401k Plan data: BHC RETIREMENT PLAN plan

BHC RETIREMENT PLAN 401k Plan overview

Plan Name	BHC RETIREMENT PLAN
Plan identification number	001

BHC RETIREMENT 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.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BROOKMONT HEALTHCARE CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name: BROOKMONT HEALTHCARE CENTER, LLC

Employer identification number (EIN): 770616109

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BHC RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 BRIAN RENDOS
001 2015-01-01 BRIAN RENDOS
001 2014-01-01 DOUGLAS POMFRET
001 2013-01-01 DOUGLAS POMFRET
001 2012-01-01 DOUGLAS POMFRET
001 2011-01-01 DOUGLAS POMFRET
001 2010-01-01 DOUGLAS POMFRET
001 2009-01-01 DOUGLAS POMFRET
001 2009-01-01 DOUGLAS POMFRET

Plan id#	Filing Submission Date	Name of Administrator
001	2016-01-01	BRIAN RENDOS
001	2015-01-01	BRIAN RENDOS
001	2014-01-01	DOUGLAS POMFRET
001	2013-01-01	DOUGLAS POMFRET
001	2012-01-01	DOUGLAS POMFRET
001	2011-01-01	DOUGLAS POMFRET
001	2010-01-01	DOUGLAS POMFRET
001	2009-01-01	DOUGLAS POMFRET
001	2009-01-01	DOUGLAS POMFRET

Plan Statistics for BHC RETIREMENT PLAN

401k plan membership statisitcs for BHC RETIREMENT PLAN

Measure Date Value
2016: BHC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: BHC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 177
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 6
Total of all active and inactive participants 2015-01-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 185
Number of participants with account balances 2015-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 4
2014: BHC RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 150
Number of retired or separated participants receiving benefits 2014-01-01 6
Number of other retired or separated participants entitled to future benefits 2014-01-01 6
Total of all active and inactive participants 2014-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 162
Number of participants with account balances 2014-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: BHC RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 131
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 14
Total of all active and inactive participants 2013-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 145
Number of participants with account balances 2013-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: BHC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 156
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 16
Total of all active and inactive participants 2012-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 173
Number of participants with account balances 2012-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: BHC RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 322
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 308
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 4
Total of all active and inactive participants 2011-01-01 312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 312
Number of participants with account balances 2011-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2010: BHC RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 128
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 33
Total of all active and inactive participants 2010-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 162
Number of participants with account balances 2010-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 3
2009: BHC RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 124
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 33
Total of all active and inactive participants 2009-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 157
Number of participants with account balances 2009-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2016: BHC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: BHC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	177
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	6
Total of all active and inactive participants	2015-01-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	185
Number of participants with account balances	2015-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	4
2014: BHC RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	150
Number of retired or separated participants receiving benefits	2014-01-01	6
Number of other retired or separated participants entitled to future benefits	2014-01-01	6
Total of all active and inactive participants	2014-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	162
Number of participants with account balances	2014-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: BHC RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	131
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	14
Total of all active and inactive participants	2013-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	145
Number of participants with account balances	2013-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: BHC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	156
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	16
Total of all active and inactive participants	2012-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	173
Number of participants with account balances	2012-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: BHC RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	322
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	308
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	4
Total of all active and inactive participants	2011-01-01	312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	312
Number of participants with account balances	2011-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2010: BHC RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	128
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	33
Total of all active and inactive participants	2010-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	162
Number of participants with account balances	2010-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	3
2009: BHC RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	124
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	33
Total of all active and inactive participants	2009-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	157
Number of participants with account balances	2009-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on BHC RETIREMENT PLAN

Measure	Date	Value
2016 : BHC RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$1,549,060
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	$1,463
Total income from all sources (including contributions)	2016-12-31	$-10,347
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$24,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$20,568
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$10,137
Value of total assets at end of year	2016-12-31	$0
Value of total assets at beginning of year	2016-12-31	$1,585,508
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,070
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$10,137
Participant contributions at beginning of year	2016-12-31	$2,345
Other income not declared elsewhere	2016-12-31	$1,204
Liabilities. Value of operating payables at beginning of year	2016-12-31	$1,463
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$17,048
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	$-34,985
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,584,045
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
Investment advisory and management fees	2016-12-31	$-1,183
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,532,830
Value of interest in common/collective trusts at beginning of year	2016-12-31	$33,285
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$-22,289
Net investment gain or loss from common/collective trusts	2016-12-31	$601
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	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$20,568
Contract administrator fees	2016-12-31	$5,253
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Did the plan have assets held for investment	2016-12-31	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	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	Yes
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	CLYDE, FERRARO & CO., LLC CPAS
Accountancy firm EIN	2016-12-31	251669808
2015 : BHC RETIREMENT 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	$1,463
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,924
Total income from all sources (including contributions)	2015-12-31	$60,461
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$498,216
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$480,397
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$103,506
Value of total assets at end of year	2015-12-31	$1,585,508
Value of total assets at beginning of year	2015-12-31	$2,024,724
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$17,819
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$36,040
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$36,040
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$90,632
Participant contributions at end of year	2015-12-31	$2,345
Participant contributions at beginning of year	2015-12-31	$5,400
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$1,463
Liabilities. Value of operating payables at end of year	2015-12-31	$1,463
Total non interest bearing cash at end of year	2015-12-31	$17,048
Total non interest bearing cash at beginning of year	2015-12-31	$2,857
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	$-437,755
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,584,045
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,021,800
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
Investment advisory and management fees	2015-12-31	$11,246
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,532,830
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,014,317
Value of interest in common/collective trusts at end of year	2015-12-31	$33,285
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-80,156
Net investment gain or loss from common/collective trusts	2015-12-31	$1,071
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	$12,874
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$2,150
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$480,397
Contract administrator fees	2015-12-31	$6,573
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$1,461
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	CLYDE, FERRARO & CO., LLC CPAS
Accountancy firm EIN	2015-12-31	251669808
2014 : BHC RETIREMENT 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	$2,924
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$1,868
Total income from all sources (including contributions)	2014-12-31	$207,869
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$120,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$99,823
Value of total corrective distributions	2014-12-31	$1,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$127,843
Value of total assets at end of year	2014-12-31	$2,024,724
Value of total assets at beginning of year	2014-12-31	$1,936,291
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$19,208
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$36,821
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$36,821
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$110,886
Participant contributions at end of year	2014-12-31	$5,400
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$1,463
Total non interest bearing cash at end of year	2014-12-31	$2,857
Total non interest bearing cash at beginning of year	2014-12-31	$4,496
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	$87,377
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,021,800
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,934,423
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
Investment advisory and management fees	2014-12-31	$10,955
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,014,317
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,931,608
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$43,205
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	$16,957
Employer contributions (assets) at end of year	2014-12-31	$2,150
Employer contributions (assets) at beginning of year	2014-12-31	$187
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$99,823
Contract administrator fees	2014-12-31	$8,253
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$1,461
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$1,868
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	PADDEN, GUERRINI & ASSOC. PC
Accountancy firm EIN	2014-12-31	232230841
2013 : BHC RETIREMENT 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	$1,868
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$2,322
Total income from all sources (including contributions)	2013-12-31	$419,351
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$62,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$45,404
Value of total corrective distributions	2013-12-31	$1,868
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$106,862
Value of total assets at end of year	2013-12-31	$1,936,291
Value of total assets at beginning of year	2013-12-31	$1,579,931
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$15,265
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$27,583
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$27,583
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$96,045
Total non interest bearing cash at end of year	2013-12-31	$4,496
Total non interest bearing cash at beginning of year	2013-12-31	$8,842
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	$356,814
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,934,423
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,577,609
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
Investment advisory and management fees	2013-12-31	$9,444
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,931,608
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,569,599
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$284,906
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	$10,817
Employer contributions (assets) at end of year	2013-12-31	$187
Employer contributions (assets) at beginning of year	2013-12-31	$1,490
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$45,404
Contract administrator fees	2013-12-31	$5,821
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$1,868
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$2,322
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	PADDEN, GUERRINI & ASSOC. PC
Accountancy firm EIN	2013-12-31	232230841
2012 : BHC RETIREMENT 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	$2,322
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	$306,578
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$148,937
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$138,980
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$133,066
Value of total assets at end of year	2012-12-31	$1,579,931
Value of total assets at beginning of year	2012-12-31	$1,419,968
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$9,957
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$31,316
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$31,316
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$175,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$118,411
Participant contributions at beginning of year	2012-12-31	$3,813
Total non interest bearing cash at end of year	2012-12-31	$8,842
Total non interest bearing cash at beginning of year	2012-12-31	$633
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	$157,641
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,577,609
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,419,968
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	$1,569,599
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,414,647
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$142,196
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	No
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	$14,655
Employer contributions (assets) at end of year	2012-12-31	$1,490
Employer contributions (assets) at beginning of year	2012-12-31	$875
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$138,980
Contract administrator fees	2012-12-31	$9,957
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$2,322
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	PADDEN, GUERRINI, & ASSOCIATES, PC
Accountancy firm EIN	2012-12-31	232230841
2011 : BHC RETIREMENT 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	$1,889
Total income from all sources (including contributions)	2011-12-31	$99,897
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$109,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$102,305
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$143,156
Value of total assets at end of year	2011-12-31	$1,419,968
Value of total assets at beginning of year	2011-12-31	$1,431,431
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,166
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$11,079
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$11,079
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$150,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$129,907
Participant contributions at end of year	2011-12-31	$3,813
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$1,582
Total non interest bearing cash at end of year	2011-12-31	$633
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	$-9,574
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,419,968
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,429,542
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
Investment advisory and management fees	2011-12-31	$7,166
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,414,647
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,375,750
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$2,712
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$2,712
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$51,452
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-54,338
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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	No
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	$13,249
Employer contributions (assets) at end of year	2011-12-31	$875
Employer contributions (assets) at beginning of year	2011-12-31	$1,517
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$102,305
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$307
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	PADDEN, GUERRINI & ASSOCIATES, PC
Accountancy firm EIN	2011-12-31	232290841
2010 : BHC RETIREMENT 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	$1,889
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$724
Total income from all sources (including contributions)	2010-12-31	$300,724
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$61,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$42,627
Value of total corrective distributions	2010-12-31	$11,390
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$139,167
Value of total assets at end of year	2010-12-31	$1,431,431
Value of total assets at beginning of year	2010-12-31	$1,190,890
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,331
Total interest from all sources	2010-12-31	$1,405
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	$150,000
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	$122,775
Participant contributions at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,083
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$1,582
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$410
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	$239,376
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,429,542
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,190,166
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 interest in pooled separate accounts at end of year	2010-12-31	$1,375,750
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,142,805
Interest earned on other investments	2010-12-31	$1,405
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$2,712
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$1,590
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$1,590
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$51,452
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$46,088
Net investment gain/loss from pooled separate accounts	2010-12-31	$160,152
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	$15,309
Employer contributions (assets) at end of year	2010-12-31	$1,517
Employer contributions (assets) at beginning of year	2010-12-31	$407
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$42,627
Contract administrator fees	2010-12-31	$7,331
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$307
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$314
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	PADDEN, GUERRINI & ASSOCIATES, P.C.
Accountancy firm EIN	2010-12-31	232290841
2009 : BHC RETIREMENT 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 BHC RETIREMENT PLAN

2016: BHC RETIREMENT 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	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: BHC RETIREMENT 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 – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BHC RETIREMENT 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BHC RETIREMENT 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BHC RETIREMENT 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BHC RETIREMENT 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
2010: BHC RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: BHC RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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

RELIANCE TRUST - METLIFE (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

25053

Policy instance

Insurance contract or identification number	25053
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PH9557

Policy instance

Insurance contract or identification number	PH9557
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 $14,497
Total amount of fees paid to insurance company	USD $114
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PH9557

Policy instance

Insurance contract or identification number	PH9557
Number of Individuals Covered	83
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,105
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

Potentially related plans

BHC RETIREMENT PLAN [EIN = 952627136]

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Company Name:	BROOKMONT HEALTHCARE CENTER, LLC
Employer identification number (EIN):	770616109
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities