401k Plan data: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES plan

EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 401k Plan overview

Plan Name	EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES
Plan identification number	503

EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

HILLSIDE FAMILY OF AGENCIES has sponsored the creation of one or more 401k plans.

Company Name: HILLSIDE FAMILY OF AGENCIES

Employer identification number (EIN): 161493407

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about HILLSIDE FAMILY OF AGENCIES

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1995-06-29

Company Identification Number: 1935346

Legal Registered Office Address: HILLSIDE FAMILY OF AGENCIES
1183 MONROE AVENUE
ROCHESTER
United States of America (USA)
14620

More information about HILLSIDE FAMILY OF AGENCIES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2019-01-01
503 2018-01-01
503 2017-01-01 PAUL PERROTTO
503 2016-01-01 PAUL PERROTTO
503 2015-01-01 PAUL PERROTTO
503 2014-01-01 PAUL PERROTTO
503 2013-01-01 PAUL PERROTTO
503 2012-01-01 PAUL PERROTTO
503 2011-01-01 PAUL PERROTTO
503 2009-01-01 PAUL PERROTTO

Plan Statistics for EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES

401k plan membership statisitcs for EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES

Measure Date Value
2019: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,248
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,091
Number of retired or separated participants receiving benefits 2019-01-01 17
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 1,108
2018: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,412
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,222
Number of retired or separated participants receiving benefits 2018-01-01 26
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 1,248
2017: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,434
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,339
Number of retired or separated participants receiving benefits 2017-01-01 36
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 1,375
Total participants 2017-01-01 1,375
2016: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,421
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,360
Number of retired or separated participants receiving benefits 2016-01-01 23
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 1,383
Total participants 2016-01-01 1,383
2015: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,440
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,399
Number of retired or separated participants receiving benefits 2015-01-01 27
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1,426
Total participants 2015-01-01 1,426
2014: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,438
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,359
Number of retired or separated participants receiving benefits 2014-01-01 23
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 1,382
Total participants 2014-01-01 1,382
2013: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,464
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,387
Number of retired or separated participants receiving benefits 2013-01-01 30
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 1,417
Total participants 2013-01-01 1,417
2012: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,569
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,420
Number of retired or separated participants receiving benefits 2012-01-01 33
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 1,453
Total participants 2012-01-01 1,453
2011: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,681
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,539
Number of retired or separated participants receiving benefits 2011-01-01 23
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 1,562
2009: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,514
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,529
Number of retired or separated participants receiving benefits 2009-01-01 58
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 1,587

Measure	Date	Value
2019: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,248
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,091
Number of retired or separated participants receiving benefits	2019-01-01	17
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	1,108
2018: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,412
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,222
Number of retired or separated participants receiving benefits	2018-01-01	26
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	1,248
2017: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,434
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,339
Number of retired or separated participants receiving benefits	2017-01-01	36
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	1,375
Total participants	2017-01-01	1,375
2016: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,421
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,360
Number of retired or separated participants receiving benefits	2016-01-01	23
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	1,383
Total participants	2016-01-01	1,383
2015: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,440
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,399
Number of retired or separated participants receiving benefits	2015-01-01	27
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1,426
Total participants	2015-01-01	1,426
2014: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,438
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,359
Number of retired or separated participants receiving benefits	2014-01-01	23
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	1,382
Total participants	2014-01-01	1,382
2013: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,464
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,387
Number of retired or separated participants receiving benefits	2013-01-01	30
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	1,417
Total participants	2013-01-01	1,417
2012: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,569
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,420
Number of retired or separated participants receiving benefits	2012-01-01	33
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	1,453
Total participants	2012-01-01	1,453
2011: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,681
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,539
Number of retired or separated participants receiving benefits	2011-01-01	23
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,562
2009: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,514
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,529
Number of retired or separated participants receiving benefits	2009-01-01	58
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,587

Form 5500 Responses for EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES

2019: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EMPLOYEE BENEFITS PLAN OF HILLSIDE FAMILY OF AGENCIES 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 78697 )

Policy contract number

10177391001

Policy instance

Insurance contract or identification number	10177391001
Number of Individuals Covered	620
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,476
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $38,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,476
Insurance broker organization code?	3

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

55059

Policy instance

Insurance contract or identification number	55059
Number of Individuals Covered	1043
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $20,848
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,848
Insurance broker organization code?	3

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1211
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $23,286
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,286
Insurance broker organization code?	3

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $23,732
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,732
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1255
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $22,630
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,630
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1268
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $22,611
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,611
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1291
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $22,579
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,579
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1305
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $22,912
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,912
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

151502

Policy instance

Insurance contract or identification number	151502
Number of Individuals Covered	1371
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $10,601
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

510502

Policy instance

Insurance contract or identification number	510502
Number of Individuals Covered	2598
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $44,367
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,839
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF NEW YORK, INC.

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Company Name:	HILLSIDE FAMILY OF AGENCIES
Employer identification number (EIN):	161493407
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1995-06-29
Company Identification Number:	1935346
Legal Registered Office Address:	HILLSIDE FAMILY OF AGENCIES 1183 MONROE AVENUE ROCHESTER United States of America (USA) 14620