401k Plan data: CHELSEA JEWISH 401(K) PLAN plan

CHELSEA JEWISH 401(K) PLAN 401k Plan overview

Plan Name	CHELSEA JEWISH 401(K) PLAN
Plan identification number	001

CHELSEA JEWISH 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ASAR ELDER SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: ASAR ELDER SERVICES, INC.

Employer identification number (EIN): 043289287

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHELSEA JEWISH 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2015-01-01
001 2014-01-01 ADAM BERMAN
001 2013-01-01 ADAM BERMAN
001 2012-01-01 ADAM BERMAN
001 2011-01-01 ADAM BERMAN
001 2010-01-01 ADAM BERMAN

Plan Statistics for CHELSEA JEWISH 401(K) PLAN

401k plan membership statisitcs for CHELSEA JEWISH 401(K) PLAN

Measure Date Value
2016: CHELSEA JEWISH 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 2
Total participants 2016-01-01 2
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: CHELSEA JEWISH 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 646
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 606
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 47
Total of all active and inactive participants 2015-01-01 653
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 653
Number of participants with account balances 2015-01-01 221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CHELSEA JEWISH 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 605
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 574
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 56
Total of all active and inactive participants 2014-01-01 630
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 630
Number of participants with account balances 2014-01-01 231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHELSEA JEWISH 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 555
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 571
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 34
Total of all active and inactive participants 2013-01-01 605
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 605
Number of participants with account balances 2013-01-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHELSEA JEWISH 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 524
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 522
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 33
Total of all active and inactive participants 2012-01-01 555
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 555
Number of participants with account balances 2012-01-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHELSEA JEWISH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 483
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 504
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 13
Total of all active and inactive participants 2011-01-01 517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 517
Number of participants with account balances 2011-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CHELSEA JEWISH 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 264
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 432
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 8
Total of all active and inactive participants 2010-01-01 440
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 440
Number of participants with account balances 2010-01-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2016: CHELSEA JEWISH 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	2
Total participants	2016-01-01	2
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: CHELSEA JEWISH 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	646
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	606
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	47
Total of all active and inactive participants	2015-01-01	653
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	653
Number of participants with account balances	2015-01-01	221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CHELSEA JEWISH 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	605
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	574
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	56
Total of all active and inactive participants	2014-01-01	630
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	630
Number of participants with account balances	2014-01-01	231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHELSEA JEWISH 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	555
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	571
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	34
Total of all active and inactive participants	2013-01-01	605
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	605
Number of participants with account balances	2013-01-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHELSEA JEWISH 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	524
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	522
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	33
Total of all active and inactive participants	2012-01-01	555
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	555
Number of participants with account balances	2012-01-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHELSEA JEWISH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	483
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	504
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	13
Total of all active and inactive participants	2011-01-01	517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	517
Number of participants with account balances	2011-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CHELSEA JEWISH 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	264
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	432
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	8
Total of all active and inactive participants	2010-01-01	440
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	440
Number of participants with account balances	2010-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on CHELSEA JEWISH 401(K) PLAN

Measure	Date	Value
2016 : CHELSEA JEWISH 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$184,020
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$8,581,389
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$8,379,883
Expenses. Certain deemed distributions of participant loans	2016-12-31	$195,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$36,940
Value of total assets at end of year	2016-12-31	$4,924
Value of total assets at beginning of year	2016-12-31	$8,402,293
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$6,270
Total interest from all sources	2016-12-31	$21,377
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$11,471
Participant contributions at end of year	2016-12-31	$2,963
Participant contributions at beginning of year	2016-12-31	$295,514
Administrative expenses (other) incurred	2016-12-31	$6,270
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	$-8,397,369
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,924
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,402,293
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	$752
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$5,446,434
Interest on participant loans	2016-12-31	$3,128
Interest earned on other investments	2016-12-31	$18,249
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,209
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,660,345
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$125,703
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	$25,469
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$8,379,883
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2016-12-31	410746749
2015 : CHELSEA JEWISH 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,066,673
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$264,095
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$255,844
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,122,953
Value of total assets at end of year	2015-12-31	$8,402,293
Value of total assets at beginning of year	2015-12-31	$7,599,715
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,251
Total interest from all sources	2015-12-31	$39,048
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$670,066
Participant contributions at end of year	2015-12-31	$295,514
Participant contributions at beginning of year	2015-12-31	$238,407
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$81,974
Administrative expenses (other) incurred	2015-12-31	$8,251
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	$802,578
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,402,293
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,599,715
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	$5,446,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,845,849
Interest on participant loans	2015-12-31	$7,172
Interest earned on other investments	2015-12-31	$31,876
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,660,345
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,515,459
Net investment gain/loss from pooled separate accounts	2015-12-31	$-95,328
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	$370,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$255,844
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2015-12-31	410746749
2014 : CHELSEA JEWISH 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,615,750
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$563,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$535,172
Expenses. Certain deemed distributions of participant loans	2014-12-31	$21,698
Value of total corrective distributions	2014-12-31	$947
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,356,533
Value of total assets at end of year	2014-12-31	$7,599,715
Value of total assets at beginning of year	2014-12-31	$6,547,937
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$6,155
Total interest from all sources	2014-12-31	$33,708
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$629,857
Participant contributions at end of year	2014-12-31	$238,407
Participant contributions at beginning of year	2014-12-31	$257,137
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$351,691
Administrative expenses (other) incurred	2014-12-31	$6,155
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,051,778
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$7,599,715
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,547,937
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,845,849
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$3,855,814
Interest on participant loans	2014-12-31	$7,833
Interest earned on other investments	2014-12-31	$25,875
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,515,459
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,434,986
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$225,509
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$374,985
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$535,172
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2014-12-31	410746749
2013 : CHELSEA JEWISH 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,631,225
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$683,255
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$678,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$941,675
Value of total assets at end of year	2013-12-31	$6,547,937
Value of total assets at beginning of year	2013-12-31	$5,599,967
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$4,798
Total interest from all sources	2013-12-31	$25,581
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$570,091
Participant contributions at end of year	2013-12-31	$257,137
Participant contributions at beginning of year	2013-12-31	$169,592
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$74,118
Administrative expenses (other) incurred	2013-12-31	$4,798
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$947,970
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,547,937
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,599,967
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$3,855,814
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,055,938
Interest on participant loans	2013-12-31	$6,302
Interest earned on other investments	2013-12-31	$19,279
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,434,986
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,374,437
Net investment gain/loss from pooled separate accounts	2013-12-31	$663,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$297,466
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$678,457
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2013-12-31	410746749
2012 : CHELSEA JEWISH 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,380,501
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$241,773
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$238,859
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$937,559
Value of total assets at end of year	2012-12-31	$5,599,967
Value of total assets at beginning of year	2012-12-31	$4,461,239
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,914
Total interest from all sources	2012-12-31	$25,389
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$558,129
Participant contributions at end of year	2012-12-31	$169,592
Participant contributions at beginning of year	2012-12-31	$123,511
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$19,813
Administrative expenses (other) incurred	2012-12-31	$2,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,138,728
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,599,967
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,461,239
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,055,938
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,082,703
Interest on participant loans	2012-12-31	$4,775
Interest earned on other investments	2012-12-31	$20,614
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,374,437
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,255,025
Net investment gain/loss from pooled separate accounts	2012-12-31	$417,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$359,617
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$238,859
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2012-12-31	410746749
2011 : CHELSEA JEWISH 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$578,056
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$325,170
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$323,633
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$652,955
Value of total assets at end of year	2011-12-31	$4,461,239
Value of total assets at beginning of year	2011-12-31	$4,208,353
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,537
Total interest from all sources	2011-12-31	$27,691
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
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	$414,524
Participant contributions at end of year	2011-12-31	$123,511
Participant contributions at beginning of year	2011-12-31	$68,788
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$14,551
Administrative expenses (other) incurred	2011-12-31	$1,537
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	$252,886
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,461,239
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,208,353
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 pooled separate accounts at end of year	2011-12-31	$3,082,703
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,956,234
Interest on participant loans	2011-12-31	$3,755
Interest earned on other investments	2011-12-31	$23,936
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,255,025
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,183,331
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-102,590
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
Contributions received in cash from employer	2011-12-31	$223,880
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$323,633
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2011-12-31	410746749
2010 : CHELSEA JEWISH 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$895,562
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$307,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$307,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$570,152
Value of total assets at end of year	2010-12-31	$4,208,353
Value of total assets at beginning of year	2010-12-31	$3,620,372
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$345
Total interest from all sources	2010-12-31	$10,474
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
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	$352,500
Participant contributions at end of year	2010-12-31	$68,788
Participant contributions at beginning of year	2010-12-31	$46,194
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$34,414
Administrative expenses (other) incurred	2010-12-31	$345
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	$587,981
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,208,353
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,620,372
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$2,956,234
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,562,413
Interest on participant loans	2010-12-31	$1,920
Interest earned on other investments	2010-12-31	$8,554
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,183,331
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$11,765
Net investment gain/loss from pooled separate accounts	2010-12-31	$314,936
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$183,238
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$307,236
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	LARSONALLEN LLP
Accountancy firm EIN	2010-12-31	410746749

Form 5500 Responses for CHELSEA JEWISH 401(K) PLAN

2016: CHELSEA JEWISH 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CHELSEA JEWISH 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CHELSEA JEWISH 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CHELSEA JEWISH 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHELSEA JEWISH 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHELSEA JEWISH 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: CHELSEA JEWISH 401(K) 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	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	221
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $27,335
Total amount of fees paid to insurance company	USD $3,834
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	231
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $24,294
Total amount of fees paid to insurance company	USD $3,368
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $24,294
Insurance broker organization code?	3
Amount paid for insurance broker fees	3368
Additional information about fees paid to insurance broker	TPA ADMINISTRATOR ALLOWANCE
Insurance broker name	THE ANGELL PENSION GROUP, INC.

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	194
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $20,761
Total amount of fees paid to insurance company	USD $2,889
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $20,761
Insurance broker organization code?	3
Amount paid for insurance broker fees	2889
Additional information about fees paid to insurance broker	TPA ADMINISTRATOR ALLOWANCE
Insurance broker name	THE ANGELL PENSION GROUP, INC.

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	179
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $17,017
Total amount of fees paid to insurance company	USD $2,351
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $17,017
Insurance broker organization code?	3
Amount paid for insurance broker fees	2351
Additional information about fees paid to insurance broker	TPA ADMINISTRATOR ALLOWANCE
Insurance broker name	THE ANGELL PENSION GROUP, INC.

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

922845

Policy instance

Insurance contract or identification number	922845
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	145
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,038
Total amount of fees paid to insurance company	USD $7,611
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

922845

Policy instance

Insurance contract or identification number	922845
Number of Individuals Covered	3
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $178
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

943415

Policy instance

Insurance contract or identification number	943415
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,938
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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

Policy contract number

877860

Policy instance

Insurance contract or identification number	877860
Number of Individuals Covered	124
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $36,922
Total amount of fees paid to insurance company	USD $9,013
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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Company Name:	ASAR ELDER SERVICES, INC.
Employer identification number (EIN):	043289287
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Plan id#	Filing Submission Date	Name of Administrator
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2015-01-01
001	2014-01-01	ADAM BERMAN
001	2013-01-01	ADAM BERMAN
001	2012-01-01	ADAM BERMAN
001	2011-01-01	ADAM BERMAN
001	2010-01-01	ADAM BERMAN