401k Plan data: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. plan

EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.
Plan identification number	002

EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

COUNSELING AND FAMILY SERVICES, INC . has sponsored the creation of one or more 401k plans.

Company Name: COUNSELING AND FAMILY SERVICES, INC .

Employer identification number (EIN): 370661193

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2021-01-01
002 2020-01-01 ANGELA FARDEN 2021-03-09
002 2019-01-01
002 2018-01-01 ANGELA FARDEN
002 2017-01-01 ROBERT FAITH 2018-09-27 ROBERT FAITH 2018-09-27
002 2017-01-01 ANGELA FARDEN 2019-07-30
002 2016-01-01 ROBERT FAITH 2017-10-10 ROBERT FAITH 2017-10-10
002 2015-01-01 ROBERT FAITH 2016-09-08 ROBERT FAITH 2016-09-08
002 2014-01-01 DOUGLAS S. ALLEN 2015-05-19 DOUGLAS S. ALLEN 2015-05-19
002 2013-01-01 DOUGLAS S. ALLAN 2014-10-15
002 2012-01-01 DOUGLAS S. ALLAN 2013-05-16 DOUGLAS S. ALLAN 2013-05-16
002 2011-01-01 DOUGLAS S. ALLAN 2012-06-20 DOUGLAS S. ALLAN 2012-06-20
002 2010-01-01 DOUGLAS S. ALLAN 2011-08-19 DOUGLAS S. ALLAN 2011-08-19

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2021-01-01
002	2020-01-01	ANGELA FARDEN	2021-03-09
002	2019-01-01
002	2018-01-01	ANGELA FARDEN
002	2017-01-01	ROBERT FAITH	2018-09-27	ROBERT FAITH	2018-09-27
002	2017-01-01	ANGELA FARDEN	2019-07-30
002	2016-01-01	ROBERT FAITH	2017-10-10	ROBERT FAITH	2017-10-10
002	2015-01-01	ROBERT FAITH	2016-09-08	ROBERT FAITH	2016-09-08
002	2014-01-01	DOUGLAS S. ALLEN	2015-05-19	DOUGLAS S. ALLEN	2015-05-19
002	2013-01-01	DOUGLAS S. ALLAN	2014-10-15
002	2012-01-01	DOUGLAS S. ALLAN	2013-05-16	DOUGLAS S. ALLAN	2013-05-16
002	2011-01-01	DOUGLAS S. ALLAN	2012-06-20	DOUGLAS S. ALLAN	2012-06-20
002	2010-01-01	DOUGLAS S. ALLAN	2011-08-19	DOUGLAS S. ALLAN	2011-08-19

Plan Statistics for EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.

Measure Date Value
2022: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 69
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 62
Total of all active and inactive participants 2022-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 133
Number of participants with account balances 2022-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 57
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 54
Total of all active and inactive participants 2021-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 111
Number of participants with account balances 2021-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2019: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 64
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 99
Number of participants with account balances 2019-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 82
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 28
Total of all active and inactive participants 2018-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 110
Number of participants with account balances 2018-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2022: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	69
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	62
Total of all active and inactive participants	2022-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	133
Number of participants with account balances	2022-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	57
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	54
Total of all active and inactive participants	2021-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	111
Number of participants with account balances	2021-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2019: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	64
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	99
Number of participants with account balances	2019-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	82
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	28
Total of all active and inactive participants	2018-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	110
Number of participants with account balances	2018-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.

Measure	Date	Value
2022 : EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2022 401k financial data
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$60,138
Expenses. Total of all expenses incurred	2022-12-31	$53,878
Benefits paid (including direct rollovers)	2022-12-31	$53,254
Total plan assets at end of year	2022-12-31	$2,223,389
Total plan assets at beginning of year	2022-12-31	$2,217,129
Value of fidelity bond covering the plan	2022-12-31	$1,000,000
Total contributions received or receivable from participants	2022-12-31	$142,211
Expenses. Other expenses not covered elsewhere	2022-12-31	$624
Contributions received from other sources (not participants or employers)	2022-12-31	$33,683
Other income received	2022-12-31	$-334,195
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$6,260
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$2,223,389
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$2,217,129
Total contributions received or receivable from employer(s)	2022-12-31	$218,439
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$0
2021 : EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$591,120
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$202,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$201,694
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$292,694
Value of total assets at end of year	2021-12-31	$2,217,129
Value of total assets at beginning of year	2021-12-31	$1,828,528
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$825
Total interest from all sources	2021-12-31	$1,909
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$591,120
Expenses. Total of all expenses incurred	2021-12-31	$202,519
Benefits paid (including direct rollovers)	2021-12-31	$201,694
Total plan assets at end of year	2021-12-31	$2,217,129
Total plan assets at beginning of year	2021-12-31	$1,828,528
Value of fidelity bond covering the plan	2021-12-31	$1,000,000
Total contributions received or receivable from participants	2021-12-31	$103,357
Expenses. Other expenses not covered elsewhere	2021-12-31	$825
Contributions received from other sources (not participants or employers)	2021-12-31	$14,800
Other income received	2021-12-31	$298,426
Net income (gross income less expenses)	2021-12-31	$388,601
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$2,217,129
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,828,528
Total contributions received or receivable from employer(s)	2021-12-31	$174,537
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	No
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$103,357
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$14,800
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$825
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$388,601
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,217,129
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,828,528
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,056,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,629,429
Interest on participant loans	2021-12-31	$0
Interest earned on other investments	2021-12-31	$1,909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$160,854
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$199,099
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$296,517
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$174,537
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$201,694
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
2019 : EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2019 401k financial data
Total income from all sources	2019-12-31	$404,001
Expenses. Total of all expenses incurred	2019-12-31	$107,141
Benefits paid (including direct rollovers)	2019-12-31	$106,487
Total plan assets at end of year	2019-12-31	$1,617,270
Total plan assets at beginning of year	2019-12-31	$1,320,410
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$72,703
Expenses. Other expenses not covered elsewhere	2019-12-31	$654
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$268,742
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$296,860
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,617,270
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$1,320,410
Total contributions received or receivable from employer(s)	2019-12-31	$62,556
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2018 401k financial data
Total income from all sources	2018-12-31	$13,984
Expenses. Total of all expenses incurred	2018-12-31	$193,917
Benefits paid (including direct rollovers)	2018-12-31	$193,184
Total plan assets at end of year	2018-12-31	$1,320,410
Total plan assets at beginning of year	2018-12-31	$1,500,343
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$62,654
Expenses. Other expenses not covered elsewhere	2018-12-31	$733
Contributions received from other sources (not participants or employers)	2018-12-31	$1,358
Other income received	2018-12-31	$-104,663
Net income (gross income less expenses)	2018-12-31	$-179,933
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$1,320,410
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$1,500,343
Total contributions received or receivable from employer(s)	2018-12-31	$54,635
Value of corrective distributions	2018-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC.

2022: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2019: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: EMPLOYEE BENEFIT PLAN OF COUNSELING AND FAMILY SERVICES, INC. 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050531F

Policy instance

Insurance contract or identification number	050531F
Number of Individuals Covered	133
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $612
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?	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 $0
Amount paid for insurance broker fees	612
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP.PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050531F

Policy instance

Insurance contract or identification number	050531F
Number of Individuals Covered	111
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $165
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?	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 $0
Amount paid for insurance broker fees	165
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050531F

Policy instance

Insurance contract or identification number	050531F
Number of Individuals Covered	99
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $172
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?	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 $0
Amount paid for insurance broker fees	172
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050531F

Policy instance

Insurance contract or identification number	050531F
Number of Individuals Covered	110
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $530
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?	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 $0
Amount paid for insurance broker fees	530
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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Company Name:	COUNSELING AND FAMILY SERVICES, INC .
Employer identification number (EIN):	370661193
NAIC Classification:	624100
NAIC Description:	Individual and Family Services