401k Plan data: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN plan

HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 401k Plan overview

Plan Name	HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN
Plan identification number	002

HEBREW SENIORLIFE EMPLOYEE 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 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

HEBREW SENIORLIFE has sponsored the creation of one or more 401k plans.

Company Name: HEBREW SENIORLIFE

Employer identification number (EIN): 042104298

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2011-01-01 ALESSANDRA DE VACA
002 2010-01-01 ALESSANDRA DE VACA
002 2009-01-01 ALESSANDRA DE VACA
002 2009-01-01 ALESSANDRA DE VACA

Plan id#	Filing Submission Date	Name of Administrator
002	2011-01-01	ALESSANDRA DE VACA
002	2010-01-01	ALESSANDRA DE VACA
002	2009-01-01	ALESSANDRA DE VACA
002	2009-01-01	ALESSANDRA DE VACA

Plan Statistics for HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN

401k plan membership statisitcs for HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN

Measure Date Value
2011: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,293
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2,269
Number of retired or separated participants receiving benefits 2011-01-01 10
Number of other retired or separated participants entitled to future benefits 2011-01-01 416
Total of all active and inactive participants 2011-01-01 2,695
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 4
Total participants 2011-01-01 2,699
Number of participants with account balances 2011-01-01 1,366
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,199
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 994
Number of retired or separated participants receiving benefits 2010-01-01 5
Number of other retired or separated participants entitled to future benefits 2010-01-01 288
Total of all active and inactive participants 2010-01-01 1,287
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 6
Total participants 2010-01-01 1,293
Number of participants with account balances 2010-01-01 1,293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,200
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 879
Number of retired or separated participants receiving benefits 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 308
Total of all active and inactive participants 2009-01-01 1,192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 7
Total participants 2009-01-01 1,199
Number of participants with account balances 2009-01-01 1,199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,293
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2,269
Number of retired or separated participants receiving benefits	2011-01-01	10
Number of other retired or separated participants entitled to future benefits	2011-01-01	416
Total of all active and inactive participants	2011-01-01	2,695
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	4
Total participants	2011-01-01	2,699
Number of participants with account balances	2011-01-01	1,366
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,199
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	994
Number of retired or separated participants receiving benefits	2010-01-01	5
Number of other retired or separated participants entitled to future benefits	2010-01-01	288
Total of all active and inactive participants	2010-01-01	1,287
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	6
Total participants	2010-01-01	1,293
Number of participants with account balances	2010-01-01	1,293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,200
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	879
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	308
Total of all active and inactive participants	2009-01-01	1,192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	7
Total participants	2009-01-01	1,199
Number of participants with account balances	2009-01-01	1,199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN

Measure	Date	Value
2011 : HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$4,576,697
Total of all expenses incurred	2011-12-31	$3,293,659
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,202,316
Expenses. Certain deemed distributions of participant loans	2011-12-31	$12,153
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$4,541,629
Value of total assets at end of year	2011-12-31	$45,320,925
Value of total assets at beginning of year	2011-12-31	$44,037,887
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$79,190
Total interest from all sources	2011-12-31	$27,892
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$570,465
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$570,465
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$4,150,457
Participant contributions at end of year	2011-12-31	$560,477
Participant contributions at beginning of year	2011-12-31	$528,451
Participant contributions at end of year	2011-12-31	$13,582
Participant contributions at beginning of year	2011-12-31	$13,218
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$349,702
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$348,324
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$391,172
Other income not declared elsewhere	2011-12-31	$1,377
Administrative expenses (other) incurred	2011-12-31	$79,190
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$1,283,038
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$45,320,925
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$44,037,887
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$31,969,079
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$30,844,939
Value of interest in pooled separate accounts at end of year	2011-12-31	$12,426,153
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$12,301,484
Interest on participant loans	2011-12-31	$27,892
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,932
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,471
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-960,256
Net investment gain/loss from pooled separate accounts	2011-12-31	$395,590
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,202,316
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	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	CARON & BLETZER PLLC
Accountancy firm EIN	2011-12-31	043499945
2010 : HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$8,256,958
Total of all expenses incurred	2010-12-31	$2,576,894
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$2,490,765
Expenses. Certain deemed distributions of participant loans	2010-12-31	$44,103
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$4,187,649
Value of total assets at end of year	2010-12-31	$44,037,887
Value of total assets at beginning of year	2010-12-31	$38,357,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$42,026
Total interest from all sources	2010-12-31	$35,203
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$552,780
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$552,780
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$3,816,965
Participant contributions at end of year	2010-12-31	$528,451
Participant contributions at beginning of year	2010-12-31	$599,262
Participant contributions at end of year	2010-12-31	$13,218
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$348,324
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$310,329
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$370,684
Other income not declared elsewhere	2010-12-31	$39,498
Administrative expenses (other) incurred	2010-12-31	$42,026
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$5,680,064
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$44,037,887
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$38,357,823
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$30,844,939
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$26,252,892
Value of interest in pooled separate accounts at end of year	2010-12-31	$12,301,484
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$11,194,826
Interest on participant loans	2010-12-31	$35,203
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,471
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$514
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$3,085,902
Net investment gain/loss from pooled separate accounts	2010-12-31	$355,926
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$2,490,765
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	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	CARON & BLETZER PLLC
Accountancy firm EIN	2010-12-31	043499945
2009 : HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for HEBREW SENIORLIFE EMPLOYEE SAVINGS PLAN

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

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Company Name:	HEBREW SENIORLIFE
Employer identification number (EIN):	042104298
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities