401k Plan data: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST plan

RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 401k Plan overview

Plan Name	RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST
Plan identification number	001

RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

RIVER VALLEY HOME CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name: RIVER VALLEY HOME CARE, INC.

Employer identification number (EIN): 411926339

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 RACHELLE PARISEAU RACHELLE PARISEAU 2018-09-26
001 2016-01-01 RACHELLE PARISEAU RACHELLE PARISEAU 2017-10-11
001 2016-01-01
001 2015-01-01 RACHELLE PARISEAU
001 2014-01-01 RACHELLE PARISEAU RACHELLE PARISEAU 2015-10-15
001 2013-01-01 RACHELLE PARISEAU 2014-07-31 RACHELLE PARISEAU 2014-07-31
001 2012-01-01 RACHELLE PARISEAU 2013-07-03
001 2011-01-01 RACHELLE PARISEAU CEO 2012-10-10
001 2010-01-01 RACHELLE PARISEAU 2011-10-10

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2020-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	RACHELLE PARISEAU		RACHELLE PARISEAU	2018-09-26
001	2016-01-01	RACHELLE PARISEAU		RACHELLE PARISEAU	2017-10-11
001	2016-01-01
001	2015-01-01	RACHELLE PARISEAU
001	2014-01-01	RACHELLE PARISEAU		RACHELLE PARISEAU	2015-10-15
001	2013-01-01	RACHELLE PARISEAU	2014-07-31	RACHELLE PARISEAU	2014-07-31
001	2012-01-01	RACHELLE PARISEAU	2013-07-03
001	2011-01-01	RACHELLE PARISEAU CEO	2012-10-10
001	2010-01-01	RACHELLE PARISEAU	2011-10-10

Plan Statistics for RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST

401k plan membership statisitcs for RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST

Measure Date Value
2020: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 92
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 12
Total of all active and inactive participants 2020-01-01 104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 104
Number of participants with account balances 2020-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 128
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 10
Total of all active and inactive participants 2019-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 138
Number of participants with account balances 2019-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 128
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 8
Total of all active and inactive participants 2018-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 136
Number of participants with account balances 2018-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 139
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 9
Total of all active and inactive participants 2017-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 148
Number of participants with account balances 2017-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 147
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 6
Total of all active and inactive participants 2016-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 153
Number of participants with account balances 2016-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 141
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 10
Total of all active and inactive participants 2015-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 151
Number of participants with account balances 2015-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 108
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 7
Total of all active and inactive participants 2014-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 115
Number of participants with account balances 2014-01-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2020: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	92
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	12
Total of all active and inactive participants	2020-01-01	104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	104
Number of participants with account balances	2020-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	128
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	10
Total of all active and inactive participants	2019-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	138
Number of participants with account balances	2019-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	128
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	8
Total of all active and inactive participants	2018-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	136
Number of participants with account balances	2018-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	139
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	9
Total of all active and inactive participants	2017-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	148
Number of participants with account balances	2017-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	147
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	6
Total of all active and inactive participants	2016-01-01	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	153
Number of participants with account balances	2016-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	141
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	10
Total of all active and inactive participants	2015-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	151
Number of participants with account balances	2015-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	108
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	7
Total of all active and inactive participants	2014-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	115
Number of participants with account balances	2014-01-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST

Measure	Date	Value
2020 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$547,469
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$218,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$217,762
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$255,569
Value of total assets at end of year	2020-12-31	$2,301,346
Value of total assets at beginning of year	2020-12-31	$1,971,999
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$360
Total interest from all sources	2020-12-31	$2,853
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$178,428
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$41,235
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	$329,347
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,301,346
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,971,999
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	$2,097,142
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,804,898
Interest earned on other investments	2020-12-31	$2,853
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$204,204
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$167,101
Net investment gain/loss from pooled separate accounts	2020-12-31	$289,047
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	$35,906
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$217,762
Contract administrator fees	2020-12-31	$360
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	ROGERS & KING CPA LLC
Accountancy firm EIN	2020-12-31	264369558
2019 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$509,809
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$38,404
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$38,204
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$194,221
Value of total assets at end of year	2019-12-31	$1,971,999
Value of total assets at beginning of year	2019-12-31	$1,500,594
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$200
Total interest from all sources	2019-12-31	$2,126
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$167,878
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	$471,405
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,971,999
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,500,594
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	$1,804,898
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,372,028
Interest earned on other investments	2019-12-31	$2,126
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$167,101
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$128,566
Net investment gain/loss from pooled separate accounts	2019-12-31	$313,462
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	Yes
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	$26,343
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$38,204
Contract administrator fees	2019-12-31	$200
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	ROGERS & KING CPA LLC
Accountancy firm EIN	2019-12-31	264369558
2018 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$7,037
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$149,185
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$148,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$116,095
Value of total assets at end of year	2018-12-31	$1,500,594
Value of total assets at beginning of year	2018-12-31	$1,642,742
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$240
Total interest from all sources	2018-12-31	$2,292
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$88,341
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	$-142,148
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,500,594
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,642,742
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	$1,372,028
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,480,334
Interest earned on other investments	2018-12-31	$2,292
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$128,566
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$162,408
Net investment gain/loss from pooled separate accounts	2018-12-31	$-111,350
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	Yes
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	$27,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$148,945
Contract administrator fees	2018-12-31	$240
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 LTD
Accountancy firm EIN	2018-12-31	411489071
2017 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$303,291
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$260,541
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$258,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$105,456
Value of total assets at end of year	2017-12-31	$1,642,742
Value of total assets at beginning of year	2017-12-31	$1,599,992
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,780
Total interest from all sources	2017-12-31	$2,356
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	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$74,936
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	$42,750
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,642,742
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,599,992
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	$1,480,334
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,446,224
Interest earned on other investments	2017-12-31	$2,356
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$162,408
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$153,768
Net investment gain/loss from pooled separate accounts	2017-12-31	$195,479
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	$30,520
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$258,761
Contract administrator fees	2017-12-31	$1,780
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 LTD
Accountancy firm EIN	2017-12-31	411489071
2016 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$216,691
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$5,503
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,068
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$113,831
Value of total assets at end of year	2016-12-31	$1,599,992
Value of total assets at beginning of year	2016-12-31	$1,388,804
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,435
Total interest from all sources	2016-12-31	$2,588
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	$500,000
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	$81,343
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	$211,188
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,599,992
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,388,804
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	$1,446,224
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,253,203
Interest earned on other investments	2016-12-31	$2,588
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$153,768
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$135,601
Net investment gain/loss from pooled separate accounts	2016-12-31	$100,272
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	$32,488
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$3,068
Contract administrator fees	2016-12-31	$2,435
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 LTD
Accountancy firm EIN	2016-12-31	411489071
2015 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$111,757
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$173,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$172,120
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$134,839
Value of total assets at end of year	2015-12-31	$1,388,804
Value of total assets at beginning of year	2015-12-31	$1,450,987
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,820
Total interest from all sources	2015-12-31	$2,058
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$72,749
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	$-62,183
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,388,804
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,450,987
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	$1,253,203
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,324,818
Interest earned on other investments	2015-12-31	$2,058
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$135,601
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$126,169
Net investment gain/loss from pooled separate accounts	2015-12-31	$-25,140
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	$62,090
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$172,120
Contract administrator fees	2015-12-31	$1,820
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	BLANSKI PETER KRONLAGE & ZOCH P.A.
Accountancy firm EIN	2015-12-31	411735076
2014 : RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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	$293,041
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$46,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$43,677
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$189,666
Value of total assets at end of year	2014-12-31	$1,450,987
Value of total assets at beginning of year	2014-12-31	$1,204,388
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,765
Total interest from all sources	2014-12-31	$1,694
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	$500,000
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	$80,321
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$81,620
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	$246,599
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,450,987
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,204,388
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	$1,324,818
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$1,100,626
Interest earned on other investments	2014-12-31	$1,694
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$126,169
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$103,762
Net investment gain/loss from pooled separate accounts	2014-12-31	$101,681
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	$27,725
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$43,677
Contract administrator fees	2014-12-31	$2,765
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	BLANSKI PETER KRONLAGE & ZOCH P.A.
Accountancy firm EIN	2014-12-31	411735076

Form 5500 Responses for RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST

2020: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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: RIVER VALLEY HOME CARE, INC. 401(K) PLAN AND TRUST 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

Insurance Providers Used on plan

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	104
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $10,094
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
Commission paid to Insurance Broker	USD $10,094
Insurance broker organization code?	3

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	138
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $8,949
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
Commission paid to Insurance Broker	USD $8,949
Insurance broker organization code?	3

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	136
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $8,049
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
Commission paid to Insurance Broker	USD $8,049
Insurance broker organization code?	3

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	148
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,887
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
Commission paid to Insurance Broker	USD $7,887
Insurance broker organization code?	3
Insurance broker name	NORTHWESTERN MUTUAL

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	151
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7,082
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
Commission paid to Insurance Broker	USD $3,541
Insurance broker organization code?	3
Insurance broker name	SECURIAN FINANCIAL SERVICES

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

Policy contract number

064893

Policy instance

Insurance contract or identification number	064893
Number of Individuals Covered	115
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,826
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
Commission paid to Insurance Broker	USD $3,413
Insurance broker organization code?	3
Insurance broker name	SECURIAN FINANCIAL SERVICES

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Company Name:	RIVER VALLEY HOME CARE, INC.
Employer identification number (EIN):	411926339
NAIC Classification:	621610
NAIC Description:	Home Health Care Services