401k Plan data: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN plan

GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 401k Plan overview

Plan Name	GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN
Plan identification number	001

GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GOOD NEIGHBOR HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: GOOD NEIGHBOR HOLDINGS, LLC

Employer identification number (EIN): 473260215

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2022-01-01 JASON MAREK
001 2021-01-01
001 2021-01-01 JASON MAREK
001 2020-01-01
001 2019-01-01
001 2017-01-01 JASON MAREK JASON MAREK 2018-10-12

Plan Statistics for GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN

401k plan membership statisitcs for GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN

Measure Date Value
2022: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 642
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 10
Number of retired or separated participants receiving benefits 2021-01-01 9
Number of other retired or separated participants entitled to future benefits 2021-01-01 83
Total of all active and inactive participants 2021-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 102
Number of participants with account balances 2021-01-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 454
2020: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 962
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 528
Number of retired or separated participants receiving benefits 2020-01-01 22
Number of other retired or separated participants entitled to future benefits 2020-01-01 43
Total of all active and inactive participants 2020-01-01 593
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 593
Number of participants with account balances 2020-01-01 441
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 193
2019: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 710
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 567
Number of retired or separated participants receiving benefits 2019-01-01 21
Number of other retired or separated participants entitled to future benefits 2019-01-01 278
Total of all active and inactive participants 2019-01-01 866
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 866
Number of participants with account balances 2019-01-01 578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 182
2017: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 356
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 417
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 64
Total of all active and inactive participants 2017-01-01 481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 481
Number of participants with account balances 2017-01-01 254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 63

Measure	Date	Value
2022: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	642
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	10
Number of retired or separated participants receiving benefits	2021-01-01	9
Number of other retired or separated participants entitled to future benefits	2021-01-01	83
Total of all active and inactive participants	2021-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	102
Number of participants with account balances	2021-01-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	454
2020: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	962
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	528
Number of retired or separated participants receiving benefits	2020-01-01	22
Number of other retired or separated participants entitled to future benefits	2020-01-01	43
Total of all active and inactive participants	2020-01-01	593
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	593
Number of participants with account balances	2020-01-01	441
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	193
2019: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	710
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	567
Number of retired or separated participants receiving benefits	2019-01-01	21
Number of other retired or separated participants entitled to future benefits	2019-01-01	278
Total of all active and inactive participants	2019-01-01	866
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	866
Number of participants with account balances	2019-01-01	578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	182
2017: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	356
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	417
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	64
Total of all active and inactive participants	2017-01-01	481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	481
Number of participants with account balances	2017-01-01	254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	63

Financial Data on GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN

Measure	Date	Value
2022 : GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-149,846
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$855,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$820,964
Value of total corrective distributions	2022-06-30	$1,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$7,248
Value of total assets at end of year	2022-06-30	$0
Value of total assets at beginning of year	2022-06-30	$1,005,786
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$33,868
Total interest from all sources	2022-06-30	$49
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$30
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-06-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$30
Administrative expenses professional fees incurred	2022-06-30	$17,373
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$100,579
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$5,615
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$3,619
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-06-30	$0
Other income not declared elsewhere	2022-06-30	$2,725
Liabilities. Value of operating payables at end of year	2022-06-30	$0
Liabilities. Value of operating payables at beginning of year	2022-06-30	$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	2022-06-30	No
Value of net income/loss	2022-06-30	$-1,005,786
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$1,005,786
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$33,120
Value of interest in pooled separate accounts at end of year	2022-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$968,598
Interest on participant loans	2022-06-30	$47
Interest earned on other investments	2022-06-30	$2
Value of interest in common/collective trusts at end of year	2022-06-30	$0
Value of interest in common/collective trusts at beginning of year	2022-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$449
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-5,123
Net investment gain/loss from pooled separate accounts	2022-06-30	$-154,775
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$1,633
Employer contributions (assets) at end of year	2022-06-30	$0
Employer contributions (assets) at beginning of year	2022-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$820,964
Contract administrator fees	2022-06-30	$16,495
Did the plan have assets held for investment	2022-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	KEITER
Accountancy firm EIN	2022-06-30	541631262
Total unrealized appreciation/depreciation of assets	2022-01-01	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-01	$0
Total income from all sources (including contributions)	2022-01-01	$-149,846
Total loss/gain on sale of assets	2022-01-01	$0
Total of all expenses incurred	2022-01-01	$855,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-01-01	$820,964
Value of total corrective distributions	2022-01-01	$1,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-01-01	$7,248
Value of total assets at end of year	2022-01-01	$0
Value of total assets at beginning of year	2022-01-01	$1,005,786
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-01-01	$33,868
Total interest from all sources	2022-01-01	$49
Total dividends received (eg from common stock, registered investment company shares)	2022-01-01	$30
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-01-01	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-01-01	$0
Total dividends received from registered investment company shares (eg mutual funds)	2022-01-01	$30
Administrative expenses professional fees incurred	2022-01-01	$17,373
Was this plan covered by a fidelity bond	2022-01-01	Yes
Value of fidelity bond cover	2022-01-01	$100,579
If this is an individual account plan, was there a blackout period	2022-01-01	No
Were there any nonexempt tranactions with any party-in-interest	2022-01-01	No
Contributions received from participants	2022-01-01	$5,615
Participant contributions at end of year	2022-01-01	$0
Participant contributions at beginning of year	2022-01-01	$3,619
Participant contributions at end of year	2022-01-01	$0
Participant contributions at beginning of year	2022-01-01	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-01-01	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-01-01	$0
Other income not declared elsewhere	2022-01-01	$2,725
Liabilities. Value of operating payables at end of year	2022-01-01	$0
Liabilities. Value of operating payables at beginning of year	2022-01-01	$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	2022-01-01	No
Value of net income/loss	2022-01-01	$-1,005,786
Value of net assets at end of year (total assets less liabilities)	2022-01-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-01-01	$1,005,786
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-01-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-01-01	No
Were any leases to which the plan was party in default or uncollectible	2022-01-01	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-01-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-01-01	$33,120
Value of interest in pooled separate accounts at end of year	2022-01-01	$0
Value of interest in pooled separate accounts at beginning of year	2022-01-01	$968,598
Interest on participant loans	2022-01-01	$47
Interest earned on other investments	2022-01-01	$2
Value of interest in common/collective trusts at end of year	2022-01-01	$0
Value of interest in common/collective trusts at beginning of year	2022-01-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-01-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-01-01	$449
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-01-01	$-5,123
Net investment gain/loss from pooled separate accounts	2022-01-01	$-154,775
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-01-01	No
Was there a failure to transmit to the plan any participant contributions	2022-01-01	No
Has the plan failed to provide any benefit when due under the plan	2022-01-01	No
Contributions received in cash from employer	2022-01-01	$1,633
Employer contributions (assets) at end of year	2022-01-01	$0
Employer contributions (assets) at beginning of year	2022-01-01	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-01-01	$820,964
Contract administrator fees	2022-01-01	$16,495
Did the plan have assets held for investment	2022-01-01	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-01-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-01-01	Yes
Opinion of an independent qualified public accountant for this plan	2022-01-01	1
Accountancy firm name	2022-01-01	KEITER
Accountancy firm EIN	2022-01-01	541631262
2021 : GOOD NEIGHBOR EMPLOYEE RETIREMENT 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	$11,118
Total income from all sources (including contributions)	2021-12-31	$701,119
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,020,883
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$905,904
Value of total corrective distributions	2021-12-31	$459
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$492,841
Value of total assets at end of year	2021-12-31	$1,005,786
Value of total assets at beginning of year	2021-12-31	$1,336,668
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$114,520
Total interest from all sources	2021-12-31	$1,713
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$517
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$517
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$132,556
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	$354,456
Participant contributions at end of year	2021-12-31	$3,619
Participant contributions at beginning of year	2021-12-31	$38,927
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,157
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$11,118
Liabilities. Value of operating payables at end of year	2021-12-31	$0
Liabilities. Value of operating payables at beginning of year	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	$-319,764
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,005,786
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,325,550
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	$33,120
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$39,856
Value of interest in pooled separate accounts at end of year	2021-12-31	$968,598
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,254,694
Interest on participant loans	2021-12-31	$1,713
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$449
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$3,191
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,174
Net investment gain/loss from pooled separate accounts	2021-12-31	$204,874
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	$137,228
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$905,904
Contract administrator fees	2021-12-31	$114,520
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	KEITER
Accountancy firm EIN	2021-12-31	541631262
2020 : GOOD NEIGHBOR EMPLOYEE RETIREMENT 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	$11,118
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$17,959
Total income from all sources (including contributions)	2020-12-31	$694,294
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$624,696
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$520,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$534,406
Value of total assets at end of year	2020-12-31	$1,336,668
Value of total assets at beginning of year	2020-12-31	$1,273,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$103,886
Total interest from all sources	2020-12-31	$2,023
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	$127,392
If this is an individual account plan, was there a blackout period	2020-12-31	Yes
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	$379,350
Participant contributions at end of year	2020-12-31	$38,927
Participant contributions at beginning of year	2020-12-31	$28,684
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$12,783
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$4,335
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$11,118
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$17,959
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	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	$69,598
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,325,550
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,255,952
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	$39,856
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	$1,254,694
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,227,092
Interest on participant loans	2020-12-31	$2,023
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	$547
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$3,191
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	$157,865
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	$150,721
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$4,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$520,810
Contract administrator fees	2020-12-31	$103,886
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	2020-12-31	Yes
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	Unqualified
Accountancy firm name	2020-12-31	KEITER
Accountancy firm EIN	2020-12-31	541631262
2019 : GOOD NEIGHBOR EMPLOYEE RETIREMENT 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	$17,959
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$12,806
Total income from all sources (including contributions)	2019-12-31	$702,150
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$133,252
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$107,025
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$527,383
Value of total assets at end of year	2019-12-31	$1,273,911
Value of total assets at beginning of year	2019-12-31	$699,860
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$26,227
Total interest from all sources	2019-12-31	$1,652
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
Administrative expenses professional fees incurred	2019-12-31	$22,142
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$100,000
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	$294,506
Participant contributions at end of year	2019-12-31	$28,684
Participant contributions at beginning of year	2019-12-31	$18,498
Participant contributions at end of year	2019-12-31	$12,783
Participant contributions at beginning of year	2019-12-31	$12,185
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$111,622
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$17,959
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$12,806
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	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
Value of net income/loss	2019-12-31	$568,898
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,255,952
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$687,054
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 registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,227,639
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$665,285
Interest on participant loans	2019-12-31	$1,652
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$173,115
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	$121,255
Employer contributions (assets) at end of year	2019-12-31	$4,805
Employer contributions (assets) at beginning of year	2019-12-31	$3,892
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$107,025
Contract administrator fees	2019-12-31	$4,085
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	KEITER
Accountancy firm EIN	2019-12-31	541631262
2018 : GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$12,806
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$10,950
Total income from all sources (including contributions)	2018-12-31	$340,739
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$98,538
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$69,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$386,603
Value of total assets at end of year	2018-12-31	$699,860
Value of total assets at beginning of year	2018-12-31	$455,803
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$29,229
Total interest from all sources	2018-12-31	$959
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$26,104
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$100,000
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	$296,545
Participant contributions at end of year	2018-12-31	$18,498
Participant contributions at beginning of year	2018-12-31	$14,476
Participant contributions at end of year	2018-12-31	$12,185
Participant contributions at beginning of year	2018-12-31	$11,857
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$828
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$12,806
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$5,635
Liabilities. Value of operating payables at end of year	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$5,315
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	$242,201
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$687,054
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$444,853
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$665,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$426,130
Interest on participant loans	2018-12-31	$959
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-46,823
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	Yes
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	$89,230
Employer contributions (assets) at end of year	2018-12-31	$3,892
Employer contributions (assets) at beginning of year	2018-12-31	$3,340
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$69,309
Contract administrator fees	2018-12-31	$3,125
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	KEITER
Accountancy firm EIN	2018-12-31	541631262
2017 : GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$10,950
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$428
Total income from all sources (including contributions)	2017-12-31	$288,401
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$74,409
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$43,750
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$235,776
Value of total assets at end of year	2017-12-31	$455,803
Value of total assets at beginning of year	2017-12-31	$231,289
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$30,659
Total interest from all sources	2017-12-31	$302
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$7,317
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$7,317
Administrative expenses professional fees incurred	2017-12-31	$27,535
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$185,790
Participant contributions at end of year	2017-12-31	$14,476
Participant contributions at beginning of year	2017-12-31	$2,741
Participant contributions at end of year	2017-12-31	$11,857
Participant contributions at beginning of year	2017-12-31	$4,294
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$5,635
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$428
Administrative expenses (other) incurred	2017-12-31	$-731
Liabilities. Value of operating payables at end of year	2017-12-31	$5,315
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$213,992
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$444,853
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$230,861
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$426,130
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$222,945
Interest on participant loans	2017-12-31	$302
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$45,006
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$49,986
Employer contributions (assets) at end of year	2017-12-31	$3,340
Employer contributions (assets) at beginning of year	2017-12-31	$1,309
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$43,750
Contract administrator fees	2017-12-31	$3,855
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	KEITER
Accountancy firm EIN	2017-12-31	541631262

Form 5500 Responses for GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN

2022: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: GOOD NEIGHBOR EMPLOYEE RETIREMENT 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: GOOD NEIGHBOR EMPLOYEE RETIREMENT 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: GOOD NEIGHBOR EMPLOYEE RETIREMENT 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 – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2017: GOOD NEIGHBOR EMPLOYEE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $1
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

469782

Policy instance

Insurance contract or identification number	469782
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $2,228
Total amount of fees paid to insurance company	USD $223
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

613953

Policy instance

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

Policy contract number

613953

Policy instance

Potentially related plans

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Company Name:	GOOD NEIGHBOR HOLDINGS, LLC
Employer identification number (EIN):	473260215
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2022-01-01	JASON MAREK
001	2021-01-01
001	2021-01-01	JASON MAREK
001	2020-01-01
001	2019-01-01
001	2017-01-01	JASON MAREK	JASON MAREK	2018-10-12