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LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameLAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN
Plan identification number 002

LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • 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

BESTSELF BEHAVIORAL HEALTH, INC. has sponsored the creation of one or more 401k plans.

Company Name:BESTSELF BEHAVIORAL HEALTH, INC.
Employer identification number (EIN):161004090
NAIC Classification:621330
NAIC Description:Offices of Mental Health Practitioners (except Physicians)

Additional information about BESTSELF BEHAVIORAL HEALTH, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1972-12-27
Company Identification Number: 249829
Legal Registered Office Address: 255 DELAWARE AVENUE
SUITE 300
BUFFALO
United States of America (USA)
14202

More information about BESTSELF BEHAVIORAL HEALTH, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01HOWARD HITZEL HOWARD HITZEL2018-10-15
0022016-01-01HOWARD HITZEL
0022015-01-01HOWARD HITZEL
0022014-01-01HOWARD HITZEL
0022013-01-01HOWARD HITZEL
0022012-01-01HOWARD HITZEL
0022011-01-01HOWARD HITZEL HOWARD HITZEL2012-10-11
0022010-01-01HOWARD HITZEL HOWARD HITZEL2011-10-12
0022009-01-01HOWARD HITZEL HOWARD HITZEL2010-10-14

Plan Statistics for LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN

Measure Date Value
2022: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,350
Total number of active participants reported on line 7a of the Form 55002022-01-011,265
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01222
Total of all active and inactive participants2022-01-011,487
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,487
Number of participants with account balances2022-01-011,198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0191
2021: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,230
Total number of active participants reported on line 7a of the Form 55002021-01-011,143
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01173
Total of all active and inactive participants2021-01-011,316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-011,316
Number of participants with account balances2021-01-011,091
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0160
2020: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,126
Total number of active participants reported on line 7a of the Form 55002020-01-011,095
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-01118
Total of all active and inactive participants2020-01-011,214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-011,214
Number of participants with account balances2020-01-011,034
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0134
2019: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01986
Total number of active participants reported on line 7a of the Form 55002019-01-01999
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01110
Total of all active and inactive participants2019-01-011,109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-011,109
Number of participants with account balances2019-01-01920
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0129
2018: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01820
Total number of active participants reported on line 7a of the Form 55002018-01-01859
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01107
Total of all active and inactive participants2018-01-01966
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01967
Number of participants with account balances2018-01-01614
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0136
2017: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01493
Total number of active participants reported on line 7a of the Form 55002017-01-01737
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01111
Total of all active and inactive participants2017-01-01848
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01848
Number of participants with account balances2017-01-01504
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0130
2016: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01230
Total number of active participants reported on line 7a of the Form 55002016-01-01249
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0115
Total of all active and inactive participants2016-01-01264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01264
Number of participants with account balances2016-01-01254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01232
Total number of active participants reported on line 7a of the Form 55002015-01-01205
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0125
Total of all active and inactive participants2015-01-01230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01230
Number of participants with account balances2015-01-01227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0110
2014: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01177
Total number of active participants reported on line 7a of the Form 55002014-01-01215
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0117
Total of all active and inactive participants2014-01-01232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01232
Number of participants with account balances2014-01-01229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0118
2013: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01190
Total number of active participants reported on line 7a of the Form 55002013-01-01142
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0135
Total of all active and inactive participants2013-01-01177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01177
Number of participants with account balances2013-01-01174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0117
2012: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01196
Total number of active participants reported on line 7a of the Form 55002012-01-01162
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0127
Total of all active and inactive participants2012-01-01189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-01190
Number of participants with account balances2012-01-01186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-017
2011: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01255
Total number of active participants reported on line 7a of the Form 55002011-01-01162
Number of other retired or separated participants entitled to future benefits2011-01-0187
Total of all active and inactive participants2011-01-01249
Total participants2011-01-01249
Number of participants with account balances2011-01-01249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0129
2010: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01259
Total number of active participants reported on line 7a of the Form 55002010-01-01163
Number of other retired or separated participants entitled to future benefits2010-01-0192
Total of all active and inactive participants2010-01-01255
Total participants2010-01-01255
Number of participants with account balances2010-01-01255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0118
2009: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01220
Total number of active participants reported on line 7a of the Form 55002009-01-01162
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0197
Total of all active and inactive participants2009-01-01259
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01259
Number of participants with account balances2009-01-01269
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-018

Financial Data on LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN

Measure Date Value
2022 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$97,776
Total of all expenses incurred2022-12-31$4,214,783
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$4,089,177
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$4,631,281
Value of total assets at end of year2022-12-31$23,461,693
Value of total assets at beginning of year2022-12-31$27,578,700
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$125,606
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$66,016
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$66,016
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,958,922
Participant contributions at end of year2022-12-31$1,932
Participant contributions at beginning of year2022-12-31$44
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$457,136
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$47
Other income not declared elsewhere2022-12-31$-831,693
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,117,007
Value of net assets at end of year (total assets less liabilities)2022-12-31$23,461,693
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$27,578,700
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$29,828
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,891,972
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,820,697
Value of interest in pooled separate accounts at end of year2022-12-31$746,674
Value of interest in pooled separate accounts at beginning of year2022-12-31$1,233,711
Value of interest in common/collective trusts at end of year2022-12-31$18,786,635
Value of interest in common/collective trusts at beginning of year2022-12-31$20,770,925
Net investment gain/loss from pooled separate accounts2022-12-31$-302,331
Net investment gain or loss from common/collective trusts2022-12-31$-3,465,497
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,215,223
Employer contributions (assets) at end of year2022-12-31$34,433
Employer contributions (assets) at beginning of year2022-12-31$753,323
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,089,177
Contract administrator fees2022-12-31$95,778
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2022-12-31160929175
2021 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$8,056,445
Total of all expenses incurred2021-12-31$4,116,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,974,872
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,647,683
Value of total assets at end of year2021-12-31$27,578,700
Value of total assets at beginning of year2021-12-31$23,638,598
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$141,471
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$55,207
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$55,207
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,549,557
Participant contributions at end of year2021-12-31$44
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$265,289
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$328
Other income not declared elsewhere2021-12-31$419
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,940,102
Value of net assets at end of year (total assets less liabilities)2021-12-31$27,578,700
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$23,638,598
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,820,697
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,389,345
Value of interest in pooled separate accounts at end of year2021-12-31$1,233,711
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,269,709
Value of interest in common/collective trusts at end of year2021-12-31$20,770,925
Value of interest in common/collective trusts at beginning of year2021-12-31$17,917,822
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$523,636
Net investment gain/loss from pooled separate accounts2021-12-31$172,281
Net investment gain or loss from common/collective trusts2021-12-31$2,657,219
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,832,837
Employer contributions (assets) at end of year2021-12-31$753,323
Employer contributions (assets) at beginning of year2021-12-31$1,061,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,974,872
Contract administrator fees2021-12-31$141,471
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2021-12-31160929175
2020 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$7,463,920
Total of all expenses incurred2020-12-31$1,077,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$966,178
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,338,132
Value of total assets at end of year2020-12-31$23,638,598
Value of total assets at beginning of year2020-12-31$17,252,109
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$111,253
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$38,609
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$38,609
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$2,158,693
Participant contributions at beginning of year2020-12-31$443
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$133,459
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$328
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$722
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$6,386,489
Value of net assets at end of year (total assets less liabilities)2020-12-31$23,638,598
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$17,252,109
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$29,981
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,389,345
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,399,957
Value of interest in pooled separate accounts at end of year2020-12-31$1,269,709
Value of interest in pooled separate accounts at beginning of year2020-12-31$691,416
Value of interest in common/collective trusts at end of year2020-12-31$17,917,822
Value of interest in common/collective trusts at beginning of year2020-12-31$12,146,496
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$590,354
Net investment gain/loss from pooled separate accounts2020-12-31$216,237
Net investment gain or loss from common/collective trusts2020-12-31$2,280,588
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$2,045,980
Employer contributions (assets) at end of year2020-12-31$1,061,394
Employer contributions (assets) at beginning of year2020-12-31$1,013,075
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$966,178
Contract administrator fees2020-12-31$81,272
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2020-12-31160929175
2019 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$6,284,180
Total of all expenses incurred2019-12-31$1,386,148
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,294,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,584,754
Value of total assets at end of year2019-12-31$17,252,109
Value of total assets at beginning of year2019-12-31$12,354,077
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$91,461
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$52,352
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$52,352
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,670,817
Participant contributions at end of year2019-12-31$443
Participant contributions at beginning of year2019-12-31$2,246
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$186,035
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$722
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,860
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$4,898,032
Value of net assets at end of year (total assets less liabilities)2019-12-31$17,252,109
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$12,354,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$19,983
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,399,957
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,525,854
Value of interest in pooled separate accounts at end of year2019-12-31$691,416
Value of interest in pooled separate accounts at beginning of year2019-12-31$702,203
Value of interest in common/collective trusts at end of year2019-12-31$12,146,496
Value of interest in common/collective trusts at beginning of year2019-12-31$8,398,616
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$694,545
Net investment gain/loss from pooled separate accounts2019-12-31$155,719
Net investment gain or loss from common/collective trusts2019-12-31$1,796,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,727,902
Employer contributions (assets) at end of year2019-12-31$1,013,075
Employer contributions (assets) at beginning of year2019-12-31$723,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,294,687
Contract administrator fees2019-12-31$71,478
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2019-12-31160929175
2018 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$1,664,986
Total of all expenses incurred2018-12-31$1,501,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,400,728
Value of total corrective distributions2018-12-31$9,857
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,471,297
Value of total assets at end of year2018-12-31$12,354,077
Value of total assets at beginning of year2018-12-31$12,190,516
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$90,840
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$37,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$37,837
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$949,845
Participant contributions at end of year2018-12-31$2,246
Participant contributions at beginning of year2018-12-31$22,346
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$274,013
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$1,860
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$1,860
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$163,561
Value of net assets at end of year (total assets less liabilities)2018-12-31$12,354,077
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$12,190,516
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,525,854
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,451,979
Value of interest in pooled separate accounts at end of year2018-12-31$702,203
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,724,407
Value of interest in common/collective trusts at end of year2018-12-31$8,398,616
Value of interest in common/collective trusts at beginning of year2018-12-31$7,624,812
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-233,400
Net investment gain/loss from pooled separate accounts2018-12-31$-34,546
Net investment gain or loss from common/collective trusts2018-12-31$-576,202
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,247,439
Employer contributions (assets) at end of year2018-12-31$723,298
Employer contributions (assets) at beginning of year2018-12-31$365,112
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,400,728
Contract administrator fees2018-12-31$90,840
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2018-12-31160929175
2017 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2017 401k financial data
Total transfer of assets to this plan2017-12-31$4,529,889
Total income from all sources (including contributions)2017-12-31$4,179,169
Total of all expenses incurred2017-12-31$452,171
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$404,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,928,891
Value of total assets at end of year2017-12-31$12,190,516
Value of total assets at beginning of year2017-12-31$3,933,629
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$47,983
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$82,183
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$82,183
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$482,096
Participant contributions at end of year2017-12-31$22,346
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$1,733,381
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$1,860
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,726,998
Value of net assets at end of year (total assets less liabilities)2017-12-31$12,190,516
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,933,629
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,451,979
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,645,403
Value of interest in pooled separate accounts at end of year2017-12-31$1,724,407
Value of interest in common/collective trusts at end of year2017-12-31$7,624,812
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$11,542
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$11,542
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,168,095
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$713,414
Employer contributions (assets) at end of year2017-12-31$365,112
Employer contributions (assets) at beginning of year2017-12-31$276,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$404,188
Contract administrator fees2017-12-31$47,983
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31Yes
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2017-12-31160929175
2016 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$0
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$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
Expenses. Interest paid2016-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022016-12-31$0
Total income from all sources (including contributions)2016-12-31$781,279
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$74,262
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$74,237
Expenses. Certain deemed distributions of participant loans2016-12-31$0
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$554,771
Value of total assets at end of year2016-12-31$3,933,629
Value of total assets at beginning of year2016-12-31$3,226,612
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$25
Total income from rents2016-12-31$0
Total interest from all sources2016-12-31$1
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$144,244
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$144,244
Assets. Real estate other than employer real property at end of year2016-12-31$0
Assets. Real estate other than employer real property at beginning of year2016-12-31$0
Administrative expenses professional fees incurred2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$0
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Assets. Other investments not covered elsewhere at end of year2016-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$5,023
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Assets. Loans (other than to participants) at end of year2016-12-31$0
Assets. Loans (other than to participants) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Other income not declared elsewhere2016-12-31$0
Administrative expenses (other) incurred2016-12-31$25
Liabilities. Value of operating payables at end of year2016-12-31$0
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$0
Value of net income/loss2016-12-31$707,017
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,933,629
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,226,612
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Assets. partnership/joint venture interests at end of year2016-12-31$0
Assets. partnership/joint venture interests at beginning of year2016-12-31$0
Investment advisory and management fees2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,645,403
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$3,019,637
Value of interest in pooled separate accounts at end of year2016-12-31$0
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Interest on participant loans2016-12-31$0
Income. Interest from loans (other than to participants)2016-12-31$0
Interest earned on other investments2016-12-31$0
Income. Interest from US Government securities2016-12-31$0
Income. Interest from corporate debt instruments2016-12-31$0
Value of interest in master investment trust accounts at end of year2016-12-31$0
Value of interest in master investment trust accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$11,542
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$6,749
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$6,749
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1
Assets. Value of investments in 103.12 investment entities at end of year2016-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2016-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Asset value of US Government securities at end of year2016-12-31$0
Asset value of US Government securities at beginning of year2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$82,263
Net investment gain/loss from pooled separate accounts2016-12-31$0
Net investment gain or loss from common/collective trusts2016-12-31$0
Net gain/loss from 103.12 investment entities2016-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Assets. Value of employer real property at end of year2016-12-31$0
Assets. Value of employer real property at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$549,748
Employer contributions (assets) at end of year2016-12-31$276,684
Employer contributions (assets) at beginning of year2016-12-31$200,226
Income. Dividends from preferred stock2016-12-31$0
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$74,237
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$0
Contract administrator fees2016-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$0
Liabilities. Value of benefit claims payable at end of year2016-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$0
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$0
Aggregate carrying amount (costs) on sale of assets2016-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2016-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2016-12-31160929175
2015 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$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
Expenses. Interest paid2015-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022015-12-31$0
Total income from all sources (including contributions)2015-12-31$399,605
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$362,139
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$362,089
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Value of total corrective distributions2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$427,408
Value of total assets at end of year2015-12-31$3,226,612
Value of total assets at beginning of year2015-12-31$3,189,146
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$50
Total income from rents2015-12-31$0
Total interest from all sources2015-12-31$19
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$153,943
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$153,943
Assets. Real estate other than employer real property at end of year2015-12-31$0
Assets. Real estate other than employer real property at beginning of year2015-12-31$0
Administrative expenses professional fees incurred2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$0
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$16,654
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Assets. Loans (other than to participants) at end of year2015-12-31$0
Assets. Loans (other than to participants) at beginning of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$50
Liabilities. Value of operating payables at end of year2015-12-31$0
Liabilities. Value of operating payables at beginning of year2015-12-31$0
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Income. Non cash contributions2015-12-31$0
Value of net income/loss2015-12-31$37,466
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,226,612
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,189,146
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Assets. partnership/joint venture interests at end of year2015-12-31$0
Assets. partnership/joint venture interests at beginning of year2015-12-31$0
Investment advisory and management fees2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$3,019,637
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,047,141
Value of interest in pooled separate accounts at end of year2015-12-31$0
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$0
Income. Interest from loans (other than to participants)2015-12-31$0
Interest earned on other investments2015-12-31$0
Income. Interest from US Government securities2015-12-31$0
Income. Interest from corporate debt instruments2015-12-31$0
Value of interest in master investment trust accounts at end of year2015-12-31$0
Value of interest in master investment trust accounts at beginning of year2015-12-31$0
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$6,749
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$19
Assets. Value of investments in 103.12 investment entities at end of year2015-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2015-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Asset value of US Government securities at end of year2015-12-31$0
Asset value of US Government securities at beginning of year2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-181,765
Net investment gain/loss from pooled separate accounts2015-12-31$0
Net investment gain or loss from common/collective trusts2015-12-31$0
Net gain/loss from 103.12 investment entities2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Assets. Value of employer real property at end of year2015-12-31$0
Assets. Value of employer real property at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$410,754
Employer contributions (assets) at end of year2015-12-31$200,226
Employer contributions (assets) at beginning of year2015-12-31$142,005
Income. Dividends from preferred stock2015-12-31$0
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$362,089
Asset. Corporate debt instrument preferred debt at end of year2015-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$0
Contract administrator fees2015-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$0
Liabilities. Value of benefit claims payable at end of year2015-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$0
Aggregate carrying amount (costs) on sale of assets2015-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2015-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2015-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2015-12-31160929175
2014 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$0
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$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
Expenses. Interest paid2014-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022014-12-31$0
Total income from all sources (including contributions)2014-12-31$473,971
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$264,273
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$264,273
Expenses. Certain deemed distributions of participant loans2014-12-31$0
Value of total corrective distributions2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$325,797
Value of total assets at end of year2014-12-31$3,189,146
Value of total assets at beginning of year2014-12-31$2,979,448
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total income from rents2014-12-31$0
Total interest from all sources2014-12-31$2
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$197,663
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$197,663
Assets. Real estate other than employer real property at end of year2014-12-31$0
Assets. Real estate other than employer real property at beginning of year2014-12-31$0
Administrative expenses professional fees incurred2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$300,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$0
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Assets. Loans (other than to participants) at end of year2014-12-31$0
Assets. Loans (other than to participants) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Other income not declared elsewhere2014-12-31$0
Administrative expenses (other) incurred2014-12-31$0
Liabilities. Value of operating payables at end of year2014-12-31$0
Liabilities. Value of operating payables at beginning of year2014-12-31$0
Total non interest bearing cash at end of year2014-12-31$0
Total non interest bearing cash at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Income. Non cash contributions2014-12-31$0
Value of net income/loss2014-12-31$209,698
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,189,146
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,979,448
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Assets. partnership/joint venture interests at end of year2014-12-31$0
Assets. partnership/joint venture interests at beginning of year2014-12-31$0
Investment advisory and management fees2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$3,047,141
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,797,347
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$0
Interest on participant loans2014-12-31$0
Income. Interest from loans (other than to participants)2014-12-31$0
Interest earned on other investments2014-12-31$0
Income. Interest from US Government securities2014-12-31$0
Income. Interest from corporate debt instruments2014-12-31$0
Value of interest in master investment trust accounts at end of year2014-12-31$0
Value of interest in master investment trust accounts at beginning of year2014-12-31$0
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$24,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$24,971
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$2
Assets. Value of investments in 103.12 investment entities at end of year2014-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2014-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Asset value of US Government securities at end of year2014-12-31$0
Asset value of US Government securities at beginning of year2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-49,491
Net investment gain/loss from pooled separate accounts2014-12-31$0
Net investment gain or loss from common/collective trusts2014-12-31$0
Net gain/loss from 103.12 investment entities2014-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Assets. Invements in employer securities at end of year2014-12-31$0
Assets. Invements in employer securities at beginning of year2014-12-31$0
Assets. Value of employer real property at end of year2014-12-31$0
Assets. Value of employer real property at beginning of year2014-12-31$0
Contributions received in cash from employer2014-12-31$325,797
Employer contributions (assets) at end of year2014-12-31$142,005
Employer contributions (assets) at beginning of year2014-12-31$157,130
Income. Dividends from preferred stock2014-12-31$0
Income. Dividends from common stock2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$264,273
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$0
Contract administrator fees2014-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$0
Liabilities. Value of benefit claims payable at end of year2014-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$0
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$0
Aggregate carrying amount (costs) on sale of assets2014-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2014-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31DOPKINS & COMPANY, LLP
Accountancy firm EIN2014-12-31160929175
2013 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$0
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$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
Expenses. Interest paid2013-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-12-31$0
Total income from all sources (including contributions)2013-12-31$730,995
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$358,880
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$358,342
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$350,624
Value of total assets at end of year2013-12-31$2,979,448
Value of total assets at beginning of year2013-12-31$2,607,333
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$538
Total income from rents2013-12-31$0
Total interest from all sources2013-12-31$2
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$151,014
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$151,014
Assets. Real estate other than employer real property at end of year2013-12-31$0
Assets. Real estate other than employer real property at beginning of year2013-12-31$0
Administrative expenses professional fees incurred2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$300,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$0
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Assets. Other investments not covered elsewhere at end of year2013-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$21,572
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Assets. Loans (other than to participants) at end of year2013-12-31$0
Assets. Loans (other than to participants) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$538
Liabilities. Value of operating payables at end of year2013-12-31$0
Liabilities. Value of operating payables at beginning of year2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$372,115
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,979,448
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,607,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$0
Investment advisory and management fees2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,797,347
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,450,911
Value of interest in pooled separate accounts at end of year2013-12-31$0
Value of interest in pooled separate accounts at beginning of year2013-12-31$0
Interest on participant loans2013-12-31$0
Income. Interest from loans (other than to participants)2013-12-31$0
Interest earned on other investments2013-12-31$0
Income. Interest from US Government securities2013-12-31$0
Income. Interest from corporate debt instruments2013-12-31$0
Value of interest in master investment trust accounts at end of year2013-12-31$0
Value of interest in master investment trust accounts at beginning of year2013-12-31$0
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$24,971
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$77,561
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$77,561
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$2
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$229,355
Net investment gain/loss from pooled separate accounts2013-12-31$0
Net investment gain or loss from common/collective trusts2013-12-31$0
Net gain/loss from 103.12 investment entities2013-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Assets. Invements in employer securities at end of year2013-12-31$0
Assets. Invements in employer securities at beginning of year2013-12-31$0
Assets. Value of employer real property at end of year2013-12-31$0
Assets. Value of employer real property at beginning of year2013-12-31$0
Contributions received in cash from employer2013-12-31$329,052
Employer contributions (assets) at end of year2013-12-31$157,130
Employer contributions (assets) at beginning of year2013-12-31$78,861
Income. Dividends from preferred stock2013-12-31$0
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$358,342
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$0
Contract administrator fees2013-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$0
Liabilities. Value of benefit claims payable at end of year2013-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$0
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$0
Aggregate carrying amount (costs) on sale of assets2013-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31FEDERSPIEL, PFEIFER & KUBICKI, CPA
Accountancy firm EIN2013-12-31161492835
2012 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$0
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$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
Expenses. Interest paid2012-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-12-31$0
Total income from all sources (including contributions)2012-12-31$528,449
Total loss/gain on sale of assets2012-12-31$87,087
Total of all expenses incurred2012-12-31$628,273
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$624,461
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Value of total corrective distributions2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$231,654
Value of total assets at end of year2012-12-31$2,607,333
Value of total assets at beginning of year2012-12-31$2,707,157
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$3,812
Total income from rents2012-12-31$0
Total interest from all sources2012-12-31$4
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$52,224
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$52,224
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$300,000
If this is an individual account plan, was there a blackout period2012-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$0
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Assets. Loans (other than to participants) at end of year2012-12-31$0
Assets. Loans (other than to participants) at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$699
Liabilities. Value of operating payables at end of year2012-12-31$0
Liabilities. Value of operating payables at beginning of year2012-12-31$0
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Income. Non cash contributions2012-12-31$0
Value of net income/loss2012-12-31$-99,824
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,607,333
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,707,157
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Assets. partnership/joint venture interests at end of year2012-12-31$0
Assets. partnership/joint venture interests at beginning of year2012-12-31$0
Investment advisory and management fees2012-12-31$3,113
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,450,911
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,603,652
Value of interest in pooled separate accounts at end of year2012-12-31$0
Value of interest in pooled separate accounts at beginning of year2012-12-31$0
Interest on participant loans2012-12-31$0
Income. Interest from loans (other than to participants)2012-12-31$0
Interest earned on other investments2012-12-31$0
Income. Interest from US Government securities2012-12-31$0
Income. Interest from corporate debt instruments2012-12-31$0
Value of interest in master investment trust accounts at end of year2012-12-31$0
Value of interest in master investment trust accounts at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$77,561
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$4
Assets. Value of investments in 103.12 investment entities at end of year2012-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Asset value of US Government securities at end of year2012-12-31$0
Asset value of US Government securities at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$157,480
Net investment gain/loss from pooled separate accounts2012-12-31$0
Net investment gain or loss from common/collective trusts2012-12-31$0
Net gain/loss from 103.12 investment entities2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Assets. Value of employer real property at end of year2012-12-31$0
Assets. Value of employer real property at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$231,654
Employer contributions (assets) at end of year2012-12-31$78,861
Employer contributions (assets) at beginning of year2012-12-31$103,505
Income. Dividends from preferred stock2012-12-31$0
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$624,461
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$0
Contract administrator fees2012-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$0
Liabilities. Value of benefit claims payable at end of year2012-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$0
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$87,087
Aggregate carrying amount (costs) on sale of assets2012-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2012-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31FEDERSPIEL, PFEIFER & KUBICKI, CPA
Accountancy firm EIN2012-12-31161492835
2011 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-111,537
Total unrealized appreciation/depreciation of assets2011-12-31$-111,537
Total income from all sources (including contributions)2011-12-31$183,329
Total of all expenses incurred2011-12-31$207,456
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$200,894
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$247,310
Value of total assets at end of year2011-12-31$2,707,157
Value of total assets at beginning of year2011-12-31$2,731,284
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$6,562
Total interest from all sources2011-12-31$47,556
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$300,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$1,222
Total non interest bearing cash at beginning of year2011-12-31$842
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-24,127
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,707,157
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,731,284
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$6,562
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,603,652
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,572,452
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$47,556
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$246,088
Employer contributions (assets) at end of year2011-12-31$103,505
Employer contributions (assets) at beginning of year2011-12-31$157,990
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$200,894
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31FEDERSPIEL, PFEIFER &KUBICK, CPA
Accountancy firm EIN2011-12-31161492835
2010 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$199,874
Total unrealized appreciation/depreciation of assets2010-12-31$199,874
Total income from all sources (including contributions)2010-12-31$557,319
Total of all expenses incurred2010-12-31$149,811
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$148,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$313,976
Value of total assets at end of year2010-12-31$2,731,284
Value of total assets at beginning of year2010-12-31$2,323,776
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,250
Total interest from all sources2010-12-31$43,469
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$300,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$4,727
Total non interest bearing cash at end of year2010-12-31$842
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$407,508
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,731,284
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,323,776
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$1,250
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$2,572,452
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,171,916
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$43,469
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$309,249
Employer contributions (assets) at end of year2010-12-31$157,990
Employer contributions (assets) at beginning of year2010-12-31$151,860
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$148,561
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31FEDERSPIEL,PFEIFER & KUBICKI, CPA
Accountancy firm EIN2010-12-31161492835
2009 : LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN

2022: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LAKE SHORE BEHAVIORAL HEALTH, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered1425
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $445
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Other information about contractFLEXIBLE INVESTMENT ANNUITY
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees445
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered1247
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees638
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered1175
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees390
Additional information about fees paid to insurance brokerREFERRAL / SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered1089
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees354
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered992
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees752
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number372757
Policy instance 1
Insurance contract or identification number372757
Number of Individuals Covered669
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,740
Total amount of fees paid to insurance companyUSD $11,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,740
Amount paid for insurance broker fees641
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
Insurance broker nameCADARET GRANT & CO. INC.

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