401k Plan data: BAY AREA COMMUNITY SERVICES 403(B) PLAN plan

BAY AREA COMMUNITY SERVICES 403(B) PLAN 401k Plan overview

Plan Name	BAY AREA COMMUNITY SERVICES 403(B) PLAN
Plan identification number	001

BAY AREA COMMUNITY SERVICES 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BAY AREA COMMUNITY SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: BAY AREA COMMUNITY SERVICES, INC.

Employer identification number (EIN): 941708069

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAY AREA COMMUNITY SERVICES 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 BETSY SCHWARZWALDER 2023-10-12
001 2021-01-01 BETSY SCHWARZWALDER 2022-09-19
001 2020-01-01 BETSY SCHWARZWALDER 2021-10-11
001 2019-01-01 BETSY SCHWARZWALDER 2020-10-11
001 2018-01-01 BETSY SCHWARZWALDER 2019-09-15
001 2017-01-01
001 2016-01-01 BETSY SCHWARZWALDER 2017-06-08
001 2015-01-01 BETSY SCHWARZWALDER 2016-06-14
001 2015-01-01 BETSY SCHWARZWALDER 2017-06-23
001 2014-01-01 BETSY SCHWARZWALDER 2015-05-04 JAMIE ALMANZA 2015-05-12
001 2013-01-01 BETSY SCHWARZWALDER 2014-07-22 JAMIE ALMANZA 2014-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	BETSY SCHWARZWALDER	2023-10-12
001	2021-01-01	BETSY SCHWARZWALDER	2022-09-19
001	2020-01-01	BETSY SCHWARZWALDER	2021-10-11
001	2019-01-01	BETSY SCHWARZWALDER	2020-10-11
001	2018-01-01	BETSY SCHWARZWALDER	2019-09-15
001	2017-01-01
001	2016-01-01	BETSY SCHWARZWALDER	2017-06-08
001	2015-01-01	BETSY SCHWARZWALDER	2016-06-14
001	2015-01-01	BETSY SCHWARZWALDER	2017-06-23
001	2014-01-01	BETSY SCHWARZWALDER	2015-05-04	JAMIE ALMANZA	2015-05-12
001	2013-01-01	BETSY SCHWARZWALDER	2014-07-22	JAMIE ALMANZA	2014-07-22

Plan Statistics for BAY AREA COMMUNITY SERVICES 403(B) PLAN

401k plan membership statisitcs for BAY AREA COMMUNITY SERVICES 403(B) PLAN

Measure Date Value
2022: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 507
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 496
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 45
Total of all active and inactive participants 2022-01-01 541
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 541
Number of participants with account balances 2022-01-01 200
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 15
2021: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 437
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 460
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 49
Total of all active and inactive participants 2021-01-01 509
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 509
Number of participants with account balances 2021-01-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 27
2020: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 399
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 408
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 31
Total of all active and inactive participants 2020-01-01 439
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 439
Number of participants with account balances 2020-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 9
2019: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 370
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 29
Total of all active and inactive participants 2019-01-01 399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 399
Number of participants with account balances 2019-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 9
2018: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 255
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 24
Total of all active and inactive participants 2018-01-01 279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 279
Number of participants with account balances 2018-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 11
2017: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 209
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 14
Total of all active and inactive participants 2017-01-01 223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 223
Number of participants with account balances 2017-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 6

Measure	Date	Value
2022: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	507
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	496
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	45
Total of all active and inactive participants	2022-01-01	541
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	541
Number of participants with account balances	2022-01-01	200
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	15
2021: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	437
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	460
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	49
Total of all active and inactive participants	2021-01-01	509
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	509
Number of participants with account balances	2021-01-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	27
2020: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	399
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	408
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	31
Total of all active and inactive participants	2020-01-01	439
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	439
Number of participants with account balances	2020-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	9
2019: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	370
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	29
Total of all active and inactive participants	2019-01-01	399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	399
Number of participants with account balances	2019-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	9
2018: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	255
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	24
Total of all active and inactive participants	2018-01-01	279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	279
Number of participants with account balances	2018-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	11
2017: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	209
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	14
Total of all active and inactive participants	2017-01-01	223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	223
Number of participants with account balances	2017-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	6

Financial Data on BAY AREA COMMUNITY SERVICES 403(B) PLAN

Measure	Date	Value
2022 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$10,198
Total income from all sources (including contributions)	2022-12-31	$641,650
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$419,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$353,138
Expenses. Certain deemed distributions of participant loans	2022-12-31	$1,205
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,265,323
Value of total assets at end of year	2022-12-31	$4,104,602
Value of total assets at beginning of year	2022-12-31	$3,892,760
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$65,267
Total interest from all sources	2022-12-31	$7,308
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$147,218
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$147,218
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$250,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$865,999
Participant contributions at end of year	2022-12-31	$84,687
Participant contributions at beginning of year	2022-12-31	$86,034
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$133,316
Other income not declared elsewhere	2022-12-31	$197
Liabilities. Value of operating payables at beginning of year	2022-12-31	$50
Total non interest bearing cash at beginning of year	2022-12-31	$11,338
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$222,040
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,104,602
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,882,562
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,555,576
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$3,329,609
Value of interest in pooled separate accounts at end of year	2022-12-31	$215,727
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$271,289
Interest on participant loans	2022-12-31	$2,598
Interest earned on other investments	2022-12-31	$4,710
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$248,612
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$194,490
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-723,099
Net investment gain/loss from pooled separate accounts	2022-12-31	$-55,297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$266,008
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$353,138
Contract administrator fees	2022-12-31	$65,267
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$10,148
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	APRIO, LLP
Accountancy firm EIN	2022-12-31	571157523
2021 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$10,198
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,682,018
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$326,506
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$271,729
Value of total corrective distributions	2021-12-31	$7,121
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,262,157
Value of total assets at end of year	2021-12-31	$3,892,760
Value of total assets at beginning of year	2021-12-31	$2,527,050
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$47,656
Total interest from all sources	2021-12-31	$5,398
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$250,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$662,018
Participant contributions at end of year	2021-12-31	$86,034
Participant contributions at beginning of year	2021-12-31	$36,368
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$373,948
Liabilities. Value of operating payables at end of year	2021-12-31	$50
Total non interest bearing cash at end of year	2021-12-31	$11,338
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,355,512
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,882,562
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,527,050
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$3,329,609
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,076,576
Value of interest in pooled separate accounts at end of year	2021-12-31	$271,289
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$233,440
Interest on participant loans	2021-12-31	$1,715
Interest earned on other investments	2021-12-31	$3,683
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$194,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$180,666
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$376,343
Net investment gain/loss from pooled separate accounts	2021-12-31	$38,120
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$226,191
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$271,729
Contract administrator fees	2021-12-31	$47,656
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$10,148
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	APRIO, LLP
Accountancy firm EIN	2021-12-31	571157523
2020 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$877,701
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$228,565
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$191,823
Value of total corrective distributions	2020-12-31	$6,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$582,317
Value of total assets at end of year	2020-12-31	$2,527,050
Value of total assets at beginning of year	2020-12-31	$1,877,914
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$30,505
Total interest from all sources	2020-12-31	$5,014
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$433,252
Participant contributions at end of year	2020-12-31	$36,368
Participant contributions at beginning of year	2020-12-31	$37,138
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$45,318
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$8
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$649,136
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,527,050
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,877,914
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,076,576
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,474,511
Value of interest in pooled separate accounts at end of year	2020-12-31	$233,440
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$251,947
Interest on participant loans	2020-12-31	$1,374
Interest earned on other investments	2020-12-31	$3,640
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$180,666
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$114,310
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$255,447
Net investment gain/loss from pooled separate accounts	2020-12-31	$34,923
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$103,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$191,823
Contract administrator fees	2020-12-31	$30,505
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	RINA ACCOUNTANCY LLP
Accountancy firm EIN	2020-12-31	841980623
2019 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$705,700
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$91,679
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$66,390
Value of total corrective distributions	2019-12-31	$1,706
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$414,157
Value of total assets at end of year	2019-12-31	$1,877,914
Value of total assets at beginning of year	2019-12-31	$1,263,893
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$23,583
Total interest from all sources	2019-12-31	$3,844
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$298,928
Participant contributions at end of year	2019-12-31	$37,138
Participant contributions at beginning of year	2019-12-31	$17,795
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$59,449
Total non interest bearing cash at end of year	2019-12-31	$8
Total non interest bearing cash at beginning of year	2019-12-31	$6
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$614,021
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,877,914
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,263,893
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,474,511
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$972,398
Value of interest in pooled separate accounts at end of year	2019-12-31	$251,947
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$205,264
Interest on participant loans	2019-12-31	$1,631
Interest earned on other investments	2019-12-31	$2,213
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$114,310
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$68,430
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$240,687
Net investment gain/loss from pooled separate accounts	2019-12-31	$47,012
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$55,780
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$66,390
Contract administrator fees	2019-12-31	$23,583
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	RINA ACCOUNTANCY LLP
Accountancy firm EIN	2019-12-31	841980623
2018 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$191,990
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$187,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$167,070
Value of total corrective distributions	2018-12-31	$302
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$263,783
Value of total assets at end of year	2018-12-31	$1,263,893
Value of total assets at beginning of year	2018-12-31	$1,259,731
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$20,456
Total interest from all sources	2018-12-31	$3,185
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$179,255
Participant contributions at end of year	2018-12-31	$17,795
Participant contributions at beginning of year	2018-12-31	$19,752
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$42,621
Total non interest bearing cash at end of year	2018-12-31	$6
Total non interest bearing cash at beginning of year	2018-12-31	$434
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$4,162
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,263,893
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,259,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$972,398
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$922,958
Value of interest in pooled separate accounts at end of year	2018-12-31	$205,264
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$229,908
Interest on participant loans	2018-12-31	$885
Interest earned on other investments	2018-12-31	$2,300
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$72,030
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$68,430
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$14,649
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-57,116
Net investment gain/loss from pooled separate accounts	2018-12-31	$-17,862
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$41,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$167,070
Contract administrator fees	2018-12-31	$20,456
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	RINA ACCOUNTANCY LLP
Accountancy firm EIN	2018-12-31	841980623
2017 : BAY AREA COMMUNITY SERVICES 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$372,403
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$87,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$70,055
Value of total corrective distributions	2017-12-31	$1,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$200,016
Value of total assets at end of year	2017-12-31	$1,259,731
Value of total assets at beginning of year	2017-12-31	$974,492
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$16,028
Total interest from all sources	2017-12-31	$3,451
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$250,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$135,433
Participant contributions at end of year	2017-12-31	$19,752
Participant contributions at beginning of year	2017-12-31	$12,082
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$44,609
Total non interest bearing cash at end of year	2017-12-31	$434
Total non interest bearing cash at beginning of year	2017-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$285,239
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,259,731
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$974,492
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$922,958
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$610,908
Value of interest in pooled separate accounts at end of year	2017-12-31	$229,908
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$223,552
Interest on participant loans	2017-12-31	$694
Interest earned on other investments	2017-12-31	$2,757
Value of interest in common/collective trusts at end of year	2017-12-31	$72,030
Value of interest in common/collective trusts at beginning of year	2017-12-31	$113,636
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$14,649
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$14,312
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$168,936
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$19,974
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$70,055
Contract administrator fees	2017-12-31	$16,028
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	RINA ACCOUNTANCY CORP.
Accountancy firm EIN	2017-12-31	943158857

Form 5500 Responses for BAY AREA COMMUNITY SERVICES 403(B) PLAN

2022: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BAY AREA COMMUNITY SERVICES 403(B) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	541
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	16
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $756
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $756
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	509
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	24
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,040
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,040
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	439
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	24
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $982
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $982
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	399
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	24
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $739
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $739
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	279
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	24
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $743
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $743
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809830

Policy instance

Insurance contract or identification number	809830
Number of Individuals Covered	223
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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	1
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

GA-751150

Policy instance

Insurance contract or identification number	GA-751150
Number of Individuals Covered	24
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,120
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,120
Insurance broker organization code?	3
Insurance broker name	WOODBURY FINSVCS INC

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Company Name:	BAY AREA COMMUNITY SERVICES, INC.
Employer identification number (EIN):	941708069
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers