401k Plan data: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST plan

TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST
Plan identification number	001

TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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

TRIBUTE HOME CARE has sponsored the creation of one or more 401k plans.

Company Name: TRIBUTE HOME CARE

Employer identification number (EIN): 455420243

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about TRIBUTE HOME CARE

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5162948

More information about TRIBUTE HOME CARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 JOHN SNEATH 2024-07-31 JOHN SNEATH 2024-07-31
001 2022-01-01 JOHN SNEATH 2023-10-12 JOHN SNEATH 2023-10-12
001 2021-01-01 JOHN SNEATH 2022-09-12 JOHN SNEATH 2022-09-12
001 2020-01-01 JOHN SNEATH 2021-10-13 JOHN SNEATH 2021-10-13
001 2019-01-01 JOHN SNEATH 2020-10-14 JOHN SNEATH 2020-10-14
001 2018-01-01
001 2017-01-01 STEPHANIE STEINERT
001 2017-01-01 STEPHANIE STEINERT
001 2016-01-01 STEPHANIE STEINERT
001 2016-01-01
001 2015-01-01 JOHN SNEATH 2016-07-28
001 2014-01-01 JOHN SNEATH 2015-07-20
001 2013-01-01 JOHN SNEATH 2014-07-02
001 2012-01-01 TRIBUTE HOME CARE LLC 2013-07-09

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	JOHN SNEATH	2024-07-31	JOHN SNEATH	2024-07-31
001	2022-01-01	JOHN SNEATH	2023-10-12	JOHN SNEATH	2023-10-12
001	2021-01-01	JOHN SNEATH	2022-09-12	JOHN SNEATH	2022-09-12
001	2020-01-01	JOHN SNEATH	2021-10-13	JOHN SNEATH	2021-10-13
001	2019-01-01	JOHN SNEATH	2020-10-14	JOHN SNEATH	2020-10-14
001	2018-01-01
001	2017-01-01	STEPHANIE STEINERT
001	2017-01-01	STEPHANIE STEINERT
001	2016-01-01	STEPHANIE STEINERT
001	2016-01-01
001	2015-01-01	JOHN SNEATH	2016-07-28
001	2014-01-01	JOHN SNEATH	2015-07-20
001	2013-01-01	JOHN SNEATH	2014-07-02
001	2012-01-01	TRIBUTE HOME CARE LLC	2013-07-09

Plan Statistics for TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2023: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2023 401k membership
Total participants, beginning-of-year 2023-01-01 419
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 422
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 25
Total of all active and inactive participants 2023-01-01 447
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 447
Number of participants with account balances 2023-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 1
2022: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 389
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 30
Total of all active and inactive participants 2022-01-01 419
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 419
Number of participants with account balances 2022-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 358
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 323
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 27
Total of all active and inactive participants 2021-01-01 351
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 351
Number of participants with account balances 2021-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 287
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 344
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 358
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 358
Number of participants with account balances 2020-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 279
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 4
Total of all active and inactive participants 2019-01-01 283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 283
Number of participants with account balances 2019-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 197
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 3
Total of all active and inactive participants 2018-01-01 200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 200
Number of participants with account balances 2018-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 201
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 3
Total of all active and inactive participants 2017-01-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 204
Number of participants with account balances 2017-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 189
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 0
Total of all active and inactive participants 2016-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 189
Number of participants with account balances 2016-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2023: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2023 401k membership
Total participants, beginning-of-year	2023-01-01	419
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	422
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	25
Total of all active and inactive participants	2023-01-01	447
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	447
Number of participants with account balances	2023-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	1
2022: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	389
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	30
Total of all active and inactive participants	2022-01-01	419
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	419
Number of participants with account balances	2022-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	358
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	323
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	27
Total of all active and inactive participants	2021-01-01	351
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	351
Number of participants with account balances	2021-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	287
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	344
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	358
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	358
Number of participants with account balances	2020-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	279
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	4
Total of all active and inactive participants	2019-01-01	283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	283
Number of participants with account balances	2019-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	197
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	3
Total of all active and inactive participants	2018-01-01	200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	200
Number of participants with account balances	2018-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	201
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	3
Total of all active and inactive participants	2017-01-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	204
Number of participants with account balances	2017-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	189
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	0
Total of all active and inactive participants	2016-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	189
Number of participants with account balances	2016-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2023 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$25,517
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$1,020,967
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$275,119
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$251,285
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$721,653
Value of total assets at end of year	2023-12-31	$2,178,926
Value of total assets at beginning of year	2023-12-31	$1,407,561
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$23,834
Total interest from all sources	2023-12-31	$3,426
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$150,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$554,094
Participant contributions at end of year	2023-12-31	$58,317
Participant contributions at beginning of year	2023-12-31	$41,647
Participant contributions at end of year	2023-12-31	$18
Participant contributions at beginning of year	2023-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$130,199
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$25,517
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$0
Administrative expenses (other) incurred	2023-12-31	$3,175
Total non interest bearing cash at end of year	2023-12-31	$58
Total non interest bearing cash at beginning of year	2023-12-31	$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	2023-12-31	No
Value of net income/loss	2023-12-31	$745,848
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$2,153,409
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$1,407,561
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Investment advisory and management fees	2023-12-31	$8,527
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$0
Value of interest in pooled separate accounts at end of year	2023-12-31	$2,120,531
Value of interest in pooled separate accounts at beginning of year	2023-12-31	$1,365,914
Interest on participant loans	2023-12-31	$3,426
Net investment gain/loss from pooled separate accounts	2023-12-31	$295,888
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$37,360
Employer contributions (assets) at end of year	2023-12-31	$2
Employer contributions (assets) at beginning of year	2023-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$251,285
Contract administrator fees	2023-12-31	$12,132
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	CARON & BLETZER
Accountancy firm EIN	2023-12-31	043499945
2022 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 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	$499,702
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$254,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$234,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$715,135
Value of total assets at end of year	2022-12-31	$1,407,561
Value of total assets at beginning of year	2022-12-31	$1,162,676
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$20,396
Total interest from all sources	2022-12-31	$1,283
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	$150,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$545,059
Participant contributions at end of year	2022-12-31	$41,647
Participant contributions at beginning of year	2022-12-31	$18,982
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$170,076
Administrative expenses (other) incurred	2022-12-31	$2,950
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$244,885
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,407,561
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,162,676
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
Investment advisory and management fees	2022-12-31	$6,130
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$0
Value of interest in pooled separate accounts at end of year	2022-12-31	$1,365,914
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$1,143,694
Interest on participant loans	2022-12-31	$1,283
Net investment gain/loss from pooled separate accounts	2022-12-31	$-216,716
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$234,421
Contract administrator fees	2022-12-31	$11,316
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	CARON & BLETZER
Accountancy firm EIN	2022-12-31	043499945
2021 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 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	$648,019
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$77,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$62,474
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$525,265
Value of total assets at end of year	2021-12-31	$1,162,676
Value of total assets at beginning of year	2021-12-31	$591,922
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$14,791
Total interest from all sources	2021-12-31	$884
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	$60,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$377,913
Participant contributions at end of year	2021-12-31	$18,982
Participant contributions at beginning of year	2021-12-31	$5,707
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$147,352
Administrative expenses (other) incurred	2021-12-31	$1,250
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	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	$570,754
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,162,676
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$591,922
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
Investment advisory and management fees	2021-12-31	$4,660
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$1,143,694
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$586,215
Interest on participant loans	2021-12-31	$884
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$121,870
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
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$62,474
Contract administrator fees	2021-12-31	$8,881
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	CARON & BLETZER
Accountancy firm EIN	2021-12-31	043499945
2020 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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	$324,903
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$29,453
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$23,559
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$211,593
Value of total assets at end of year	2020-12-31	$591,922
Value of total assets at beginning of year	2020-12-31	$296,472
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$5,894
Total interest from all sources	2020-12-31	$569
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
Administrative expenses professional fees incurred	2020-12-31	$2,556
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$30,000
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	$207,890
Participant contributions at end of year	2020-12-31	$5,707
Participant contributions at beginning of year	2020-12-31	$9,235
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$3,703
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$295,450
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$591,922
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$296,472
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
Investment advisory and management fees	2020-12-31	$1,729
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$171,270
Value of interest in pooled separate accounts at end of year	2020-12-31	$586,215
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Income. Interest from loans (other than to participants)	2020-12-31	$569
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$115,967
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$112,020
Net investment gain or loss from common/collective trusts	2020-12-31	$721
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	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$23,559
Contract administrator fees	2020-12-31	$1,609
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	CARON & BLETZER
Accountancy firm EIN	2020-12-31	043499945
2019 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$0
Total transfer of assets from this plan	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 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 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	$162,376
Total income from all sources (including contributions)	2019-12-31	$162,376
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$3,230
Total of all expenses incurred	2019-12-31	$3,230
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,440
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$140,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$140,739
Value of total assets at end of year	2019-12-31	$296,472
Value of total assets at end of year	2019-12-31	$296,472
Value of total assets at beginning of year	2019-12-31	$137,326
Value of total assets at beginning of year	2019-12-31	$137,326
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$790
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$790
Total interest from all sources	2019-12-31	$395
Total interest from all sources	2019-12-31	$395
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$3,600
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$3,600
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$3,600
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$3,600
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$14,000
Value of fidelity bond cover	2019-12-31	$14,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$133,947
Contributions received from participants	2019-12-31	$133,947
Participant contributions at end of year	2019-12-31	$9,235
Participant contributions at end of year	2019-12-31	$9,235
Participant contributions at beginning of year	2019-12-31	$863
Participant contributions at beginning of year	2019-12-31	$863
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$2,542
Participant contributions at beginning of year	2019-12-31	$2,542
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$6,792
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$6,792
Administrative expenses (other) incurred	2019-12-31	$790
Administrative expenses (other) incurred	2019-12-31	$790
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	2019-12-31	No
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	$159,146
Value of net income/loss	2019-12-31	$159,146
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$296,472
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$296,472
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$137,326
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$137,326
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$171,270
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$171,270
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$41,542
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$41,542
Interest on participant loans	2019-12-31	$395
Interest on participant loans	2019-12-31	$395
Value of interest in common/collective trusts at end of year	2019-12-31	$115,967
Value of interest in common/collective trusts at end of year	2019-12-31	$115,967
Value of interest in common/collective trusts at beginning of year	2019-12-31	$92,379
Value of interest in common/collective trusts at beginning of year	2019-12-31	$92,379
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$14,991
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$14,991
Net investment gain or loss from common/collective trusts	2019-12-31	$2,651
Net investment gain or loss from common/collective trusts	2019-12-31	$2,651
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,440
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,440
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CARON & BLETZER
Accountancy firm name	2019-12-31	CARON & BLETZER
Accountancy firm EIN	2019-12-31	043499945
Accountancy firm EIN	2019-12-31	043499945
2018 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets from this plan	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	$41,029
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$15,574
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$14,990
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$43,516
Value of total assets at end of year	2018-12-31	$137,326
Value of total assets at beginning of year	2018-12-31	$111,871
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$584
Total interest from all sources	2018-12-31	$12
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$808
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$12,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
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	$43,516
Participant contributions at end of year	2018-12-31	$863
Participant contributions at beginning of year	2018-12-31	$2,965
Participant contributions at end of year	2018-12-31	$2,542
Administrative expenses (other) incurred	2018-12-31	$584
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	$25,455
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$137,326
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$111,871
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$41,542
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$822
Interest on participant loans	2018-12-31	$12
Value of interest in common/collective trusts at end of year	2018-12-31	$92,379
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$108,084
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$108,084
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-3,747
Net investment gain or loss from common/collective trusts	2018-12-31	$440
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$14,990
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	2018-12-31	Yes
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	CARON & BLETZER
Accountancy firm EIN	2018-12-31	043499945
2017 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$50,750
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$2,645
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,604
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$37,201
Value of total assets at end of year	2017-12-31	$111,871
Value of total assets at beginning of year	2017-12-31	$63,766
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$41
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$-2,975
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$28
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$28
Assets. Real estate other than employer real property at end of year	2017-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$30,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Funding deficiency by the employer to the plan for this plan year	2017-12-31	$0
Minimum employer required contribution for this plan year	2017-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$37,201
Participant contributions at end of year	2017-12-31	$2,965
Participant contributions at beginning of year	2017-12-31	$1,008
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Assets. Loans (other than to participants) at end of year	2017-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$1
Liabilities. Value of operating payables at end of year	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$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	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$48,105
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$111,871
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$63,766
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
Assets. partnership/joint venture interests at end of year	2017-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$822
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$62,646
Interest on participant loans	2017-12-31	$-3,074
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$0
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Value of interest in master investment trust accounts at end of year	2017-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2017-12-31	$0
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$108,084
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$112
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$112
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$99
Assets. Value of investments in 103.12 investment entities at end of year	2017-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Asset value of US Government securities at end of year	2017-12-31	$0
Asset value of US Government securities at beginning of year	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$16,496
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
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
Assets. Invements in employer securities at beginning of year	2017-12-31	$0
Assets. Value of employer real property at end of year	2017-12-31	$0
Assets. Value of employer real property at beginning of year	2017-12-31	$0
Contributions received in cash from employer	2017-12-31	$0
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,604
Asset. Corporate debt instrument preferred debt at end of year	2017-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$0
Contract administrator fees	2017-12-31	$40
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-12-31	$0
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
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945
2016 : TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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	$40,751
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$45,588
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$36,940
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Value of total corrective distributions	2016-12-31	$8,491
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$37,188
Value of total assets at end of year	2016-12-31	$63,766
Value of total assets at beginning of year	2016-12-31	$68,603
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$157
Total interest from all sources	2016-12-31	$33
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$3,007
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$3,007
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$30,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$37,188
Participant contributions at end of year	2016-12-31	$1,008
Participant contributions at beginning of year	2016-12-31	$0
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$-4,837
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$63,766
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$68,603
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
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$62,646
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$68,603
Interest on participant loans	2016-12-31	$33
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$112
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$523
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
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
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$0
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$36,940
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$157
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
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
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945

Form 5500 Responses for TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST

2023: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 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: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 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: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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 – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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 – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
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 – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: TRIBUTE HOME CARE LLC 401 K PROFIT SHARING PLAN 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143842

Policy instance

Insurance contract or identification number	143842
Number of Individuals Covered	155
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,011
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143842

Policy instance

Insurance contract or identification number	143842
Number of Individuals Covered	129
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $5,344
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	5344
Additional information about fees paid to insurance broker	TPA FEES/COMPENSATION
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143842

Policy instance

Insurance contract or identification number	143842
Number of Individuals Covered	119
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,768
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2768
Additional information about fees paid to insurance broker	TPA FEES/COMPENSATION
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143842

Policy instance

Insurance contract or identification number	143842
Number of Individuals Covered	85
Insurance policy start date	2020-04-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,556
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2556
Additional information about fees paid to insurance broker	TPA FEES/COMPENSATION
Insurance broker organization code?	5

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Company Name:	TRIBUTE HOME CARE
Employer identification number (EIN):	455420243
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5162948