401k Plan data: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST plan

DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST
Plan identification number	004

DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined 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).
Money purchase (other than target benefit)
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

DEER VALLEY HOME HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: DEER VALLEY HOME HEALTH SERVICES, LLC

Employer identification number (EIN): 201611498

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2021-01-01
004 2020-01-01 ADA TAYLOR 2021-10-13
004 2019-01-01 ADA TAYLOR 2020-10-13
004 2018-01-01 ADA TAYLOR 2019-10-15
004 2017-01-01 ADA TAYLOR 2019-06-28
004 2016-01-01 ADA TAYLOR 2019-06-28
004 2015-01-01 ADA TAYLOR 2019-06-28
004 2014-01-01 ADA TAYLOR 2015-10-14
004 2013-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
004	2021-01-01
004	2020-01-01	ADA TAYLOR	2021-10-13
004	2019-01-01	ADA TAYLOR	2020-10-13
004	2018-01-01	ADA TAYLOR	2019-10-15
004	2017-01-01	ADA TAYLOR	2019-06-28
004	2016-01-01	ADA TAYLOR	2019-06-28
004	2015-01-01	ADA TAYLOR	2019-06-28
004	2014-01-01	ADA TAYLOR	2015-10-14
004	2013-01-01

Plan Statistics for DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST

Measure Date Value
2021: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 424
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 122
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 279
Total of all active and inactive participants 2021-01-01 401
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 401
Number of participants with account balances 2021-01-01 401
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 10
2020: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 412
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 121
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 289
Total of all active and inactive participants 2020-01-01 410
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 410
Number of participants with account balances 2020-01-01 410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 30
2019: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 129
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 267
Total of all active and inactive participants 2019-01-01 396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 397
Number of participants with account balances 2019-01-01 397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 23
2018: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 264
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 162
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 214
Total of all active and inactive participants 2018-01-01 376
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 377
Number of participants with account balances 2018-01-01 377
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 48
2017: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 313
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 155
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 165
Total of all active and inactive participants 2017-01-01 320
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 320
Number of participants with account balances 2017-01-01 313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 50
2016: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 157
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 132
Total of all active and inactive participants 2016-01-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 289
Number of participants with account balances 2016-01-01 285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 66
2015: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 170
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 43
Total of all active and inactive participants 2015-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 213
Number of participants with account balances 2015-01-01 204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 14

Measure	Date	Value
2021: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	424
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	122
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	279
Total of all active and inactive participants	2021-01-01	401
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	401
Number of participants with account balances	2021-01-01	401
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	10
2020: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	412
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	121
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	289
Total of all active and inactive participants	2020-01-01	410
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	410
Number of participants with account balances	2020-01-01	410
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	30
2019: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	129
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	267
Total of all active and inactive participants	2019-01-01	396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	397
Number of participants with account balances	2019-01-01	397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	23
2018: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	264
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	162
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	214
Total of all active and inactive participants	2018-01-01	376
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	377
Number of participants with account balances	2018-01-01	377
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	48
2017: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	313
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	155
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	165
Total of all active and inactive participants	2017-01-01	320
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	320
Number of participants with account balances	2017-01-01	313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	50
2016: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	157
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	132
Total of all active and inactive participants	2016-01-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	289
Number of participants with account balances	2016-01-01	285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	66
2015: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	170
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	43
Total of all active and inactive participants	2015-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	213
Number of participants with account balances	2015-01-01	204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	14

Financial Data on DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2021 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$2,767
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$2,861
Total income from all sources (including contributions)	2021-12-31	$336,400
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$170,768
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$168,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$139,223
Value of total assets at end of year	2021-12-31	$1,885,778
Value of total assets at beginning of year	2021-12-31	$1,720,240
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,550
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$47,775
Participant contributions at end of year	2021-12-31	$3,289
Participant contributions at beginning of year	2021-12-31	$2,752
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$2,767
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$2,861
Other income not declared elsewhere	2021-12-31	$849
Administrative expenses (other) incurred	2021-12-31	$2,550
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$165,632
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,883,011
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,717,379
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$1,540,197
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,481,257
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$29,090
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$14,477
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$196,328
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$91,448
Employer contributions (assets) at end of year	2021-12-31	$313,202
Employer contributions (assets) at beginning of year	2021-12-31	$221,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$168,218
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MARCUM LLP
Accountancy firm EIN	2021-12-31	111986323
2020 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$2,861
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$59
Total income from all sources (including contributions)	2020-12-31	$423,826
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$72,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$70,948
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$248,688
Value of total assets at end of year	2020-12-31	$1,720,240
Value of total assets at beginning of year	2020-12-31	$1,366,360
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,800
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$43,241
Participant contributions at end of year	2020-12-31	$2,752
Participant contributions at beginning of year	2020-12-31	$2,430
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$2,861
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$59
Administrative expenses (other) incurred	2020-12-31	$1,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$351,078
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,717,379
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,366,301
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,481,257
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$851,326
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$14,477
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$6,337
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$175,138
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$205,447
Employer contributions (assets) at end of year	2020-12-31	$221,754
Employer contributions (assets) at beginning of year	2020-12-31	$506,267
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$70,948
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	BWTP PC
Accountancy firm EIN	2020-12-31	431698328
2019 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$59
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$59
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$412,843
Total income from all sources (including contributions)	2019-12-31	$412,843
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$83,401
Total of all expenses incurred	2019-12-31	$83,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$80,776
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$80,776
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$256,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$256,293
Value of total assets at end of year	2019-12-31	$1,366,360
Value of total assets at end of year	2019-12-31	$1,366,360
Value of total assets at beginning of year	2019-12-31	$1,036,859
Value of total assets at beginning of year	2019-12-31	$1,036,859
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,625
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,625
Total interest from all sources	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$38,728
Contributions received from participants	2019-12-31	$38,728
Participant contributions at end of year	2019-12-31	$2,430
Participant contributions at end of year	2019-12-31	$2,430
Participant contributions at beginning of year	2019-12-31	$1,497
Participant contributions at beginning of year	2019-12-31	$1,497
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$59
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$59
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$2,625
Administrative expenses (other) incurred	2019-12-31	$2,625
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$329,442
Value of net income/loss	2019-12-31	$329,442
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,366,301
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,366,301
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,036,859
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,036,859
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$851,326
Value of interest in pooled separate accounts at end of year	2019-12-31	$851,326
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$632,505
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$632,505
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$6,337
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$6,337
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$16,696
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$16,696
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$156,550
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$156,550
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$217,565
Contributions received in cash from employer	2019-12-31	$217,565
Employer contributions (assets) at end of year	2019-12-31	$506,267
Employer contributions (assets) at end of year	2019-12-31	$506,267
Employer contributions (assets) at beginning of year	2019-12-31	$386,161
Employer contributions (assets) at beginning of year	2019-12-31	$386,161
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$80,776
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$80,776
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BWTP PC
Accountancy firm name	2019-12-31	BWTP PC
Accountancy firm EIN	2019-12-31	431698328
2018 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$224,456
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$216,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$213,834
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$272,270
Value of total assets at end of year	2018-12-31	$1,036,859
Value of total assets at beginning of year	2018-12-31	$1,028,637
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,400
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$49,281
Participant contributions at end of year	2018-12-31	$1,497
Participant contributions at beginning of year	2018-12-31	$905
Administrative expenses (other) incurred	2018-12-31	$2,400
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$8,222
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,036,859
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,028,637
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$632,505
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$739,963
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$16,696
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$36,053
Net investment gain/loss from pooled separate accounts	2018-12-31	$-47,814
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$222,989
Employer contributions (assets) at end of year	2018-12-31	$386,161
Employer contributions (assets) at beginning of year	2018-12-31	$251,716
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$213,834
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BWTP PC
Accountancy firm EIN	2018-12-31	431698328
2017 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$384,755
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$141,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$138,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$295,624
Value of total assets at end of year	2017-12-31	$1,028,637
Value of total assets at beginning of year	2017-12-31	$785,492
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,575
Total interest from all sources	2017-12-31	$192
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$300,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$46,070
Participant contributions at end of year	2017-12-31	$905
Participant contributions at beginning of year	2017-12-31	$1,038
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$243,145
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,028,637
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$785,492
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$739,963
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$508,539
Interest earned on other investments	2017-12-31	$192
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$36,053
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$7,396
Net investment gain/loss from pooled separate accounts	2017-12-31	$88,939
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$249,554
Employer contributions (assets) at end of year	2017-12-31	$251,716
Employer contributions (assets) at beginning of year	2017-12-31	$268,519
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$138,035
Contract administrator fees	2017-12-31	$3,575
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BWTP PC
Accountancy firm EIN	2017-12-31	431698328
2016 : DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$309,992
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$64,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$64,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$294,905
Value of total assets at end of year	2016-12-31	$785,492
Value of total assets at beginning of year	2016-12-31	$540,351
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$792
Total interest from all sources	2016-12-31	$14
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$42,397
Participant contributions at end of year	2016-12-31	$1,038
Participant contributions at beginning of year	2016-12-31	$5,043
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$356
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$6,983
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$245,141
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$785,492
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$540,351
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$508,539
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$302,029
Interest earned on other investments	2016-12-31	$14
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$7,396
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$15,073
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$252,152
Employer contributions (assets) at end of year	2016-12-31	$268,519
Employer contributions (assets) at beginning of year	2016-12-31	$226,296
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$64,059
Contract administrator fees	2016-12-31	$792
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BWTP PC
Accountancy firm EIN	2016-12-31	431698328

Form 5500 Responses for DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST

2021: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: DEER VALLEY HOME HEALTH SERVICES INC 401K PROFIT SHARING PLAN AND TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37476

Policy instance

Insurance contract or identification number	G37476
Number of Individuals Covered	320
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $3,844
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $3,844
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37476

Policy instance

Insurance contract or identification number	G37476
Number of Individuals Covered	350
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,710
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $2,710
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37476

Policy instance

Insurance contract or identification number	G37476
Number of Individuals Covered	250
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,060
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $2,060
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37476

Policy instance

Insurance contract or identification number	G37476
Number of Individuals Covered	259
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,720
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $1,720
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37476

Policy instance

Insurance contract or identification number	G37476
Number of Individuals Covered	229
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,465
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	DEER VALLEY HOME HEALTH SERVICES, LLC
Employer identification number (EIN):	201611498
NAIC Classification:	621610
NAIC Description:	Home Health Care Services