401k Plan data: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN plan

HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 401k Plan overview

Plan Name	HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN
Plan identification number	001

HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT 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.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

HOSPICE OF CENTRAL OHIO has sponsored the creation of one or more 401k plans.

Company Name: HOSPICE OF CENTRAL OHIO

Employer identification number (EIN): 311059756

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 CALVIN W. ROBINSON 2020-10-15
001 2018-01-01
001 2018-01-01
001 2017-01-01 CALVIN W. ROBINSON
001 2016-01-01 CALVIN W. ROBINSON
001 2015-01-01 CALVIN W. ROBINSON
001 2014-01-01 CALVIN ROBINSON
001 2013-01-01 CALVIN ROBINSON
001 2012-01-01 CALVIN ROBINSON
001 2011-01-01 CALVIN ROBINSON CALVIN ROBINSON 2014-06-18
001 2010-01-01 CALVIN ROBINSON
001 2009-01-01 CALVIN ROBINSON
001 2009-01-01 CALVIN ROBINSON 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01	CALVIN W. ROBINSON	2020-10-15
001	2018-01-01
001	2018-01-01
001	2017-01-01	CALVIN W. ROBINSON
001	2016-01-01	CALVIN W. ROBINSON
001	2015-01-01	CALVIN W. ROBINSON
001	2014-01-01	CALVIN ROBINSON
001	2013-01-01	CALVIN ROBINSON
001	2012-01-01	CALVIN ROBINSON
001	2011-01-01	CALVIN ROBINSON		CALVIN ROBINSON	2014-06-18
001	2010-01-01	CALVIN ROBINSON
001	2009-01-01	CALVIN ROBINSON
001	2009-01-01			CALVIN ROBINSON	2010-10-15

Plan Statistics for HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN

401k plan membership statisitcs for HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN

Measure Date Value
2018: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 168
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 33
Total of all active and inactive participants 2018-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 201
Number of participants with account balances 2018-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 168
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 33
Total of all active and inactive participants 2017-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 201
Number of participants with account balances 2017-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 159
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 23
Total of all active and inactive participants 2016-01-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 182
Number of participants with account balances 2016-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 10
2015: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 155
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 29
Total of all active and inactive participants 2015-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 184
Number of participants with account balances 2015-01-01 114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 144
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 77
Total of all active and inactive participants 2014-01-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 221
Number of participants with account balances 2014-01-01 178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 126
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 30
Total of all active and inactive participants 2013-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 156
Number of participants with account balances 2013-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 12
2012: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 214
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 170
Number of retired or separated participants receiving benefits 2012-01-01 21
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 191
Number of participants with account balances 2012-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 10
2011: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 200
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 126
Number of retired or separated participants receiving benefits 2011-01-01 11
Number of other retired or separated participants entitled to future benefits 2011-01-01 77
Total of all active and inactive participants 2011-01-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 214
Number of participants with account balances 2011-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 7
2010: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 121
Number of retired or separated participants receiving benefits 2010-01-01 10
Number of other retired or separated participants entitled to future benefits 2010-01-01 74
Total of all active and inactive participants 2010-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 205
Number of participants with account balances 2010-01-01 177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 9
2009: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 164
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 164
Number of participants with account balances 2009-01-01 164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2018: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	168
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	33
Total of all active and inactive participants	2018-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	201
Number of participants with account balances	2018-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	168
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	33
Total of all active and inactive participants	2017-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	201
Number of participants with account balances	2017-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	159
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	23
Total of all active and inactive participants	2016-01-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	182
Number of participants with account balances	2016-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	10
2015: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	155
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	29
Total of all active and inactive participants	2015-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	184
Number of participants with account balances	2015-01-01	114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	144
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	77
Total of all active and inactive participants	2014-01-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	221
Number of participants with account balances	2014-01-01	178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	126
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	30
Total of all active and inactive participants	2013-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	156
Number of participants with account balances	2013-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	12
2012: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	214
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	170
Number of retired or separated participants receiving benefits	2012-01-01	21
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	191
Number of participants with account balances	2012-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	10
2011: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	200
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	126
Number of retired or separated participants receiving benefits	2011-01-01	11
Number of other retired or separated participants entitled to future benefits	2011-01-01	77
Total of all active and inactive participants	2011-01-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	214
Number of participants with account balances	2011-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	7
2010: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	121
Number of retired or separated participants receiving benefits	2010-01-01	10
Number of other retired or separated participants entitled to future benefits	2010-01-01	74
Total of all active and inactive participants	2010-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	205
Number of participants with account balances	2010-01-01	177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	9
2009: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	164
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	164
Number of participants with account balances	2009-01-01	164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN

Measure	Date	Value
2018 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT 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	$122,696
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$5,245,634
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$5,240,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$7,111
Value of total assets at end of year	2018-12-31	$224,264
Value of total assets at beginning of year	2018-12-31	$5,347,202
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$5,523
Total interest from all sources	2018-12-31	$117
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,527
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$1,527
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$2,000,000
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
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$48,434
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$7,111
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) 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	$-5,122,938
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$224,264
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,347,202
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,970,793
Value of interest in pooled separate accounts at end of year	2018-12-31	$171,187
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$190,194
Interest on participant loans	2018-12-31	$78
Interest earned on other investments	2018-12-31	$39
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$53,077
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$137,781
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$113,941
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
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$5,240,111
Contract administrator fees	2018-12-31	$5,523
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	PLANTE MORAN
Accountancy firm EIN	2018-12-31	381357951
2017 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 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	$1,271,546
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$147,388
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$145,412
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$539,193
Value of total assets at end of year	2017-12-31	$5,347,202
Value of total assets at beginning of year	2017-12-31	$4,223,044
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,976
Total interest from all sources	2017-12-31	$4,353
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$83,699
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$83,699
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$2,000,000
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	$290,133
Participant contributions at end of year	2017-12-31	$48,434
Participant contributions at beginning of year	2017-12-31	$67,636
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$59,203
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) 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	$1,124,158
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,347,202
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,223,044
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	$4,970,793
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,853,605
Value of interest in pooled separate accounts at end of year	2017-12-31	$190,194
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$173,310
Interest on participant loans	2017-12-31	$2,114
Interest earned on other investments	2017-12-31	$2,239
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$137,781
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$128,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$615,703
Net investment gain/loss from pooled separate accounts	2017-12-31	$28,598
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	$189,857
Employer contributions (assets) at end of year	2017-12-31	$0
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	$145,412
Contract administrator fees	2017-12-31	$1,976
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	PLANTE MORAN
Accountancy firm EIN	2017-12-31	381357951
2016 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$787,584
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$603,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$601,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$518,669
Value of total assets at end of year	2016-12-31	$4,223,044
Value of total assets at beginning of year	2016-12-31	$4,039,280
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,399
Total interest from all sources	2016-12-31	$4,956
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$44,611
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$44,611
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$300,373
Participant contributions at end of year	2016-12-31	$67,636
Participant contributions at beginning of year	2016-12-31	$40,738
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$65,462
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$183,764
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,223,044
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,039,280
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,853,605
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,592,006
Value of interest in pooled separate accounts at end of year	2016-12-31	$173,310
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$174,157
Interest on participant loans	2016-12-31	$2,144
Interest earned on other investments	2016-12-31	$2,812
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$128,493
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$232,379
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$207,634
Net investment gain/loss from pooled separate accounts	2016-12-31	$11,714
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	$152,834
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$601,421
Contract administrator fees	2016-12-31	$2,399
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	HW & CO.
Accountancy firm EIN	2016-12-31	341663157
2015 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$489,055
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$652,646
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$648,804
Expenses. Certain deemed distributions of participant loans	2015-12-31	$1,272
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$535,486
Value of total assets at end of year	2015-12-31	$4,039,280
Value of total assets at beginning of year	2015-12-31	$4,202,871
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,570
Total interest from all sources	2015-12-31	$5,160
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$36,637
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$36,637
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$297,988
Participant contributions at end of year	2015-12-31	$40,738
Participant contributions at beginning of year	2015-12-31	$65,587
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$34,529
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$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	2015-12-31	No
Value of net income/loss	2015-12-31	$-163,591
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,039,280
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,202,871
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,592,006
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$3,721,740
Value of interest in pooled separate accounts at end of year	2015-12-31	$174,157
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$262,146
Interest on participant loans	2015-12-31	$2,200
Interest earned on other investments	2015-12-31	$2,960
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$232,379
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$153,398
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-86,637
Net investment gain/loss from pooled separate accounts	2015-12-31	$-1,591
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$202,969
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$648,804
Contract administrator fees	2015-12-31	$2,570
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	HW & CO.
Accountancy firm EIN	2015-12-31	341663157
2014 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$726,127
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$265,713
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$263,106
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$506,881
Value of total assets at end of year	2014-12-31	$4,202,871
Value of total assets at beginning of year	2014-12-31	$3,742,457
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,607
Total interest from all sources	2014-12-31	$5,634
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$60,303
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$60,303
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$299,010
Participant contributions at end of year	2014-12-31	$65,587
Participant contributions at beginning of year	2014-12-31	$68,828
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$5,343
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$22,610
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$11,073
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$460,414
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,202,871
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,742,457
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$3,721,740
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$3,192,676
Value of interest in pooled separate accounts at end of year	2014-12-31	$262,146
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$328,407
Interest on participant loans	2014-12-31	$2,814
Interest earned on other investments	2014-12-31	$2,820
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$153,398
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$144,263
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$127,050
Net investment gain/loss from pooled separate accounts	2014-12-31	$15,186
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$185,261
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$2,940
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$263,106
Contract administrator fees	2014-12-31	$2,607
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	HW & CO.
Accountancy firm EIN	2014-12-31	341663157
2013 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$895,705
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$162,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$159,640
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$363,963
Value of total assets at end of year	2013-12-31	$3,742,457
Value of total assets at beginning of year	2013-12-31	$3,009,090
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$2,698
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$4,662
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$35,100
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$35,100
Administrative expenses professional fees incurred	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$245,133
Participant contributions at end of year	2013-12-31	$68,828
Participant contributions at beginning of year	2013-12-31	$33,366
Participant contributions at end of year	2013-12-31	$5,343
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$67,173
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$0
Liabilities. Value of operating payables at end of year	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$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	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$733,367
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,742,457
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,009,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$3,192,676
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,560,311
Value of interest in pooled separate accounts at end of year	2013-12-31	$328,407
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$282,293
Interest on participant loans	2013-12-31	$1,962
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$2,700
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$144,263
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$133,120
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$429,873
Net investment gain/loss from pooled separate accounts	2013-12-31	$62,107
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$51,657
Employer contributions (assets) at end of year	2013-12-31	$2,940
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$159,640
Contract administrator fees	2013-12-31	$2,698
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HW & CO.
Accountancy firm EIN	2013-12-31	341663157
2012 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$719,215
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$189,766
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$187,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$383,207
Value of total assets at end of year	2012-12-31	$3,009,090
Value of total assets at beginning of year	2012-12-31	$2,479,646
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,018
Total interest from all sources	2012-12-31	$2,904
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$36,890
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$36,890
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$165,863
Participant contributions at end of year	2012-12-31	$33,366
Participant contributions at beginning of year	2012-12-31	$12,507
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$17,040
Other income not declared elsewhere	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$529,449
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,009,090
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,479,646
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,560,311
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,024,144
Value of interest in pooled separate accounts at end of year	2012-12-31	$282,293
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$258,844
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$2,904
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$133,120
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$115,260
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$260,172
Net investment gain/loss from pooled separate accounts	2012-12-31	$36,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$217,344
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$51,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$187,748
Contract administrator fees	2012-12-31	$2,018
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HOWARD WERSHBALE & CO
Accountancy firm EIN	2012-12-31	341663157
2011 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$337,519
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$248,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$246,813
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$388,893
Value of total assets at end of year	2011-12-31	$2,479,646
Value of total assets at beginning of year	2011-12-31	$2,391,055
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,115
Total interest from all sources	2011-12-31	$3,640
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$26,207
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$26,207
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$172,469
Participant contributions at end of year	2011-12-31	$12,507
Participant contributions at beginning of year	2011-12-31	$16,507
Participant contributions at end of year	2011-12-31	$17,040
Participant contributions at beginning of year	2011-12-31	$15,222
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$7,461
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$88,591
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,479,646
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,391,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$2,024,144
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,924,755
Value of interest in pooled separate accounts at end of year	2011-12-31	$258,844
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$300,222
Interest on participant loans	2011-12-31	$653
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$2,987
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$115,260
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$112,806
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-69,752
Net investment gain/loss from pooled separate accounts	2011-12-31	$-11,469
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$208,963
Employer contributions (assets) at end of year	2011-12-31	$51,851
Employer contributions (assets) at beginning of year	2011-12-31	$21,543
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$246,813
Contract administrator fees	2011-12-31	$2,115
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	HOWARD WERSHBALE & CO
Accountancy firm EIN	2011-12-31	341663157
2010 : HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,262,408
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$104,437
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$70,207
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,053,142
Value of total assets at end of year	2010-12-31	$2,391,055
Value of total assets at beginning of year	2010-12-31	$1,233,084
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$34,230
Total interest from all sources	2010-12-31	$3,662
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$24,576
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$24,576
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$167,246
Participant contributions at end of year	2010-12-31	$16,507
Participant contributions at end of year	2010-12-31	$15,222
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$691,939
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,157,971
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,391,055
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,233,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,924,755
Value of interest in pooled separate accounts at end of year	2010-12-31	$300,222
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,059,804
Interest on participant loans	2010-12-31	$70
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$3,592
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$112,806
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$162,384
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$108,199
Net investment gain/loss from pooled separate accounts	2010-12-31	$72,829
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$193,957
Employer contributions (assets) at end of year	2010-12-31	$21,543
Employer contributions (assets) at beginning of year	2010-12-31	$10,896
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$70,207
Contract administrator fees	2010-12-31	$34,230
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	HOWARD, WERSHBALE, & CO.
Accountancy firm EIN	2010-12-31	341663157

Form 5500 Responses for HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN

2018: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT 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: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 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: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: HOSPICE OF CENTRAL OHIO EMPLOYEE RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	41
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $25
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
Commission paid to Insurance Broker	USD $25
Insurance broker organization code?	3

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $86
Total amount of fees paid to insurance company	USD $22
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $86
Insurance broker organization code?	3
Amount paid for insurance broker fees	22
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	42
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $24
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
Commission paid to Insurance Broker	USD $24
Insurance broker organization code?	3
Insurance broker name	ANDREW CROOP

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	188
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $76
Total amount of fees paid to insurance company	USD $79
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	1
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
Amount paid for insurance broker fees	79
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $76
Insurance broker name	JEFFREY M. MCCLOSKEY

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	181
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $425
Total amount of fees paid to insurance company	USD $125
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $425
Insurance broker organization code?	3
Amount paid for insurance broker fees	125
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	TRINITY PENSION CONSULTANTS INC

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	49
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $26
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26
Insurance broker organization code?	3
Insurance broker name	RICHARD HELMER

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	164
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $327
Total amount of fees paid to insurance company	USD $84
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $327
Insurance broker organization code?	3
Amount paid for insurance broker fees	84
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	TRINITY PENSION CONSULTANTS INC

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	61
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $83
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $71
Insurance broker organization code?	3
Insurance broker name	RICHARD HELMER

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	165
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11,120
Total amount of fees paid to insurance company	USD $2,932
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,120
Amount paid for insurance broker fees	216
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	TRINITY PENSION CONSULTANTS INC

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	70
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $81
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $81
Insurance broker organization code?	3
Insurance broker name	STEVE W. FISHER

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	164
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $6,873
Total amount of fees paid to insurance company	USD $1,628
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,873
Amount paid for insurance broker fees	403
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE AND PRORATED INCENTIVE, NOT DEDUCTED FROM PLAN
Insurance broker organization code?	3
Insurance broker name	TRINITY PENSION CONSULTANTS, INC

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	77
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $55
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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
Commission paid to Insurance Broker	USD $55
Insurance broker organization code?	3
Insurance broker name	STEVE FISHER

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	79
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $56
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	153
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $7,973
Total amount of fees paid to insurance company	USD $1,622
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	130
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,781
Total amount of fees paid to insurance company	USD $798
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

48961

Policy instance

Insurance contract or identification number	48961
Number of Individuals Covered	85
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,858
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

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Company Name:	HOSPICE OF CENTRAL OHIO
Employer identification number (EIN):	311059756
NAIC Classification:	621610
NAIC Description:	Home Health Care Services