401k Plan data: ARC OF GENESEE ORLEANS 401(K) PLAN plan

ARC OF GENESEE ORLEANS 401(K) PLAN 401k Plan overview

Plan Name	ARC OF GENESEE ORLEANS 401(K) PLAN
Plan identification number	002

ARC OF GENESEE ORLEANS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

GENESEE-ORLEANS COUNTIES CHAPTER, NYSARC, INC. has sponsored the creation of one or more 401k plans.

Company Name: GENESEE-ORLEANS COUNTIES CHAPTER, NYSARC, INC.

Employer identification number (EIN): 237150957

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARC OF GENESEE ORLEANS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 KEVIN GRAHAM

Plan Statistics for ARC OF GENESEE ORLEANS 401(K) PLAN

401k plan membership statisitcs for ARC OF GENESEE ORLEANS 401(K) PLAN

Measure Date Value
2022: ARC OF GENESEE ORLEANS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 627
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: ARC OF GENESEE ORLEANS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 636
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 550
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 77
Total of all active and inactive participants 2021-01-01 627
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 627
Number of participants with account balances 2021-01-01 241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: ARC OF GENESEE ORLEANS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 743
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 558
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 78
Total of all active and inactive participants 2020-01-01 636
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 636
Number of participants with account balances 2020-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: ARC OF GENESEE ORLEANS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 731
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 683
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 60
Total of all active and inactive participants 2019-01-01 743
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 743
Number of participants with account balances 2019-01-01 282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 6
2018: ARC OF GENESEE ORLEANS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 702
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 681
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 50
Total of all active and inactive participants 2018-01-01 731
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 731
Number of participants with account balances 2018-01-01 265
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 15
2017: ARC OF GENESEE ORLEANS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 624
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 672
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 30
Total of all active and inactive participants 2017-01-01 702
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 702
Number of participants with account balances 2017-01-01 267
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 12

Measure	Date	Value
2022: ARC OF GENESEE ORLEANS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	627
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: ARC OF GENESEE ORLEANS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	636
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	550
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	77
Total of all active and inactive participants	2021-01-01	627
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	627
Number of participants with account balances	2021-01-01	241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: ARC OF GENESEE ORLEANS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	743
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	558
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	78
Total of all active and inactive participants	2020-01-01	636
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	636
Number of participants with account balances	2020-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: ARC OF GENESEE ORLEANS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	731
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	683
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	60
Total of all active and inactive participants	2019-01-01	743
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	743
Number of participants with account balances	2019-01-01	282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	6
2018: ARC OF GENESEE ORLEANS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	702
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	681
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	50
Total of all active and inactive participants	2018-01-01	731
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	731
Number of participants with account balances	2018-01-01	265
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	15
2017: ARC OF GENESEE ORLEANS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	624
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	672
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	30
Total of all active and inactive participants	2017-01-01	702
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	702
Number of participants with account balances	2017-01-01	267
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	12

Financial Data on ARC OF GENESEE ORLEANS 401(K) PLAN

Measure	Date	Value
2022 : ARC OF GENESEE ORLEANS 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-02-15	$0
Total transfer of assets from this plan	2022-02-15	$4,870,378
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-02-15	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-02-15	$0
Total income from all sources (including contributions)	2022-02-15	$-182,314
Total loss/gain on sale of assets	2022-02-15	$0
Total of all expenses incurred	2022-02-15	$78,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-02-15	$63,882
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-02-15	$38,595
Value of total assets at end of year	2022-02-15	$0
Value of total assets at beginning of year	2022-02-15	$5,131,645
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-02-15	$15,071
Total interest from all sources	2022-02-15	$1,215
Total dividends received (eg from common stock, registered investment company shares)	2022-02-15	$26
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-02-15	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-02-15	$0
Total dividends received from registered investment company shares (eg mutual funds)	2022-02-15	$26
Was this plan covered by a fidelity bond	2022-02-15	Yes
Value of fidelity bond cover	2022-02-15	$500,000
If this is an individual account plan, was there a blackout period	2022-02-15	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-02-15	No
Contributions received from participants	2022-02-15	$23,178
Participant contributions at end of year	2022-02-15	$0
Participant contributions at beginning of year	2022-02-15	$136,972
Total non interest bearing cash at end of year	2022-02-15	$0
Total non interest bearing cash at beginning of year	2022-02-15	$402
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-02-15	No
Value of net income/loss	2022-02-15	$-261,267
Value of net assets at end of year (total assets less liabilities)	2022-02-15	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-02-15	$5,131,645
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-02-15	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-02-15	No
Were any leases to which the plan was party in default or uncollectible	2022-02-15	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-02-15	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-02-15	$4,959,170
Interest on participant loans	2022-02-15	$1,215
Value of interest in common/collective trusts at end of year	2022-02-15	$0
Value of interest in common/collective trusts at beginning of year	2022-02-15	$35,101
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-02-15	$-222,244
Net investment gain or loss from common/collective trusts	2022-02-15	$94
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-02-15	No
Was there a failure to transmit to the plan any participant contributions	2022-02-15	No
Has the plan failed to provide any benefit when due under the plan	2022-02-15	No
Contributions received in cash from employer	2022-02-15	$15,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-02-15	$63,882
Contract administrator fees	2022-02-15	$15,071
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-02-15	Yes
Did the plan have assets held for investment	2022-02-15	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	2022-02-15	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-02-15	Yes
Opinion of an independent qualified public accountant for this plan	2022-02-15	Unqualified
Accountancy firm name	2022-02-15	BONADIO & CO., LLP
Accountancy firm EIN	2022-02-15	161131146
2021 : ARC OF GENESEE ORLEANS 401(K) PLAN 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,199,844
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,484,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,417,540
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$556,759
Value of total assets at end of year	2021-12-31	$5,131,645
Value of total assets at beginning of year	2021-12-31	$5,416,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$67,176
Total interest from all sources	2021-12-31	$10,284
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$167,423
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$167,423
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$333,119
Participant contributions at end of year	2021-12-31	$136,972
Participant contributions at beginning of year	2021-12-31	$184,904
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$15,128
Total non interest bearing cash at end of year	2021-12-31	$402
Total non interest bearing cash at beginning of year	2021-12-31	$415
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
Value of net income/loss	2021-12-31	$-284,872
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,131,645
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$5,416,517
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
Investment advisory and management fees	2021-12-31	$17,901
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,959,170
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,188,710
Interest on participant loans	2021-12-31	$10,284
Value of interest in common/collective trusts at end of year	2021-12-31	$35,101
Value of interest in common/collective trusts at beginning of year	2021-12-31	$42,488
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$464,655
Net investment gain or loss from common/collective trusts	2021-12-31	$723
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	No
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	$208,512
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,417,540
Contract administrator fees	2021-12-31	$49,275
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	BONADIO & CO., LLP
Accountancy firm EIN	2021-12-31	161131146
2020 : ARC OF GENESEE ORLEANS 401(K) PLAN 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,360,977
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$605,040
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$541,036
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$571,148
Value of total assets at end of year	2020-12-31	$5,416,517
Value of total assets at beginning of year	2020-12-31	$4,660,580
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$64,004
Total interest from all sources	2020-12-31	$12,955
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$189,967
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$189,967
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	$327,503
Participant contributions at end of year	2020-12-31	$184,904
Participant contributions at beginning of year	2020-12-31	$218,120
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$5,537
Total non interest bearing cash at end of year	2020-12-31	$415
Total non interest bearing cash at beginning of year	2020-12-31	$369
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	$755,937
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,416,517
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,660,580
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
Investment advisory and management fees	2020-12-31	$13,014
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,188,710
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,302,533
Interest on participant loans	2020-12-31	$12,955
Value of interest in common/collective trusts at end of year	2020-12-31	$42,488
Value of interest in common/collective trusts at beginning of year	2020-12-31	$9,584
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$129,974
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$586,260
Net investment gain or loss from common/collective trusts	2020-12-31	$647
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	$238,108
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$541,036
Contract administrator fees	2020-12-31	$50,990
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	BONADIO & CO., LLP
Accountancy firm EIN	2020-12-31	161131146
2019 : ARC OF GENESEE ORLEANS 401(K) PLAN 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	$0
Total liabilities at end 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 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	$1,267,798
Total income from all sources (including contributions)	2019-12-31	$1,267,798
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	$499,911
Total of all expenses incurred	2019-12-31	$499,911
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$441,883
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$441,883
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$550,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$550,517
Value of total assets at end of year	2019-12-31	$4,660,580
Value of total assets at end of year	2019-12-31	$4,660,580
Value of total assets at beginning of year	2019-12-31	$3,892,693
Value of total assets at beginning of year	2019-12-31	$3,892,693
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$58,028
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$58,028
Total interest from all sources	2019-12-31	$11,619
Total interest from all sources	2019-12-31	$11,619
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$113,941
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$113,941
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
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$113,941
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$113,941
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	Yes
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
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	$301,246
Contributions received from participants	2019-12-31	$301,246
Participant contributions at end of year	2019-12-31	$218,120
Participant contributions at end of year	2019-12-31	$218,120
Participant contributions at beginning of year	2019-12-31	$193,592
Participant contributions at beginning of year	2019-12-31	$193,592
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$30,312
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$30,312
Total non interest bearing cash at end of year	2019-12-31	$369
Total non interest bearing cash at end of year	2019-12-31	$369
Total non interest bearing cash at beginning of year	2019-12-31	$68
Total non interest bearing cash at beginning of year	2019-12-31	$68
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	$767,887
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,660,580
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,660,580
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,892,693
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,892,693
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
Investment advisory and management fees	2019-12-31	$14,226
Investment advisory and management fees	2019-12-31	$14,226
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,302,533
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,302,533
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,410,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,410,496
Interest on participant loans	2019-12-31	$11,619
Interest on participant loans	2019-12-31	$11,619
Value of interest in common/collective trusts at end of year	2019-12-31	$9,584
Value of interest in common/collective trusts at end of year	2019-12-31	$9,584
Value of interest in common/collective trusts at beginning of year	2019-12-31	$27,101
Value of interest in common/collective trusts at beginning of year	2019-12-31	$27,101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$129,974
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$129,974
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$260,810
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$260,810
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$591,398
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$591,398
Net investment gain or loss from common/collective trusts	2019-12-31	$323
Net investment gain or loss from common/collective trusts	2019-12-31	$323
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	$218,959
Contributions received in cash from employer	2019-12-31	$218,959
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$626
Employer contributions (assets) at beginning of year	2019-12-31	$626
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$441,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$441,883
Contract administrator fees	2019-12-31	$43,802
Contract administrator fees	2019-12-31	$43,802
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	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	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	Yes
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	BONADIO & CO., LLP
Accountancy firm name	2019-12-31	BONADIO & CO., LLP
Accountancy firm EIN	2019-12-31	161131146
Accountancy firm EIN	2019-12-31	161131146
2018 : ARC OF GENESEE ORLEANS 401(K) PLAN 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	$474,233
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$387,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$338,593
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$670,940
Value of total assets at end of year	2018-12-31	$3,892,693
Value of total assets at beginning of year	2018-12-31	$3,806,195
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$49,142
Total interest from all sources	2018-12-31	$10,134
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$114,596
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$114,596
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	Yes
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	$318,728
Participant contributions at end of year	2018-12-31	$193,592
Participant contributions at beginning of year	2018-12-31	$163,356
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$11,898
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$123,800
Total non interest bearing cash at end of year	2018-12-31	$68
Total non interest bearing cash at beginning of year	2018-12-31	$20
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	$86,498
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,892,693
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,806,195
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
Investment advisory and management fees	2018-12-31	$5,654
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$3,410,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,264,360
Interest on participant loans	2018-12-31	$10,134
Value of interest in common/collective trusts at end of year	2018-12-31	$27,101
Value of interest in common/collective trusts at beginning of year	2018-12-31	$1,405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$260,810
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$356,052
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-322,028
Net investment gain or loss from common/collective trusts	2018-12-31	$591
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	$228,412
Employer contributions (assets) at end of year	2018-12-31	$626
Employer contributions (assets) at beginning of year	2018-12-31	$9,104
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$338,593
Contract administrator fees	2018-12-31	$43,488
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	Yes
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	Yes
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	BONADIO & CO., LLP
Accountancy firm EIN	2018-12-31	161131146
2017 : ARC OF GENESEE ORLEANS 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$3,267,928
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	$707,207
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$168,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$157,167
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$592,265
Value of total assets at end of year	2017-12-31	$3,806,195
Value of total assets at beginning of year	2017-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$11,773
Total interest from all sources	2017-12-31	$2,564
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$78,060
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$78,060
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
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	$305,749
Participant contributions at end of year	2017-12-31	$163,356
Participant contributions at beginning of year	2017-12-31	$0
Participant contributions at end of year	2017-12-31	$11,898
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$46,706
Total non interest bearing cash at end of year	2017-12-31	$20
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
Value of net income/loss	2017-12-31	$538,267
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,806,195
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$0
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 registered invesment companies (eg mutual funds) at end of year	2017-12-31	$3,264,360
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$2,564
Value of interest in common/collective trusts at end of year	2017-12-31	$1,405
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$356,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$33,906
Net investment gain or loss from common/collective trusts	2017-12-31	$412
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	$239,810
Employer contributions (assets) at end of year	2017-12-31	$9,104
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$157,167
Contract administrator fees	2017-12-31	$11,773
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
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	Yes
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	BONADIO & CO., LLP
Accountancy firm EIN	2017-12-31	161131146

Form 5500 Responses for ARC OF GENESEE ORLEANS 401(K) PLAN

2022: ARC OF GENESEE ORLEANS 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ARC OF GENESEE ORLEANS 401(K) PLAN 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: ARC OF GENESEE ORLEANS 401(K) PLAN 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: ARC OF GENESEE ORLEANS 401(K) PLAN 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: ARC OF GENESEE ORLEANS 401(K) PLAN 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: ARC OF GENESEE ORLEANS 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

415614

Policy instance

Insurance contract or identification number	415614
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

415614

Policy instance

Insurance contract or identification number	415614
Number of Individuals Covered	42
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

415614

Policy instance

Insurance contract or identification number	415614
Number of Individuals Covered	47
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	No
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

415614

Policy instance

Insurance contract or identification number	415614
Number of Individuals Covered	303
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	No
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:	GENESEE-ORLEANS COUNTIES CHAPTER, NYSARC, INC.
Employer identification number (EIN):	237150957
NAIC Classification:	624100
NAIC Description:	Individual and Family Services