401k Plan data: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN plan

GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 401k Plan overview

Plan Name	GRACE HOSPICE OF OKLAHOMA 401(K) PLAN
Plan identification number	001

GRACE HOSPICE OF OKLAHOMA 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.
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

GRACE HOSPICE OF OKLAHOMA has sponsored the creation of one or more 401k plans.

Company Name: GRACE HOSPICE OF OKLAHOMA

Employer identification number (EIN): 731595477

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRACE HOSPICE OF OKLAHOMA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2020-01-01
001 2019-01-01 OTIS EVERSOLE 2020-05-26
001 2018-01-01 OTIS EVERSOLE 2019-05-03
001 2017-01-01 OTIS EVERSOLE 2018-06-15
001 2016-01-01 OTIS EVERSOLE 2017-07-10
001 2015-01-01 OTIS EVERSOLE 2016-07-14
001 2014-01-01 OTIS EVERSOLE 2015-08-13
001 2013-01-01 OTIS EVERSOLE 2014-09-20
001 2012-01-01 OTIS EVERSOLE 2013-07-02
001 2011-01-01 OTIS EVERSOLE 2012-07-03
001 2009-01-01 OTIS EVERSOLE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01
001	2020-01-01
001	2019-01-01	OTIS EVERSOLE	2020-05-26
001	2018-01-01	OTIS EVERSOLE	2019-05-03
001	2017-01-01	OTIS EVERSOLE	2018-06-15
001	2016-01-01	OTIS EVERSOLE	2017-07-10
001	2015-01-01	OTIS EVERSOLE	2016-07-14
001	2014-01-01	OTIS EVERSOLE	2015-08-13
001	2013-01-01	OTIS EVERSOLE	2014-09-20
001	2012-01-01	OTIS EVERSOLE	2013-07-02
001	2011-01-01	OTIS EVERSOLE	2012-07-03
001	2009-01-01	OTIS EVERSOLE

Plan Statistics for GRACE HOSPICE OF OKLAHOMA 401(K) PLAN

401k plan membership statisitcs for GRACE HOSPICE OF OKLAHOMA 401(K) PLAN

Measure Date Value
2021: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 0
Number of participants with account balances 2021-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 70
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 30
Total of all active and inactive participants 2020-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 100
Number of participants with account balances 2020-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 12
2009: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 92
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 81
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 11
Total of all active and inactive participants 2009-01-01 92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 92
Number of participants with account balances 2009-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 5

Measure	Date	Value
2021: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	70
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	30
Total of all active and inactive participants	2020-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	100
Number of participants with account balances	2020-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	12
2009: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	92
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	81
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	11
Total of all active and inactive participants	2009-01-01	92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	92
Number of participants with account balances	2009-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	5

Financial Data on GRACE HOSPICE OF OKLAHOMA 401(K) PLAN

Measure	Date	Value
2021 : GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$164,081
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,044,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,029,612
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$21,540
Value of total assets at end of year	2021-12-31	$0
Value of total assets at beginning of year	2021-12-31	$1,880,739
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$15,208
Total interest from all sources	2021-12-31	$1,693
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$189,000
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	$2,213
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$111,269
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-1,880,739
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,880,739
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	$15,208
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,701,134
Interest on participant loans	2021-12-31	$1,693
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$140,848
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$19,327
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$68,336
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,029,612
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Did the plan have assets held for investment	2021-12-31	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	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	Yes
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	REGIER CARR & MONROE LLP
Accountancy firm EIN	2021-12-31	480573184
2020 : GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$515,890
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$147,010
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$139,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$208,570
Value of total assets at end of year	2020-12-31	$1,880,739
Value of total assets at beginning of year	2020-12-31	$1,511,859
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$7,931
Total interest from all sources	2020-12-31	$4,483
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,100
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$1,100
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$189,000
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	$140,139
Participant contributions at end of year	2020-12-31	$111,269
Participant contributions at beginning of year	2020-12-31	$68,903
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$95
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	$368,880
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,880,739
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,511,859
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,701,134
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,352,745
Interest on participant loans	2020-12-31	$4,483
Net investment gain/loss from pooled separate accounts	2020-12-31	$301,737
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$68,336
Employer contributions (assets) at end of year	2020-12-31	$68,336
Employer contributions (assets) at beginning of year	2020-12-31	$90,211
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$139,079
Contract administrator fees	2020-12-31	$7,931
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	REGIER CARR & MONROE LLP
Accountancy firm EIN	2020-12-31	480573184
2010 : GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$189,331
Expenses. Total of all expenses incurred	2010-12-31	$147,837
Benefits paid (including direct rollovers)	2010-12-31	$142,340
Total plan assets at end of year	2010-12-31	$484,012
Total plan assets at beginning of year	2010-12-31	$442,518
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$103,416
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$41,548
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$41,494
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$484,012
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$442,518
Assets. Value of participant loans	2010-12-31	$8,682
Total contributions received or receivable from employer(s)	2010-12-31	$44,367
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$5,497
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for GRACE HOSPICE OF OKLAHOMA 401(K) PLAN

2021: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	Yes
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: GRACE HOSPICE OF OKLAHOMA 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	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
2009: GRACE HOSPICE OF OKLAHOMA 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-802849

Policy instance

Insurance contract or identification number	GA-802849
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,587
Total amount of fees paid to insurance company	USD $803
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,587
Insurance broker organization code?	3
Amount paid for insurance broker fees	803
Additional information about fees paid to insurance broker	SALES/ADMINISTRATION

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-802849

Policy instance

Insurance contract or identification number	GA-802849
Number of Individuals Covered	72
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,584
Total amount of fees paid to insurance company	USD $694
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,584
Insurance broker organization code?	3
Amount paid for insurance broker fees	694
Additional information about fees paid to insurance broker	SALES/ADMINISTRATION

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-802849

Policy instance

Insurance contract or identification number	GA-802849
Number of Individuals Covered	59
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,562
Total amount of fees paid to insurance company	USD $201
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?	Yes
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

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Company Name:	GRACE HOSPICE OF OKLAHOMA
Employer identification number (EIN):	731595477
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations