401k Plan data: THE ADANTA GROUP 401(K) PLAN plan

THE ADANTA GROUP 401(K) PLAN 401k Plan overview

Plan Name	THE ADANTA GROUP 401(K) PLAN
Plan identification number	001

THE ADANTA GROUP 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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

LAKE CUMBERLAND REGIONAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: LAKE CUMBERLAND REGIONAL, INC.

Employer identification number (EIN): 610666065

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE ADANTA GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JACK LEWIS
001 2016-01-01 JACK LEWIS
001 2015-09-01 JACK LEWIS

Plan Statistics for THE ADANTA GROUP 401(K) PLAN

401k plan membership statisitcs for THE ADANTA GROUP 401(K) PLAN

Measure Date Value
2020: THE ADANTA GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
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 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Number of participants with account balances 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: THE ADANTA GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 121
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 22
Total of all active and inactive participants 2019-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 143
Number of participants with account balances 2019-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: THE ADANTA GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 143
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 2018-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 151
Number of participants with account balances 2018-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: THE ADANTA GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 214
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 167
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 5
Total of all active and inactive participants 2017-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 172
Number of participants with account balances 2017-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE ADANTA GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 242
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 192
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 22
Total of all active and inactive participants 2016-01-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 214
Number of participants with account balances 2016-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE ADANTA GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-09-01 245
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 217
Number of retired or separated participants receiving benefits 2015-09-01 0
Number of other retired or separated participants entitled to future benefits 2015-09-01 25
Total of all active and inactive participants 2015-09-01 242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-09-01 0
Total participants 2015-09-01 242
Number of participants with account balances 2015-09-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-09-01 0

Measure	Date	Value
2020: THE ADANTA GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
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	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Number of participants with account balances	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: THE ADANTA GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	121
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	22
Total of all active and inactive participants	2019-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	143
Number of participants with account balances	2019-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: THE ADANTA GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	143
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	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	151
Number of participants with account balances	2018-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: THE ADANTA GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	214
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	167
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	5
Total of all active and inactive participants	2017-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	172
Number of participants with account balances	2017-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE ADANTA GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	242
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	192
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	22
Total of all active and inactive participants	2016-01-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	214
Number of participants with account balances	2016-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE ADANTA GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-09-01	245
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	217
Number of retired or separated participants receiving benefits	2015-09-01	0
Number of other retired or separated participants entitled to future benefits	2015-09-01	25
Total of all active and inactive participants	2015-09-01	242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-09-01	0
Total participants	2015-09-01	242
Number of participants with account balances	2015-09-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-09-01	0

Financial Data on THE ADANTA GROUP 401(K) PLAN

Measure	Date	Value
2020 : THE ADANTA GROUP 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-08-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-08-31	$0
Total income from all sources (including contributions)	2020-08-31	$-66,006
Total loss/gain on sale of assets	2020-08-31	$0
Total of all expenses incurred	2020-08-31	$875,613
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-08-31	$871,034
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-08-31	$5,867
Value of total assets at end of year	2020-08-31	$0
Value of total assets at beginning of year	2020-08-31	$941,619
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-08-31	$4,579
Total interest from all sources	2020-08-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-08-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-08-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2020-08-31	$0
Was this plan covered by a fidelity bond	2020-08-31	Yes
Value of fidelity bond cover	2020-08-31	$150,000
If this is an individual account plan, was there a blackout period	2020-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-08-31	No
Contributions received from participants	2020-08-31	$5,867
Participant contributions at end of year	2020-08-31	$0
Participant contributions at beginning of year	2020-08-31	$0
Participant contributions at end of year	2020-08-31	$0
Participant contributions at beginning of year	2020-08-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-08-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-08-31	$0
Administrative expenses (other) incurred	2020-08-31	$4,579
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-08-31	No
Value of net income/loss	2020-08-31	$-941,619
Value of net assets at end of year (total assets less liabilities)	2020-08-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-08-31	$941,619
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-08-31	No
Were any leases to which the plan was party in default or uncollectible	2020-08-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-08-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-08-31	$930,376
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-08-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-08-31	$11,243
Net investment gain/loss from pooled separate accounts	2020-08-31	$-71,873
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-08-31	No
Was there a failure to transmit to the plan any participant contributions	2020-08-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-08-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-08-31	$871,034
Did the plan have assets held for investment	2020-08-31	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	2020-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2020-08-31	Disclaimer
Accountancy firm name	2020-08-31	BLUE & CO., LLC
Accountancy firm EIN	2020-08-31	351178661
2019 : THE ADANTA GROUP 401(K) PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to 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 beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$190,692
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$93,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$82,813
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$27,751
Value of total assets at end of year	2019-12-31	$941,619
Value of total assets at beginning of year	2019-12-31	$844,147
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,407
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$10
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$150,000
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	$27,751
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$905
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$10,407
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
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$97,472
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$941,619
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$844,147
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
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$930,376
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$832,835
Interest on participant loans	2019-12-31	$10
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$11,243
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$10,407
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$162,931
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$0
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$82,813
Contract administrator fees	2019-12-31	$0
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
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
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	BLUE & CO., LLC
Accountancy firm EIN	2019-12-31	351178661
2018 : THE ADANTA GROUP 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	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
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$288
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$129,335
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$118,002
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$48,433
Value of total assets at end of year	2018-12-31	$844,147
Value of total assets at beginning of year	2018-12-31	$973,194
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$11,333
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$131
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$0
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$150,000
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	$32,854
Participant contributions at end of year	2018-12-31	$905
Participant contributions at beginning of year	2018-12-31	$4,173
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$15,579
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$11,333
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
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-129,047
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$844,147
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$973,194
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
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$832,835
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$959,310
Interest on participant loans	2018-12-31	$131
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$0
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$10,407
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$9,711
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-48,276
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$118,002
Contract administrator fees	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
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	BLUE & CO., LLC
Accountancy firm EIN	2018-12-31	351178661
2017 : THE ADANTA GROUP 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$181,643
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$80,464
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$70,497
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$45,704
Value of total assets at end of year	2017-12-31	$973,194
Value of total assets at beginning of year	2017-12-31	$872,015
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$9,967
Total interest from all sources	2017-12-31	$407
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$150,000
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	$45,704
Participant contributions at end of year	2017-12-31	$4,173
Participant contributions at beginning of year	2017-12-31	$11,457
Participant contributions at end of year	2017-12-31	$0
Participant contributions 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
Administrative expenses (other) incurred	2017-12-31	$9,967
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	$101,179
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$973,194
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$872,015
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 registered invesment companies (eg mutual funds) at end of year	2017-12-31	$959,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$828,255
Interest on participant loans	2017-12-31	$407
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$9,711
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$32,303
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$135,532
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	Yes
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	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$70,497
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	BLUE & CO., LLC
Accountancy firm EIN	2017-12-31	351178661
2016 : THE ADANTA GROUP 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$121,588
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$468,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$457,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$47,653
Value of total assets at end of year	2016-12-31	$872,015
Value of total assets at beginning of year	2016-12-31	$1,219,398
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$11,870
Total interest from all sources	2016-12-31	$789
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$150,000
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	$47,653
Participant contributions at end of year	2016-12-31	$11,457
Participant contributions at beginning of year	2016-12-31	$57,874
Administrative expenses (other) incurred	2016-12-31	$11,870
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	$-347,383
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$872,015
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,219,398
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$828,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,154,254
Interest on participant loans	2016-12-31	$789
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$32,303
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$7,270
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$73,146
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$457,101
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	BLUE & CO., LLC
Accountancy firm EIN	2016-12-31	351178661
2015 : THE ADANTA GROUP 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$1,238,145
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	$-17,615
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,132
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$12,075
Value of total assets at end of year	2015-12-31	$1,219,398
Value of total assets at beginning of year	2015-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,132
Total interest from all sources	2015-12-31	$289
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$150,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$12,075
Participant contributions at end of year	2015-12-31	$57,874
Participant contributions at beginning of year	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$1,132
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	$-18,747
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,219,398
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$0
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,154,254
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$289
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$7,270
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-29,979
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
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

Form 5500 Responses for THE ADANTA GROUP 401(K) PLAN

2020: THE ADANTA GROUP 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: THE ADANTA GROUP 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: THE ADANTA GROUP 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: THE ADANTA GROUP 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE ADANTA GROUP 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THE ADANTA GROUP 401(K) PLAN 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	First time form 5500 has been submitted	Yes
2015-09-01	Submission has been amended	No
2015-09-01	This submission is the final filing	No
2015-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-09-01	Plan is a collectively bargained plan	No
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan funding arrangement – Trust	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

512503-000

Policy instance

Insurance contract or identification number	512503-000
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-08-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $165
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	165
Additional information about fees paid to insurance broker	ADMINISTRATION FEES, REVENUE SHARING
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

512503-000

Policy instance

Insurance contract or identification number	512503-000
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $460
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	460
Additional information about fees paid to insurance broker	ADMINISTRATION FEES, REVENUE SHARING
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

512503-000

Policy instance

Insurance contract or identification number	512503-000
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $461
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	461
Additional information about fees paid to insurance broker	ADMINISTRATION FEES, REVENUE SHARING
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

512503-000

Policy instance

Insurance contract or identification number	512503-000
Number of Individuals Covered	59
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $460
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	460
Additional information about fees paid to insurance broker	ADMINISTRATION FEES, REVENUE SHARING
Insurance broker organization code?	5
Insurance broker name	CREATIVE RETIREMENT SYSTEMS, INC.

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

512503-000

Policy instance

Insurance contract or identification number	512503-000
Number of Individuals Covered	242
Insurance policy start date	2015-09-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LAKE CUMBERLAND REGIONAL, INC.
Employer identification number (EIN):	610666065
NAIC Classification:	624100
NAIC Description:	Individual and Family Services