401k Plan data: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN plan

HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN
Plan identification number	001

HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 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.
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

HOSPICE OF SOUTHERN MAINE has sponsored the creation of one or more 401k plans.

Company Name: HOSPICE OF SOUTHERN MAINE

Employer identification number (EIN): 010540180

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about HOSPICE OF SOUTHERN MAINE

Jurisdiction of Incorporation: Maine Bureau of Corporations, Elections & Commissions

Incorporation Date:

Company Identification Number: 20010248ND

More information about HOSPICE OF SOUTHERN MAINE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 DARYL J. CADY 2023-06-29 DARYL J. CADY 2023-06-29
001 2021-01-01 DARYL J. CADY 2022-08-04 DARYL J. CADY 2022-08-04
001 2020-01-01 DARYL J. CADY 2021-05-17 DARYL J. CADY 2021-05-17
001 2019-01-01 DARYL J. CADY 2020-05-05 DARYL J. CADY 2020-05-05
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 DARYL J CADY 2015-05-06 BARBARA L MCKEEN 2015-04-28
001 2013-01-01 ELAINE BRADY 2014-07-10 MARY CELIA O'NEIL 2014-07-10
001 2012-01-01 MARY CELIA ONEIL 2013-07-10 MARY CELIA ONEIL 2013-07-10
001 2011-01-01 MARY CELIA O'NEIL 2012-06-21
001 2010-01-01 MICHELLE L. MALO 2011-07-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	DARYL J. CADY	2023-06-29	DARYL J. CADY	2023-06-29
001	2021-01-01	DARYL J. CADY	2022-08-04	DARYL J. CADY	2022-08-04
001	2020-01-01	DARYL J. CADY	2021-05-17	DARYL J. CADY	2021-05-17
001	2019-01-01	DARYL J. CADY	2020-05-05	DARYL J. CADY	2020-05-05
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	DARYL J CADY	2015-05-06	BARBARA L MCKEEN	2015-04-28
001	2013-01-01	ELAINE BRADY	2014-07-10	MARY CELIA O'NEIL	2014-07-10
001	2012-01-01	MARY CELIA ONEIL	2013-07-10	MARY CELIA ONEIL	2013-07-10
001	2011-01-01	MARY CELIA O'NEIL	2012-06-21
001	2010-01-01	MICHELLE L. MALO	2011-07-13

Plan Statistics for HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN

Measure Date Value
2022: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 140
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 24
Total of all active and inactive participants 2022-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 165
Number of participants with account balances 2022-01-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 15
2021: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 144
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 18
Total of all active and inactive participants 2021-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 162
Number of participants with account balances 2021-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 10
2020: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 138
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 13
Total of all active and inactive participants 2020-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 151
Number of participants with account balances 2020-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 129
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 11
Total of all active and inactive participants 2019-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 140
Number of participants with account balances 2019-01-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 9
2018: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 132
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 10
Total of all active and inactive participants 2018-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 142
Number of participants with account balances 2018-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 8
2017: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 120
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 12
Total of all active and inactive participants 2017-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 132
Number of participants with account balances 2017-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 11
2016: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 124
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 10
Total of all active and inactive participants 2016-01-01 134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 134
Number of participants with account balances 2016-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 12
2015: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 121
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 6
Total of all active and inactive participants 2015-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 127
Number of participants with account balances 2015-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 6

Measure	Date	Value
2022: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	140
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	24
Total of all active and inactive participants	2022-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	165
Number of participants with account balances	2022-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	15
2021: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	144
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	18
Total of all active and inactive participants	2021-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	162
Number of participants with account balances	2021-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	10
2020: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	138
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	13
Total of all active and inactive participants	2020-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	151
Number of participants with account balances	2020-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	129
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	11
Total of all active and inactive participants	2019-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	140
Number of participants with account balances	2019-01-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	9
2018: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	132
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	10
Total of all active and inactive participants	2018-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	142
Number of participants with account balances	2018-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	8
2017: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	120
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	12
Total of all active and inactive participants	2017-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	132
Number of participants with account balances	2017-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	11
2016: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	124
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	10
Total of all active and inactive participants	2016-01-01	134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	134
Number of participants with account balances	2016-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	12
2015: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	121
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	6
Total of all active and inactive participants	2015-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	127
Number of participants with account balances	2015-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	6

Financial Data on HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN

Measure	Date	Value
2022 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$91,892
Total of all expenses incurred	2022-12-31	$403,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$358,599
Expenses. Certain deemed distributions of participant loans	2022-12-31	$559
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,190,098
Value of total assets at end of year	2022-12-31	$5,961,139
Value of total assets at beginning of year	2022-12-31	$6,272,304
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$43,899
Total interest from all sources	2022-12-31	$5,862
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
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	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
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	$645,689
Participant contributions at end of year	2022-12-31	$87,485
Participant contributions at beginning of year	2022-12-31	$88,191
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$351,188
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	$-311,165
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$5,961,139
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,272,304
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	$5,452,300
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,812,131
Interest on participant loans	2022-12-31	$5,862
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$421,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$371,982
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,104,068
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	No
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	$193,221
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$358,599
Contract administrator fees	2022-12-31	$43,899
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2022-12-31	043499945
2021 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$1,480,308
Total of all expenses incurred	2021-12-31	$207,133
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$163,487
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$757,785
Value of total assets at end of year	2021-12-31	$6,272,304
Value of total assets at beginning of year	2021-12-31	$4,999,129
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$43,646
Total interest from all sources	2021-12-31	$6,092
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$314,870
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$314,870
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$582,903
Participant contributions at end of year	2021-12-31	$88,191
Participant contributions at beginning of year	2021-12-31	$97,129
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	$1,273,175
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,272,304
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,999,129
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	$5,812,131
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,657,234
Interest on participant loans	2021-12-31	$6,092
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$371,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$244,766
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$401,561
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	$174,882
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$163,487
Contract administrator fees	2021-12-31	$43,646
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2021-12-31	043499945
2020 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,434,347
Total of all expenses incurred	2020-12-31	$61,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$37,760
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$692,726
Value of total assets at end of year	2020-12-31	$4,999,129
Value of total assets at beginning of year	2020-12-31	$3,625,812
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$23,270
Total interest from all sources	2020-12-31	$8,034
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$147,493
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$147,493
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$528,290
Participant contributions at end of year	2020-12-31	$97,129
Participant contributions at beginning of year	2020-12-31	$111,096
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	$1,373,317
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,999,129
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,625,812
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	$4,657,234
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,287,703
Interest on participant loans	2020-12-31	$8,034
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$244,766
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$227,013
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$586,094
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$164,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$37,760
Contract administrator fees	2020-12-31	$23,270
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2020-12-31	043499945
2019 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2019 401k financial data
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	$1,263,505
Total of all expenses incurred	2019-12-31	$319,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$292,845
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$258
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$646,592
Value of total assets at end of year	2019-12-31	$3,625,812
Value of total assets at beginning of year	2019-12-31	$2,682,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$26,858
Total interest from all sources	2019-12-31	$3,900
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$613,013
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$613,013
Administrative expenses professional fees incurred	2019-12-31	$26,858
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$438,172
Participant contributions at end of year	2019-12-31	$111,096
Participant contributions at beginning of year	2019-12-31	$59,559
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$73,239
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$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	2019-12-31	No
Value of net income/loss	2019-12-31	$943,544
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,625,812
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,682,268
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	$3,287,703
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,377,656
Interest on participant loans	2019-12-31	$3,900
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$227,013
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$245,053
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	$135,181
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$292,845
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2019-12-31	043499945
2018 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2018 401k financial data
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	$570,316
Total of all expenses incurred	2018-12-31	$248,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$212,623
Expenses. Certain deemed distributions of participant loans	2018-12-31	$10,534
Value of total corrective distributions	2018-12-31	$583
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$692,718
Value of total assets at end of year	2018-12-31	$2,682,268
Value of total assets at beginning of year	2018-12-31	$2,360,817
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$25,125
Total interest from all sources	2018-12-31	$2,260
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$25,125
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$343,361
Participant contributions at end of year	2018-12-31	$59,559
Participant contributions at beginning of year	2018-12-31	$18,306
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$255,764
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$1
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	$321,451
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,682,268
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,360,817
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	$2,377,656
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,167,123
Interest on participant loans	2018-12-31	$2,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$245,053
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$175,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-124,663
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	$93,593
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$212,623
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2018-12-31	043499945
2017 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2017 401k financial data
Total liabilities at end 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	$801,009
Total of all expenses incurred	2017-12-31	$250,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$231,098
Value of total corrective distributions	2017-12-31	$946
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$449,363
Value of total assets at end of year	2017-12-31	$2,360,817
Value of total assets at beginning of year	2017-12-31	$1,810,769
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$18,917
Total interest from all sources	2017-12-31	$923
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$18,917
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
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$311,208
Participant contributions at end of year	2017-12-31	$18,306
Participant contributions at beginning of year	2017-12-31	$27,085
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$54,518
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	$550,048
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,360,817
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,810,769
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	$2,167,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,615,637
Interest on participant loans	2017-12-31	$923
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$175,388
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$168,047
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$350,723
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	No
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	$83,637
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$231,098
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945
2016 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$518,697
Total of all expenses incurred	2016-12-31	$175,970
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$168,423
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$410,742
Value of total assets at end of year	2016-12-31	$1,810,769
Value of total assets at beginning of year	2016-12-31	$1,468,042
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$7,547
Total interest from all sources	2016-12-31	$655
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$7,547
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$250,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$275,314
Participant contributions at end of year	2016-12-31	$27,085
Participant contributions at beginning of year	2016-12-31	$19,858
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$71,037
Other income not declared elsewhere	2016-12-31	$841
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	$342,727
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,810,769
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,468,042
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,615,637
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,245,944
Interest on participant loans	2016-12-31	$655
Interest earned on other investments	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$168,047
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$202,240
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$106,459
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	$64,391
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$168,423
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945
2015 : HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$251,611
Total of all expenses incurred	2015-12-31	$156,204
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$151,764
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$233,250
Value of total assets at end of year	2015-12-31	$1,468,042
Value of total assets at beginning of year	2015-12-31	$1,372,635
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,440
Total interest from all sources	2015-12-31	$360
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$4,440
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$250,000
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	$213,804
Participant contributions at end of year	2015-12-31	$19,858
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$14,442
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	$95,407
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,468,042
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,372,635
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,245,944
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,119,017
Interest on participant loans	2015-12-31	$360
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$202,240
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$253,618
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$18,001
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	$5,004
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$151,764
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
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2015-12-31	043499945

Form 5500 Responses for HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN

2022: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2021: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2020: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2019: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2018: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2017: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS 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 - Trust	Yes
2016: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HOSPICE OF SOUTHERN MAINE RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	25
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	16
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	95
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	86
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	84
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892295-001

Policy instance

Insurance contract or identification number	892295-001
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,484
Total amount of fees paid to insurance company	USD $0
Commission paid to Insurance Broker	USD $1,484
Insurance broker organization code?	7
Insurance broker name	VALMARK SECURITIES

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372713-01

Policy instance

Insurance contract or identification number	372713-01
Number of Individuals Covered	70
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

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Company Name:	HOSPICE OF SOUTHERN MAINE
Employer identification number (EIN):	010540180
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	Maine Bureau of Corporations, Elections & Commissions
Incorporation Date:
Company Identification Number:	20010248ND