401k Plan data: CASCADE RETIREMENT BENEFIT PLAN plan

CASCADE RETIREMENT BENEFIT PLAN 401k Plan overview

Plan Name	CASCADE RETIREMENT BENEFIT PLAN
Plan identification number	001

CASCADE RETIREMENT BENEFIT 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.
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

CASCADE HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: CASCADE HEALTH SERVICES, LLC

Employer identification number (EIN): 752908605

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASCADE RETIREMENT BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 LORI MITCHELL
001 2013-01-01 RON HANEY
001 2012-01-01 RON HANEY
001 2011-01-01 RON HANEY
001 2009-01-01 RON HANEY

Plan Statistics for CASCADE RETIREMENT BENEFIT PLAN

401k plan membership statisitcs for CASCADE RETIREMENT BENEFIT PLAN

Measure Date Value
2017: CASCADE RETIREMENT BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 260
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
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 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1
2016: CASCADE RETIREMENT BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 244
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 191
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 30
Total of all active and inactive participants 2016-01-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 221
Number of participants with account balances 2016-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4
2015: CASCADE RETIREMENT BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 148
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 32
Total of all active and inactive participants 2015-01-01 180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 180
Number of participants with account balances 2015-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 6
2014: CASCADE RETIREMENT BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 215
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 13
Total of all active and inactive participants 2014-01-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 228
Number of participants with account balances 2014-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CASCADE RETIREMENT BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 156
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 33
Total of all active and inactive participants 2013-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 189
Number of participants with account balances 2013-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 10
2012: CASCADE RETIREMENT BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 246
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 43
Total of all active and inactive participants 2012-01-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 289
Number of participants with account balances 2012-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: CASCADE RETIREMENT BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 288
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 38
Total of all active and inactive participants 2011-01-01 326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 326
Number of participants with account balances 2011-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2009: CASCADE RETIREMENT BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 216
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 36
Total of all active and inactive participants 2009-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 252
Number of participants with account balances 2009-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2017: CASCADE RETIREMENT BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	260
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
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	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: CASCADE RETIREMENT BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	244
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	191
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	30
Total of all active and inactive participants	2016-01-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	221
Number of participants with account balances	2016-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4
2015: CASCADE RETIREMENT BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	148
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	32
Total of all active and inactive participants	2015-01-01	180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	180
Number of participants with account balances	2015-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	6
2014: CASCADE RETIREMENT BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	215
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	13
Total of all active and inactive participants	2014-01-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	228
Number of participants with account balances	2014-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CASCADE RETIREMENT BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	156
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	33
Total of all active and inactive participants	2013-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	189
Number of participants with account balances	2013-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	10
2012: CASCADE RETIREMENT BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	246
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	43
Total of all active and inactive participants	2012-01-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	289
Number of participants with account balances	2012-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: CASCADE RETIREMENT BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	288
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	38
Total of all active and inactive participants	2011-01-01	326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	326
Number of participants with account balances	2011-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2009: CASCADE RETIREMENT BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	216
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	36
Total of all active and inactive participants	2009-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	252
Number of participants with account balances	2009-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on CASCADE RETIREMENT BENEFIT PLAN

Measure	Date	Value
2017 : CASCADE RETIREMENT BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-10-31	$0
Total income from all sources (including contributions)	2017-10-31	$117,640
Total loss/gain on sale of assets	2017-10-31	$0
Total of all expenses incurred	2017-10-31	$1,071,264
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-10-31	$1,048,409
Value of total corrective distributions	2017-10-31	$14,778
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-10-31	$37,653
Value of total assets at end of year	2017-10-31	$0
Value of total assets at beginning of year	2017-10-31	$953,624
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-10-31	$8,077
Total interest from all sources	2017-10-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-10-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-10-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-10-31	$0
Was this plan covered by a fidelity bond	2017-10-31	Yes
Value of fidelity bond cover	2017-10-31	$115,000
If this is an individual account plan, was there a blackout period	2017-10-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-10-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-10-31	No
Contributions received from participants	2017-10-31	$32,578
Administrative expenses (other) incurred	2017-10-31	$5,077
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-10-31	No
Value of net income/loss	2017-10-31	$-953,624
Value of net assets at end of year (total assets less liabilities)	2017-10-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-10-31	$953,624
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-10-31	No
Were any leases to which the plan was party in default or uncollectible	2017-10-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-10-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-10-31	$953,624
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-10-31	$79,987
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-10-31	No
Was there a failure to transmit to the plan any participant contributions	2017-10-31	No
Has the plan failed to provide any benefit when due under the plan	2017-10-31	No
Contributions received in cash from employer	2017-10-31	$5,075
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-10-31	$1,048,409
Contract administrator fees	2017-10-31	$3,000
Did the plan have assets held for investment	2017-10-31	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	2017-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-10-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-10-31	Disclaimer
Accountancy firm name	2017-10-31	AXLEY & RODE LLP
Accountancy firm EIN	2017-10-31	750767305
2016 : CASCADE RETIREMENT BENEFIT 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	$1,255
Total income from all sources (including contributions)	2016-12-31	$125,904
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$185,834
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$178,229
Value of total corrective distributions	2016-12-31	$6,955
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$85,861
Value of total assets at end of year	2016-12-31	$953,624
Value of total assets at beginning of year	2016-12-31	$1,014,809
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$650
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$115,000
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	$76,217
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	$-59,930
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$953,624
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,013,554
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	$953,624
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,014,809
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$40,043
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$9,644
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$178,229
Contract administrator fees	2016-12-31	$650
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$1,255
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	AXLEY & RODE LLP
Accountancy firm EIN	2016-12-31	750767305
2015 : CASCADE RETIREMENT BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,255
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,255
Total income from all sources (including contributions)	2015-12-31	$104,762
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$227,819
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$222,559
Value of total corrective distributions	2015-12-31	$4,610
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$121,278
Value of total assets at end of year	2015-12-31	$1,014,809
Value of total assets at beginning of year	2015-12-31	$1,137,866
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$650
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$115,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$120,284
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	$-123,057
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,013,554
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,136,611
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	$1,014,809
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,137,866
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-16,516
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$994
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$222,559
Contract administrator fees	2015-12-31	$650
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$1,255
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$1,255
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2015-12-31	750767305
2014 : CASCADE RETIREMENT BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$1,255
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$204,901
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$134,974
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$127,511
Value of total corrective distributions	2014-12-31	$6,263
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$167,317
Value of total assets at end of year	2014-12-31	$1,137,866
Value of total assets at beginning of year	2014-12-31	$1,066,684
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,200
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$115,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$150,331
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$69,927
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,136,611
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,066,684
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,137,866
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,066,684
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$37,584
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$16,986
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$127,511
Contract administrator fees	2014-12-31	$1,200
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$1,255
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2014-12-31	750767305
2013 : CASCADE RETIREMENT BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$323,518
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$168,898
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$161,913
Value of total corrective distributions	2013-12-31	$5,185
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$208,197
Value of total assets at end of year	2013-12-31	$1,066,684
Value of total assets at beginning of year	2013-12-31	$912,064
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,800
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$100,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$159,087
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$23,830
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$154,620
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,066,684
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$912,064
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,066,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$912,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$115,321
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$25,280
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$161,913
Contract administrator fees	2013-12-31	$1,800
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2013-12-31	750767305
2012 : CASCADE RETIREMENT BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$256,268
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$36,910
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$29,503
Value of total corrective distributions	2012-12-31	$7,057
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$191,120
Value of total assets at end of year	2012-12-31	$912,064
Value of total assets at beginning of year	2012-12-31	$692,706
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$350
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$75,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$163,396
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$81,850
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$2,494
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$219,358
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$912,064
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$692,706
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$912,064
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$473,650
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$127,137
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$65,148
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$25,230
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$10,069
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$29,503
Contract administrator fees	2012-12-31	$350
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2012-12-31	750767305
2011 : CASCADE RETIREMENT BENEFIT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$168,457
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$42,783
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$20,801
Value of total corrective distributions	2011-12-31	$21,632
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$190,019
Value of total assets at end of year	2011-12-31	$692,706
Value of total assets at beginning of year	2011-12-31	$567,032
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$350
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$50,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$168,262
Participant contributions at end of year	2011-12-31	$81,850
Participant contributions at beginning of year	2011-12-31	$11,143
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$125,674
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$692,706
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$567,032
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$473,650
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$127,137
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$554,210
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-21,562
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$21,757
Employer contributions (assets) at end of year	2011-12-31	$10,069
Employer contributions (assets) at beginning of year	2011-12-31	$1,679
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$20,801
Contract administrator fees	2011-12-31	$350
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2011-12-31	750767305
2010 : CASCADE RETIREMENT BENEFIT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$210,409
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$65,800
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$57,490
Value of total corrective distributions	2010-12-31	$7,660
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$161,690
Value of total assets at end of year	2010-12-31	$567,032
Value of total assets at beginning of year	2010-12-31	$422,423
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$650
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$50,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$135,008
Participant contributions at end of year	2010-12-31	$11,143
Participant contributions at beginning of year	2010-12-31	$101
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$7,184
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$208
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$144,609
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$567,032
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$422,423
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$554,210
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$422,089
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$48,719
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$19,498
Employer contributions (assets) at end of year	2010-12-31	$1,679
Employer contributions (assets) at beginning of year	2010-12-31	$25
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$57,490
Contract administrator fees	2010-12-31	$650
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	AXLEY & RODE LLP
Accountancy firm EIN	2010-12-31	750767305
2009 : CASCADE RETIREMENT BENEFIT 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 CASCADE RETIREMENT BENEFIT PLAN

2017: CASCADE RETIREMENT BENEFIT 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	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: CASCADE RETIREMENT BENEFIT 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: CASCADE RETIREMENT BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CASCADE RETIREMENT BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CASCADE RETIREMENT BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CASCADE RETIREMENT BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CASCADE RETIREMENT BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CASCADE RETIREMENT BENEFIT 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

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $3,783
Total amount of fees paid to insurance company	USD $412
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
Commission paid to Insurance Broker	USD $3,783
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MALCOLM THOMPSON & ASSOCIATES

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	58
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,798
Total amount of fees paid to insurance company	USD $480
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?	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 $4,798
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MALCOLM THOMPSON & ASSOCIATES

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	62
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,524
Total amount of fees paid to insurance company	USD $452
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?	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 $4,524
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MALCOLM THOMPSON & ASSOCIATES

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	73
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,341
Total amount of fees paid to insurance company	USD $434
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?	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 $4,341
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MALCOLM THOMPSON & ASSOCIATES

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	91
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,685
Total amount of fees paid to insurance company	USD $368
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?	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 $2,632
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MALCOLM THOMPSON & ASSOCIATES

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	83
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,972
Total amount of fees paid to insurance company	USD $297
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?	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

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

Policy contract number

027639

Policy instance

Insurance contract or identification number	027639
Number of Individuals Covered	87
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,259
Total amount of fees paid to insurance company	USD $226
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?	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:	CASCADE HEALTH SERVICES, LLC
Employer identification number (EIN):	752908605
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities