401k Plan data: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN plan

SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 401k Plan overview

Plan Name	SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN
Plan identification number	001

SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

SUPPORTIVE LIVING SOLUTIONS has sponsored the creation of one or more 401k plans.

Company Name: SUPPORTIVE LIVING SOLUTIONS

Employer identification number (EIN): 412011528

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

Additional information about SUPPORTIVE LIVING SOLUTIONS

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2011-03-28

Company Identification Number: 2008884

Legal Registered Office Address: 600 WAYNE AVENUE
-
DAYTON
United States of America (USA)
45410

More information about SUPPORTIVE LIVING SOLUTIONS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUPPORTIVE LIVING SOLUTIONS 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
001 2017-01-01 BILL ARRIGONI 2018-10-09
001 2016-01-01 BILL ARRIGONI 2017-06-26
001 2016-01-01 BILL ARRIGONI 2018-08-01
001 2015-01-01 BILL ARRIGONI 2016-08-24
001 2014-01-01 BILL ARRIGONI 2015-06-16
001 2013-01-01 BILL ARRIGONI 2014-07-23
001 2012-10-01 BILL ARRIGONI 2013-02-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	BILL ARRIGONI	2018-10-09
001	2016-01-01	BILL ARRIGONI	2017-06-26
001	2016-01-01	BILL ARRIGONI	2018-08-01
001	2015-01-01	BILL ARRIGONI	2016-08-24
001	2014-01-01	BILL ARRIGONI	2015-06-16
001	2013-01-01	BILL ARRIGONI	2014-07-23
001	2012-10-01	BILL ARRIGONI	2013-02-15

Plan Statistics for SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN

401k plan membership statisitcs for SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN

Measure Date Value
2022: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 151
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 68
Total of all active and inactive participants 2022-01-01 219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 219
Number of participants with account balances 2022-01-01 209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 132
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 67
Total of all active and inactive participants 2021-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 199
Number of participants with account balances 2021-01-01 187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 104
2020: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 133
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 80
Total of all active and inactive participants 2020-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 213
Number of participants with account balances 2020-01-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 146
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 50
Total of all active and inactive participants 2019-01-01 196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 196
Number of participants with account balances 2019-01-01 176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 27
2018: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 110
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 59
Total of all active and inactive participants 2018-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 169
Number of participants with account balances 2018-01-01 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 52

Measure	Date	Value
2022: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	151
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	68
Total of all active and inactive participants	2022-01-01	219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	219
Number of participants with account balances	2022-01-01	209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	132
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	67
Total of all active and inactive participants	2021-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	199
Number of participants with account balances	2021-01-01	187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	104
2020: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	133
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	80
Total of all active and inactive participants	2020-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	213
Number of participants with account balances	2020-01-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	146
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	50
Total of all active and inactive participants	2019-01-01	196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	196
Number of participants with account balances	2019-01-01	176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	27
2018: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	110
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	59
Total of all active and inactive participants	2018-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	169
Number of participants with account balances	2018-01-01	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	52

Financial Data on SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN

Measure	Date	Value
2022 : SUPPORTIVE LIVING SOLUTIONS 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	$-84,944
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$258,563
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$237,921
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$338,494
Value of total assets at end of year	2022-12-31	$1,999,824
Value of total assets at beginning of year	2022-12-31	$2,343,331
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$20,642
Total interest from all sources	2022-12-31	$1,086
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$33,795
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$33,795
Was this plan covered by a fidelity bond	2022-12-31	No
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	$244,603
Participant contributions at end of year	2022-12-31	$32,477
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$1,163
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$938
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$1,958
Other income not declared elsewhere	2022-12-31	$12
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	$-343,507
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,999,824
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,343,331
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
Investment advisory and management fees	2022-12-31	$19,223
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,966,184
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,342,393
Interest on participant loans	2022-12-31	$1,086
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-458,331
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	$91,933
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$237,921
Contract administrator fees	2022-12-31	$1,419
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	Disclaimer
Accountancy firm name	2022-12-31	THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN	2022-12-31	814229648
2021 : SUPPORTIVE LIVING SOLUTIONS 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	$708,922
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$365,930
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$343,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$374,721
Value of total assets at end of year	2021-12-31	$2,343,331
Value of total assets at beginning of year	2021-12-31	$2,000,339
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$22,576
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$40,224
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$40,224
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	$266,638
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$938
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$21
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	$342,992
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,343,331
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,000,339
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$10,677
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,342,393
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,995,190
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$5,149
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$293,956
Net investment gain/loss from pooled separate accounts	2021-12-31	$21
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	$108,083
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$343,354
Contract administrator fees	2021-12-31	$11,899
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
Accountancy firm name	2021-12-31	THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN	2021-12-31	814229648
2020 : SUPPORTIVE LIVING SOLUTIONS 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	$700,459
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$268,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$245,096
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$439,044
Value of total assets at end of year	2020-12-31	$2,000,339
Value of total assets at beginning of year	2020-12-31	$1,568,106
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$23,130
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$12,063
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$12,063
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$335,376
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$970
Other income not declared elsewhere	2020-12-31	$5
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	$432,233
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,000,339
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,568,106
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	$1,995,190
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$178,105
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$1,390,001
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$5,149
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$91,116
Net investment gain/loss from pooled separate accounts	2020-12-31	$158,231
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	$102,698
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$245,096
Contract administrator fees	2020-12-31	$23,130
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	THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN	2020-12-31	814229648
2019 : SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2019 401k financial data
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 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	$658,296
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$140,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$122,060
Value of total corrective distributions	2019-12-31	$181
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$393,784
Value of total assets at end of year	2019-12-31	$1,568,106
Value of total assets at beginning of year	2019-12-31	$1,050,630
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$18,579
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$299,640
Other income not declared elsewhere	2019-12-31	$171
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	$517,476
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,568,106
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,050,630
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 leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$178,105
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$102,500
Value of interest in common/collective trusts at end of year	2019-12-31	$1,390,001
Value of interest in common/collective trusts at beginning of year	2019-12-31	$948,130
Net investment gain/loss from pooled separate accounts	2019-12-31	$28,063
Net investment gain or loss from common/collective trusts	2019-12-31	$236,278
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
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	$94,144
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$122,060
Contract administrator fees	2019-12-31	$18,579
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN	2019-12-31	814229648
2018 : SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$274,594
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$144,108
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$125,764
Value of total corrective distributions	2018-12-31	$2,814
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$389,293
Value of total assets at end of year	2018-12-31	$1,050,630
Value of total assets at beginning of year	2018-12-31	$920,144
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$15,530
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$260,652
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$36,209
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	$130,486
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,050,630
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$920,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$102,500
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$79,900
Value of interest in common/collective trusts at end of year	2018-12-31	$948,130
Value of interest in common/collective trusts at beginning of year	2018-12-31	$840,244
Net investment gain/loss from pooled separate accounts	2018-12-31	$-13,396
Net investment gain or loss from common/collective trusts	2018-12-31	$-101,303
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$92,432
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$125,764
Contract administrator fees	2018-12-31	$15,530
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
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	THE AMERICAN AUDITORS GROUP, LLC
Accountancy firm EIN	2018-12-31	814229648

Form 5500 Responses for SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN

2022: SUPPORTIVE LIVING SOLUTIONS 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: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
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: SUPPORTIVE LIVING SOLUTIONS 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: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SUPPORTIVE LIVING SOLUTIONS 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

SU1502

Policy instance

Insurance contract or identification number	SU1502
Number of Individuals Covered	209
Insurance policy start date	2022-11-19
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

SU1502

Policy instance

Insurance contract or identification number	SU1502
Number of Individuals Covered	187
Insurance policy start date	2021-11-19
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

618706

Policy instance

Insurance contract or identification number	618706
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-11-18
Total amount of commissions paid to insurance broker	USD $770
Total amount of fees paid to insurance company	USD $101
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $770
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

SU1502

Policy instance

Insurance contract or identification number	SU1502
Number of Individuals Covered	3
Insurance policy start date	2020-11-19
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

618706

Policy instance

Insurance contract or identification number	618706
Number of Individuals Covered	180
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $674
Total amount of fees paid to insurance company	USD $137
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $674
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3

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

Policy contract number

618706

Policy instance

Insurance contract or identification number	618706
Number of Individuals Covered	168
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $456
Total amount of fees paid to insurance company	USD $92
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $456
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3

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Company Name:	SUPPORTIVE LIVING SOLUTIONS
Employer identification number (EIN):	412011528
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2011-03-28
Company Identification Number:	2008884
Legal Registered Office Address:	600 WAYNE AVENUE - DAYTON United States of America (USA) 45410