Other income not declared elsewhere	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$281,391
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,279,115
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,997,724
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	$3,392,507
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,256,798
Interest earned on other investments	2021-12-31	$19,117
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$886,608
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$740,926
Net investment gain/loss from pooled separate accounts	2021-12-31	$537,708
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	$61,236
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$527,113
Contract administrator fees	2021-12-31	$8,266
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2021-12-31	411489071
2020 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$644,059
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$47,313
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$45,859
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$267,360
Value of total assets at end of year	2020-12-31	$3,997,724
Value of total assets at beginning of year	2020-12-31	$3,400,978
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,454
Total interest from all sources	2020-12-31	$19,845
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	Yes
Value of fidelity bond cover	2020-12-31	$340,098
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	$210,619
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	$596,746
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,997,724
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,400,978
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	$3,256,798
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,906,205
Interest earned on other investments	2020-12-31	$19,845
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$740,926
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$494,773
Net investment gain/loss from pooled separate accounts	2020-12-31	$356,854
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	$56,741
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$45,859
Contract administrator fees	2020-12-31	$1,454
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2020-12-31	411489071
2019 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$846,899
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$471,573
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$469,854
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$247,653
Value of total assets at end of year	2019-12-31	$3,400,978
Value of total assets at beginning of year	2019-12-31	$3,025,652
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,719
Total interest from all sources	2019-12-31	$16,377
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$302,565
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	$192,565
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	$375,326
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,400,978
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,025,652
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	$2,906,205
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$2,572,630
Interest earned on other investments	2019-12-31	$16,377
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$494,773
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$453,022
Net investment gain/loss from pooled separate accounts	2019-12-31	$582,869
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	$55,088
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$469,854
Contract administrator fees	2019-12-31	$1,719
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2019-12-31	411489071
2018 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$106,517
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$558,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$554,407
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$232,194
Value of total assets at end of year	2018-12-31	$3,025,652
Value of total assets at beginning of year	2018-12-31	$3,477,299
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$3,757
Total interest from all sources	2018-12-31	$15,658
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$347,730
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	$178,643
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	$-451,647
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,025,652
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,477,299
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	$2,572,630
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,037,544
Interest earned on other investments	2018-12-31	$15,658
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$453,022
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$439,755
Net investment gain/loss from pooled separate accounts	2018-12-31	$-141,335
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	$53,551
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$554,407
Contract administrator fees	2018-12-31	$3,757
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2018-12-31	411489071
2017 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$664,783
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$90,209
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$88,497
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$230,346
Value of total assets at end of year	2017-12-31	$3,477,299
Value of total assets at beginning of year	2017-12-31	$2,902,725
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,712
Total interest from all sources	2017-12-31	$15,264
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$347,730
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$169,768
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$2,229
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	$574,574
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,477,299
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,902,725
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	$3,037,544
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,484,167
Interest earned on other investments	2017-12-31	$15,264
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$439,755
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$418,558
Net investment gain/loss from pooled separate accounts	2017-12-31	$419,173
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	$58,349
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$88,497
Contract administrator fees	2017-12-31	$1,712
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2017-12-31	411489071
2016 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$434,937
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$70,861
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$70,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$212,421
Value of total assets at end of year	2016-12-31	$2,902,725
Value of total assets at beginning of year	2016-12-31	$2,538,649
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$639
Total interest from all sources	2016-12-31	$15,191
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$156,671
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$6,559
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	$364,076
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,902,725
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,538,649
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	$2,484,167
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$2,130,018
Interest earned on other investments	2016-12-31	$15,191
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$418,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$408,631
Net investment gain/loss from pooled separate accounts	2016-12-31	$207,325
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	No
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	$49,191
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$70,222
Contract administrator fees	2016-12-31	$639
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2016-12-31	411489071
2015 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$181,158
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$561,481
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$559,262
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$169,663
Value of total assets at end of year	2015-12-31	$2,538,649
Value of total assets at beginning of year	2015-12-31	$2,918,972
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,219
Total interest from all sources	2015-12-31	$18,226
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$300,000
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	$145,436
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	$-380,323
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,538,649
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,918,972
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	$2,130,018
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$2,406,375
Interest earned on other investments	2015-12-31	$18,226
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$408,631
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$512,597
Net investment gain/loss from pooled separate accounts	2015-12-31	$-6,731
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$24,227
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$559,262
Contract administrator fees	2015-12-31	$2,219
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2015-12-31	411489071
2014 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$336,508
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$25,585
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$25,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$146,956
Value of total assets at end of year	2014-12-31	$2,918,972
Value of total assets at beginning of year	2014-12-31	$2,608,049
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$504
Total interest from all sources	2014-12-31	$19,810
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$300,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$124,322
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	$310,923
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,918,972
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,608,049
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	$2,406,375
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$2,115,197
Interest earned on other investments	2014-12-31	$19,810
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$512,597
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$492,852
Net investment gain/loss from pooled separate accounts	2014-12-31	$169,742
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$22,634
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$25,081
Contract administrator fees	2014-12-31	$504
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2014-12-31	411489071
2013 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$538,424
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$83,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$83,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$136,594
Value of total assets at end of year	2013-12-31	$2,608,049
Value of total assets at beginning of year	2013-12-31	$2,153,514
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$652
Total interest from all sources	2013-12-31	$19,391
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$265,000
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	$115,576
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	$454,535
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,608,049
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,153,514
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	$2,115,197
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,665,253
Interest earned on other investments	2013-12-31	$19,391
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$492,852
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$488,261
Net investment gain/loss from pooled separate accounts	2013-12-31	$382,439
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	$21,018
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$83,237
Contract administrator fees	2013-12-31	$652
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2013-12-31	411489071
2012 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$343,850
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$20,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$20,652
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$120,904
Value of total assets at end of year	2012-12-31	$2,153,514
Value of total assets at beginning of year	2012-12-31	$1,830,436
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$120
Total interest from all sources	2012-12-31	$20,499
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$215,000
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
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$100,172
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	$323,078
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$2,153,514
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,830,436
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	$1,665,253
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,380,771
Interest earned on other investments	2012-12-31	$20,499
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$488,261
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$449,665
Net investment gain/loss from pooled separate accounts	2012-12-31	$202,447
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	$20,732
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$20,652
Contract administrator fees	2012-12-31	$120
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2012-12-31	411489071
2011 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$123,659
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$169,655
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$167,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$115,808
Value of total assets at end of year	2011-12-31	$1,830,436
Value of total assets at beginning of year	2011-12-31	$1,876,432
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,197
Total interest from all sources	2011-12-31	$20,962
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$200,000
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
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$92,520
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$-45,996
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,830,436
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,876,432
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	$1,380,771
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,436,363
Interest earned on other investments	2011-12-31	$20,962
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$449,665
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$440,069
Net investment gain/loss from pooled separate accounts	2011-12-31	$-13,111
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	$23,101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$167,458
Contract administrator fees	2011-12-31	$2,197
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
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	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2011-12-31	411489071
2010 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$322,039
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$100,976
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$100,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$137,930
Value of total assets at end of year	2010-12-31	$1,876,432
Value of total assets at beginning of year	2010-12-31	$1,655,369
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$360
Total interest from all sources	2010-12-31	$21,233
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$200,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$114,617
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$221,063
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,876,432
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,655,369
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,436,363
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,237,882
Interest earned on other investments	2010-12-31	$21,233
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$440,069
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$417,487
Net investment gain/loss from pooled separate accounts	2010-12-31	$162,876
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$23,313
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$100,616
Contract administrator fees	2010-12-31	$360
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SMITH SCHAFER & ASSOCIATES
Accountancy firm EIN	2010-12-31	411489071
2009 : HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN

2022: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: HIAWATHA HOMES, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

012174

Policy instance

Insurance contract or identification number	012174
Number of Individuals Covered	223
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,030
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 $5,030
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

012174

Policy instance

Insurance contract or identification number	012174
Number of Individuals Covered	217
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $6,014
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 $6,014
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

012174

Policy instance

Insurance contract or identification number	012174
Number of Individuals Covered	242
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,885
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 $4,885
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	257
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,593
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 $4,593
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	269
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,792
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 $4,792
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	265
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,503
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 $4,503
Insurance broker organization code?	3
Insurance broker name	CETERA FINANCIAL SPECIALISTS

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	288
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,678
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 $3,678
Insurance broker organization code?	3
Insurance broker name	CETERA FINANCIAL SPECIALISTS

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	268
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,924
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 $3,924
Insurance broker organization code?	3
Insurance broker name	CETERA FINANCIAL SPECIALISTS

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	293
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,386
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 $3,386
Insurance broker organization code?	3
Insurance broker name	CETERA FINANCIAL SPECIALISTS

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	276
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,906
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,906
Insurance broker organization code?	3
Insurance broker name	MARK ELLINGSON

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	285
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,578
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

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

12174-100

Policy instance

Insurance contract or identification number	12174-100
Number of Individuals Covered	288
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,512
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

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Company Name:	HIAWATHA HOMES, INC.
Employer identification number (EIN):	411278404
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities