401k Plan data: CORNERSTONE 401(K) PLAN plan

CORNERSTONE 401(K) PLAN 401k Plan overview

Plan Name	CORNERSTONE 401(K) PLAN
Plan identification number	001

CORNERSTONE 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HEALTH SERVICES NETWORK, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTH SERVICES NETWORK, INC.

Employer identification number (EIN): 411760229

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CORNERSTONE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 ALLEN POTVIN 2019-10-15 ALLEN POTVIN 2019-10-15
001 2017-01-01 ALLEN POTVIN 2018-09-24 ALLEN POTVIN 2018-09-24
001 2016-01-01 ALLEN POTVIN 2017-07-27 ALLEN POTVIN 2017-07-27
001 2015-01-01 ALLEN POTVIN 2016-09-27 ALLEN POTVIN 2016-09-27
001 2014-01-01 ALLEN POTVIN 2015-07-14 ALLEN POTVIN 2015-07-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01	ALLEN POTVIN	2019-10-15	ALLEN POTVIN	2019-10-15
001	2017-01-01	ALLEN POTVIN	2018-09-24	ALLEN POTVIN	2018-09-24
001	2016-01-01	ALLEN POTVIN	2017-07-27	ALLEN POTVIN	2017-07-27
001	2015-01-01	ALLEN POTVIN	2016-09-27	ALLEN POTVIN	2016-09-27
001	2014-01-01	ALLEN POTVIN	2015-07-14	ALLEN POTVIN	2015-07-14

Plan Statistics for CORNERSTONE 401(K) PLAN

401k plan membership statisitcs for CORNERSTONE 401(K) PLAN

Measure Date Value
2022: CORNERSTONE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 98
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 19
Total of all active and inactive participants 2022-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 117
Number of participants with account balances 2022-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: CORNERSTONE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 104
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 24
Total of all active and inactive participants 2021-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 128
Number of participants with account balances 2021-01-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 8
2020: CORNERSTONE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 111
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 18
Total of all active and inactive participants 2020-01-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 129
Number of participants with account balances 2020-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: CORNERSTONE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 101
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 2019-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 136
Number of participants with account balances 2019-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 10

Measure	Date	Value
2022: CORNERSTONE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	98
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	19
Total of all active and inactive participants	2022-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	117
Number of participants with account balances	2022-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: CORNERSTONE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	104
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	24
Total of all active and inactive participants	2021-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	128
Number of participants with account balances	2021-01-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	8
2020: CORNERSTONE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	111
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	18
Total of all active and inactive participants	2020-01-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	129
Number of participants with account balances	2020-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: CORNERSTONE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	101
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	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	136
Number of participants with account balances	2019-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	10

Financial Data on CORNERSTONE 401(K) PLAN

Measure	Date	Value
2022 : CORNERSTONE 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-5,722
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$151,962
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$131,445
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$246,129
Value of total assets at end of year	2022-12-31	$1,413,601
Value of total assets at beginning of year	2022-12-31	$1,571,285
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$20,517
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$177,335
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$-157,684
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,413,601
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,571,285
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,273,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$1,461,050
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$68,622
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$41,695
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-251,851
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$68,794
Employer contributions (assets) at end of year	2022-12-31	$71,646
Employer contributions (assets) at beginning of year	2022-12-31	$68,540
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$131,445
Contract administrator fees	2022-12-31	$20,517
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2022-12-31	410746749
2021 : CORNERSTONE 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$419,539
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$99,331
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$67,801
Value of total corrective distributions	2021-12-31	$14,633
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$239,284
Value of total assets at end of year	2021-12-31	$1,571,285
Value of total assets at beginning of year	2021-12-31	$1,251,077
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$16,897
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$178,266
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$320,208
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,571,285
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,251,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$1,461,050
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,175,926
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$41,695
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$7,747
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$180,255
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	$61,018
Employer contributions (assets) at end of year	2021-12-31	$68,540
Employer contributions (assets) at beginning of year	2021-12-31	$67,404
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$67,801
Contract administrator fees	2021-12-31	$16,897
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2021-12-31	410746749
2020 : CORNERSTONE 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$398,742
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$68,329
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$54,279
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$241,358
Value of total assets at end of year	2020-12-31	$1,251,077
Value of total assets at beginning of year	2020-12-31	$920,664
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,050
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$176,077
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$2,153
Administrative expenses (other) incurred	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$330,413
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,251,077
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$920,664
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$1,175,926
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$859,349
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$7,747
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$3,845
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$157,384
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$63,128
Employer contributions (assets) at end of year	2020-12-31	$67,404
Employer contributions (assets) at beginning of year	2020-12-31	$57,470
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$54,279
Contract administrator fees	2020-12-31	$14,050
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2020-12-31	410746749
2019 : CORNERSTONE 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$346,748
Total income from all sources (including contributions)	2019-12-31	$346,748
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$51,603
Total of all expenses incurred	2019-12-31	$51,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$42,416
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$42,416
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$208,245
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$208,245
Value of total assets at end of year	2019-12-31	$920,664
Value of total assets at end of year	2019-12-31	$920,664
Value of total assets at beginning of year	2019-12-31	$625,519
Value of total assets at beginning of year	2019-12-31	$625,519
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,187
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,187
Total interest from all sources	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$153,428
Contributions received from participants	2019-12-31	$153,428
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$48
Other income not declared elsewhere	2019-12-31	$48
Administrative expenses (other) incurred	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$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	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$295,145
Value of net income/loss	2019-12-31	$295,145
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$920,664
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$920,664
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$625,519
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$625,519
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$859,349
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$859,349
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$574,405
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$574,405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,845
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,845
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,705
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,705
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$138,455
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$138,455
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$54,817
Contributions received in cash from employer	2019-12-31	$54,817
Employer contributions (assets) at end of year	2019-12-31	$57,470
Employer contributions (assets) at end of year	2019-12-31	$57,470
Employer contributions (assets) at beginning of year	2019-12-31	$48,409
Employer contributions (assets) at beginning of year	2019-12-31	$48,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$42,416
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$42,416
Contract administrator fees	2019-12-31	$9,187
Contract administrator fees	2019-12-31	$9,187
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm name	2019-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2019-12-31	410746749

Form 5500 Responses for CORNERSTONE 401(K) PLAN

2022: CORNERSTONE 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	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 funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: CORNERSTONE 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CORNERSTONE 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CORNERSTONE 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371076-01

Policy instance

Insurance contract or identification number	371076-01
Number of Individuals Covered	1
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 $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371076-01

Policy instance

Insurance contract or identification number	371076-01
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 $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371076-01

Policy instance

Insurance contract or identification number	371076-01
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

371076-01

Policy instance

Insurance contract or identification number	371076-01
Number of Individuals Covered	0
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 $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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Company Name:	HEALTH SERVICES NETWORK, INC.
Employer identification number (EIN):	411760229
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities