401k Plan data: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN plan

CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan Name	CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number	501

CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

CEDAR LAKE LODGE, INC. has sponsored the creation of one or more 401k plans.

Company Name: CEDAR LAKE LODGE, INC.

Employer identification number (EIN): 610713587

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

Additional information about CEDAR LAKE LODGE, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1991-06-25

Company Identification Number: 1557491

Legal Registered Office Address: 43 WAYNE AVENUE
Rockland
STONY POINT
United States of America (USA)
10980

More information about CEDAR LAKE LODGE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-09-01 MARGARET WAUGH 2023-03-30
501 2020-09-01 MARGARET WAUGH 2022-06-08
501 2019-09-01 MARGARET WAUGH 2021-03-17
501 2018-09-01 MARGARET WAUGH 2020-05-29
501 2017-09-01
501 2016-09-01
501 2015-09-01
501 2014-09-01
501 2013-09-01
501 2012-09-01 CLYDE LANG
501 2011-09-01 CLYDE D. LANG
501 2009-09-01 DIANA C. RAGSDALE

Plan Statistics for CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2021: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-09-01 257
Total number of active participants reported on line 7a of the Form 5500 2021-09-01 234
Number of retired or separated participants receiving benefits 2021-09-01 0
Number of other retired or separated participants entitled to future benefits 2021-09-01 0
Total of all active and inactive participants 2021-09-01 234
Number of employers contributing to the scheme 2021-09-01 0
2020: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-09-01 279
Total number of active participants reported on line 7a of the Form 5500 2020-09-01 257
Number of retired or separated participants receiving benefits 2020-09-01 0
Number of other retired or separated participants entitled to future benefits 2020-09-01 0
Total of all active and inactive participants 2020-09-01 257
Number of employers contributing to the scheme 2020-09-01 0
2019: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-09-01 287
Total number of active participants reported on line 7a of the Form 5500 2019-09-01 279
Number of retired or separated participants receiving benefits 2019-09-01 0
Number of other retired or separated participants entitled to future benefits 2019-09-01 0
Total of all active and inactive participants 2019-09-01 279
Number of employers contributing to the scheme 2019-09-01 0
2018: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-09-01 279
Total number of active participants reported on line 7a of the Form 5500 2018-09-01 287
Total of all active and inactive participants 2018-09-01 287
2017: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-09-01 294
Total number of active participants reported on line 7a of the Form 5500 2017-09-01 279
Total of all active and inactive participants 2017-09-01 279
2016: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-09-01 274
Total number of active participants reported on line 7a of the Form 5500 2016-09-01 294
Total of all active and inactive participants 2016-09-01 294
2015: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-09-01 293
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 274
Total of all active and inactive participants 2015-09-01 274
2014: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-09-01 328
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 293
Total of all active and inactive participants 2014-09-01 293
2013: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-09-01 329
Total number of active participants reported on line 7a of the Form 5500 2013-09-01 328
Total of all active and inactive participants 2013-09-01 328
2012: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-09-01 298
Total number of active participants reported on line 7a of the Form 5500 2012-09-01 329
Total of all active and inactive participants 2012-09-01 329
2011: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 296
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 298
Total of all active and inactive participants 2011-09-01 298
2009: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 278
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 292
Total of all active and inactive participants 2009-09-01 292

Measure	Date	Value
2021: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-09-01	257
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	234
Number of retired or separated participants receiving benefits	2021-09-01	0
Number of other retired or separated participants entitled to future benefits	2021-09-01	0
Total of all active and inactive participants	2021-09-01	234
Number of employers contributing to the scheme	2021-09-01	0
2020: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-09-01	279
Total number of active participants reported on line 7a of the Form 5500	2020-09-01	257
Number of retired or separated participants receiving benefits	2020-09-01	0
Number of other retired or separated participants entitled to future benefits	2020-09-01	0
Total of all active and inactive participants	2020-09-01	257
Number of employers contributing to the scheme	2020-09-01	0
2019: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-09-01	287
Total number of active participants reported on line 7a of the Form 5500	2019-09-01	279
Number of retired or separated participants receiving benefits	2019-09-01	0
Number of other retired or separated participants entitled to future benefits	2019-09-01	0
Total of all active and inactive participants	2019-09-01	279
Number of employers contributing to the scheme	2019-09-01	0
2018: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-09-01	279
Total number of active participants reported on line 7a of the Form 5500	2018-09-01	287
Total of all active and inactive participants	2018-09-01	287
2017: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-09-01	294
Total number of active participants reported on line 7a of the Form 5500	2017-09-01	279
Total of all active and inactive participants	2017-09-01	279
2016: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-09-01	274
Total number of active participants reported on line 7a of the Form 5500	2016-09-01	294
Total of all active and inactive participants	2016-09-01	294
2015: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-09-01	293
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	274
Total of all active and inactive participants	2015-09-01	274
2014: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-09-01	328
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	293
Total of all active and inactive participants	2014-09-01	293
2013: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-09-01	329
Total number of active participants reported on line 7a of the Form 5500	2013-09-01	328
Total of all active and inactive participants	2013-09-01	328
2012: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-09-01	298
Total number of active participants reported on line 7a of the Form 5500	2012-09-01	329
Total of all active and inactive participants	2012-09-01	329
2011: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	296
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	298
Total of all active and inactive participants	2011-09-01	298
2009: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	278
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	292
Total of all active and inactive participants	2009-09-01	292

Financial Data on CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN

Measure	Date	Value
2022 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-08-31	$3,020,241
Total of all expenses incurred	2022-08-31	$3,087,019
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-08-31	$3,053,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-08-31	$3,007,061
Value of total assets at end of year	2022-08-31	$2,362,967
Value of total assets at beginning of year	2022-08-31	$2,429,745
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-08-31	$33,716
Total interest from all sources	2022-08-31	$4,788
Total dividends received (eg from common stock, registered investment company shares)	2022-08-31	$8,392
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-08-31	No
Was this plan covered by a fidelity bond	2022-08-31	Yes
Value of fidelity bond cover	2022-08-31	$500,000
If this is an individual account plan, was there a blackout period	2022-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-08-31	No
Contributions received from participants	2022-08-31	$568,542
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-08-31	$3,053,303
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-08-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-08-31	$0
Administrative expenses (other) incurred	2022-08-31	$33,716
Total non interest bearing cash at end of year	2022-08-31	$339,431
Total non interest bearing cash at beginning of year	2022-08-31	$286,742
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-08-31	No
Value of net income/loss	2022-08-31	$-66,778
Value of net assets at end of year (total assets less liabilities)	2022-08-31	$2,362,967
Value of net assets at beginning of year (total assets less liabilities)	2022-08-31	$2,429,745
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-08-31	No
Were any leases to which the plan was party in default or uncollectible	2022-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-08-31	$1,449,657
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-08-31	$1,535,408
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-08-31	$1,535,408
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-08-31	$4,788
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-08-31	Yes
Was there a failure to transmit to the plan any participant contributions	2022-08-31	No
Has the plan failed to provide any benefit when due under the plan	2022-08-31	No
Contributions received in cash from employer	2022-08-31	$2,438,519
Income. Dividends from preferred stock	2022-08-31	$8,392
Asset. Corporate debt instrument preferred debt at end of year	2022-08-31	$573,879
Asset. Corporate debt instrument preferred debt at beginning of year	2022-08-31	$607,595
Did the plan have assets held for investment	2022-08-31	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	2022-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-08-31	No
Opinion of an independent qualified public accountant for this plan	2022-08-31	Unqualified
Accountancy firm name	2022-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2022-08-31	611064249
2021 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-08-31	$194
Total unrealized appreciation/depreciation of assets	2021-08-31	$194
Total income from all sources (including contributions)	2021-08-31	$3,267,735
Total of all expenses incurred	2021-08-31	$2,375,184
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-08-31	$2,375,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-08-31	$3,259,833
Value of total assets at end of year	2021-08-31	$2,429,745
Value of total assets at beginning of year	2021-08-31	$1,537,194
Total interest from all sources	2021-08-31	$1,271
Total dividends received (eg from common stock, registered investment company shares)	2021-08-31	$6,437
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-08-31	No
Was this plan covered by a fidelity bond	2021-08-31	Yes
Value of fidelity bond cover	2021-08-31	$500,000
If this is an individual account plan, was there a blackout period	2021-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-08-31	No
Contributions received from participants	2021-08-31	$615,129
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-08-31	$2,375,184
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-08-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-08-31	$39,380
Total non interest bearing cash at end of year	2021-08-31	$286,742
Total non interest bearing cash at beginning of year	2021-08-31	$53,213
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-08-31	No
Value of net income/loss	2021-08-31	$892,551
Value of net assets at end of year (total assets less liabilities)	2021-08-31	$2,429,745
Value of net assets at beginning of year (total assets less liabilities)	2021-08-31	$1,537,194
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-08-31	No
Were any leases to which the plan was party in default or uncollectible	2021-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-08-31	$1,535,408
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-08-31	$1,444,601
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-08-31	$1,444,601
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-08-31	$1,271
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-08-31	Yes
Was there a failure to transmit to the plan any participant contributions	2021-08-31	No
Has the plan failed to provide any benefit when due under the plan	2021-08-31	No
Contributions received in cash from employer	2021-08-31	$2,644,704
Income. Dividends from preferred stock	2021-08-31	$6,437
Asset. Corporate debt instrument preferred debt at end of year	2021-08-31	$607,595
Did the plan have assets held for investment	2021-08-31	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	2021-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-08-31	No
Opinion of an independent qualified public accountant for this plan	2021-08-31	Unqualified
Accountancy firm name	2021-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2021-08-31	611064249
2020 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-08-31	$11,925
Total unrealized appreciation/depreciation of assets	2020-08-31	$11,925
Total income from all sources (including contributions)	2020-08-31	$2,848,867
Total of all expenses incurred	2020-08-31	$2,862,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-08-31	$2,862,824
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-08-31	$2,825,335
Value of total assets at end of year	2020-08-31	$1,537,194
Value of total assets at beginning of year	2020-08-31	$1,551,151
Total interest from all sources	2020-08-31	$1,238
Total dividends received (eg from common stock, registered investment company shares)	2020-08-31	$7,177
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-08-31	No
Was this plan covered by a fidelity bond	2020-08-31	Yes
Value of fidelity bond cover	2020-08-31	$500,000
If this is an individual account plan, was there a blackout period	2020-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-08-31	No
Contributions received from participants	2020-08-31	$648,135
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-08-31	$2,862,824
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-08-31	$39,380
Other income not declared elsewhere	2020-08-31	$3,192
Total non interest bearing cash at end of year	2020-08-31	$53,213
Total non interest bearing cash at beginning of year	2020-08-31	$442
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-08-31	No
Value of net income/loss	2020-08-31	$-13,957
Value of net assets at end of year (total assets less liabilities)	2020-08-31	$1,537,194
Value of net assets at beginning of year (total assets less liabilities)	2020-08-31	$1,551,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-08-31	No
Were any leases to which the plan was party in default or uncollectible	2020-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-08-31	$1,444,601
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-08-31	$1,550,709
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-08-31	$1,550,709
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-08-31	$1,238
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-08-31	Yes
Was there a failure to transmit to the plan any participant contributions	2020-08-31	No
Has the plan failed to provide any benefit when due under the plan	2020-08-31	No
Contributions received in cash from employer	2020-08-31	$2,177,200
Income. Dividends from preferred stock	2020-08-31	$7,177
Did the plan have assets held for investment	2020-08-31	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	2020-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-08-31	No
Opinion of an independent qualified public accountant for this plan	2020-08-31	Unqualified
Accountancy firm name	2020-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2020-08-31	611064249
2019 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-08-31	$2,572,742
Total of all expenses incurred	2019-08-31	$2,822,686
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-08-31	$2,822,686
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-08-31	$2,572,641
Value of total assets at end of year	2019-08-31	$1,551,151
Value of total assets at beginning of year	2019-08-31	$1,801,095
Total interest from all sources	2019-08-31	$101
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-08-31	No
Was this plan covered by a fidelity bond	2019-08-31	Yes
Value of fidelity bond cover	2019-08-31	$500,000
If this is an individual account plan, was there a blackout period	2019-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-08-31	No
Contributions received from participants	2019-08-31	$599,932
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-08-31	$2,822,686
Total non interest bearing cash at end of year	2019-08-31	$442
Total non interest bearing cash at beginning of year	2019-08-31	$442
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-08-31	No
Value of net income/loss	2019-08-31	$-249,944
Value of net assets at end of year (total assets less liabilities)	2019-08-31	$1,551,151
Value of net assets at beginning of year (total assets less liabilities)	2019-08-31	$1,801,095
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-08-31	No
Were any leases to which the plan was party in default or uncollectible	2019-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-08-31	$1,550,709
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-08-31	$1,800,653
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-08-31	$1,800,653
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-08-31	$101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-08-31	No
Was there a failure to transmit to the plan any participant contributions	2019-08-31	No
Has the plan failed to provide any benefit when due under the plan	2019-08-31	No
Contributions received in cash from employer	2019-08-31	$1,972,709
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	2019-08-31	No
Did the plan have assets held for investment	2019-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-08-31	No
Opinion of an independent qualified public accountant for this plan	2019-08-31	Unqualified
Accountancy firm name	2019-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2019-08-31	611064249
2018 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-08-31	$2,454,710
Total of all expenses incurred	2018-08-31	$2,158,693
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-08-31	$2,158,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-08-31	$2,454,696
Value of total assets at end of year	2018-08-31	$1,801,095
Value of total assets at beginning of year	2018-08-31	$1,505,078
Total interest from all sources	2018-08-31	$14
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-08-31	No
Was this plan covered by a fidelity bond	2018-08-31	Yes
Value of fidelity bond cover	2018-08-31	$500,000
If this is an individual account plan, was there a blackout period	2018-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-08-31	No
Contributions received from participants	2018-08-31	$514,182
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-08-31	$2,158,693
Total non interest bearing cash at end of year	2018-08-31	$442
Total non interest bearing cash at beginning of year	2018-08-31	$560
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-08-31	No
Value of net income/loss	2018-08-31	$296,017
Value of net assets at end of year (total assets less liabilities)	2018-08-31	$1,801,095
Value of net assets at beginning of year (total assets less liabilities)	2018-08-31	$1,505,078
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-08-31	No
Were any leases to which the plan was party in default or uncollectible	2018-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-08-31	$1,800,653
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-08-31	$1,504,518
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-08-31	$1,504,518
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-08-31	$14
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-08-31	No
Was there a failure to transmit to the plan any participant contributions	2018-08-31	No
Has the plan failed to provide any benefit when due under the plan	2018-08-31	No
Contributions received in cash from employer	2018-08-31	$1,940,514
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	2018-08-31	No
Did the plan have assets held for investment	2018-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-08-31	No
Opinion of an independent qualified public accountant for this plan	2018-08-31	Unqualified
Accountancy firm name	2018-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2018-08-31	611064249
2017 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-08-31	$2,326,444
Total of all expenses incurred	2017-08-31	$2,322,830
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-08-31	$2,322,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-08-31	$2,326,436
Value of total assets at end of year	2017-08-31	$1,505,078
Value of total assets at beginning of year	2017-08-31	$1,501,464
Total interest from all sources	2017-08-31	$8
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-08-31	No
Was this plan covered by a fidelity bond	2017-08-31	Yes
Value of fidelity bond cover	2017-08-31	$500,000
If this is an individual account plan, was there a blackout period	2017-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-08-31	No
Contributions received from participants	2017-08-31	$512,983
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-08-31	$2,322,830
Total non interest bearing cash at end of year	2017-08-31	$560
Total non interest bearing cash at beginning of year	2017-08-31	$560
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-08-31	No
Value of net income/loss	2017-08-31	$3,614
Value of net assets at end of year (total assets less liabilities)	2017-08-31	$1,505,078
Value of net assets at beginning of year (total assets less liabilities)	2017-08-31	$1,501,464
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-08-31	No
Were any leases to which the plan was party in default or uncollectible	2017-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-08-31	$1,504,518
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-08-31	$1,500,904
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-08-31	$1,500,904
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-08-31	$8
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-08-31	No
Was there a failure to transmit to the plan any participant contributions	2017-08-31	No
Has the plan failed to provide any benefit when due under the plan	2017-08-31	No
Contributions received in cash from employer	2017-08-31	$1,813,453
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	2017-08-31	No
Did the plan have assets held for investment	2017-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-08-31	No
Opinion of an independent qualified public accountant for this plan	2017-08-31	Unqualified
Accountancy firm name	2017-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2017-08-31	611064249
2016 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-08-31	$2,339,227
Total of all expenses incurred	2016-08-31	$2,007,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-08-31	$2,007,545
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-08-31	$2,339,218
Value of total assets at end of year	2016-08-31	$1,501,464
Value of total assets at beginning of year	2016-08-31	$1,169,782
Total interest from all sources	2016-08-31	$9
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-08-31	No
Was this plan covered by a fidelity bond	2016-08-31	Yes
Value of fidelity bond cover	2016-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-08-31	No
Contributions received from participants	2016-08-31	$485,242
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-08-31	$2,007,545
Total non interest bearing cash at end of year	2016-08-31	$560
Total non interest bearing cash at beginning of year	2016-08-31	$560
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-08-31	No
Value of net income/loss	2016-08-31	$331,682
Value of net assets at end of year (total assets less liabilities)	2016-08-31	$1,501,464
Value of net assets at beginning of year (total assets less liabilities)	2016-08-31	$1,169,782
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-08-31	No
Were any leases to which the plan was party in default or uncollectible	2016-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-08-31	$1,500,904
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-08-31	$1,169,222
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-08-31	$1,169,222
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-08-31	$9
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-08-31	No
Was there a failure to transmit to the plan any participant contributions	2016-08-31	No
Has the plan failed to provide any benefit when due under the plan	2016-08-31	No
Contributions received in cash from employer	2016-08-31	$1,853,976
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	2016-08-31	No
Did the plan have assets held for investment	2016-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-08-31	No
Opinion of an independent qualified public accountant for this plan	2016-08-31	Unqualified
Accountancy firm name	2016-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2016-08-31	611064249
2015 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-08-31	$2,158,862
Total of all expenses incurred	2015-08-31	$2,115,651
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-08-31	$2,115,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-08-31	$2,158,828
Value of total assets at end of year	2015-08-31	$1,169,782
Value of total assets at beginning of year	2015-08-31	$1,126,571
Total interest from all sources	2015-08-31	$34
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-08-31	No
Was this plan covered by a fidelity bond	2015-08-31	Yes
Value of fidelity bond cover	2015-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-08-31	No
Contributions received from participants	2015-08-31	$445,717
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-08-31	$2,115,651
Total non interest bearing cash at end of year	2015-08-31	$560
Total non interest bearing cash at beginning of year	2015-08-31	$177
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-08-31	No
Value of net income/loss	2015-08-31	$43,211
Value of net assets at end of year (total assets less liabilities)	2015-08-31	$1,169,782
Value of net assets at beginning of year (total assets less liabilities)	2015-08-31	$1,126,571
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-08-31	No
Were any leases to which the plan was party in default or uncollectible	2015-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-08-31	$1,169,222
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-08-31	$1,126,394
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-08-31	$1,126,394
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-08-31	$34
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-08-31	No
Was there a failure to transmit to the plan any participant contributions	2015-08-31	No
Has the plan failed to provide any benefit when due under the plan	2015-08-31	No
Contributions received in cash from employer	2015-08-31	$1,713,111
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	2015-08-31	No
Did the plan have assets held for investment	2015-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-08-31	No
Opinion of an independent qualified public accountant for this plan	2015-08-31	Unqualified
Accountancy firm name	2015-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2015-08-31	611064249
2014 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-08-31	$2,459,748
Total of all expenses incurred	2014-08-31	$2,469,106
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-08-31	$2,469,106
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-08-31	$2,081,652
Value of total assets at end of year	2014-08-31	$1,126,571
Value of total assets at beginning of year	2014-08-31	$1,135,929
Total interest from all sources	2014-08-31	$226
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-08-31	No
Was this plan covered by a fidelity bond	2014-08-31	Yes
Value of fidelity bond cover	2014-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-08-31	No
Contributions received from participants	2014-08-31	$483,159
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-08-31	$2,469,106
Other income not declared elsewhere	2014-08-31	$377,870
Total non interest bearing cash at end of year	2014-08-31	$177
Total non interest bearing cash at beginning of year	2014-08-31	$177
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-08-31	No
Value of net income/loss	2014-08-31	$-9,358
Value of net assets at end of year (total assets less liabilities)	2014-08-31	$1,126,571
Value of net assets at beginning of year (total assets less liabilities)	2014-08-31	$1,135,929
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-08-31	No
Were any leases to which the plan was party in default or uncollectible	2014-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-08-31	$1,126,394
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-08-31	$1,135,752
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-08-31	$1,135,752
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-08-31	$226
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-08-31	No
Was there a failure to transmit to the plan any participant contributions	2014-08-31	No
Has the plan failed to provide any benefit when due under the plan	2014-08-31	No
Contributions received in cash from employer	2014-08-31	$1,598,493
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	2014-08-31	No
Did the plan have assets held for investment	2014-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-08-31	No
Opinion of an independent qualified public accountant for this plan	2014-08-31	Unqualified
Accountancy firm name	2014-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2014-08-31	611064249
2013 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-08-31	$1,951,831
Total of all expenses incurred	2013-08-31	$2,156,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-08-31	$2,156,053
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-08-31	$1,803,052
Value of total assets at end of year	2013-08-31	$1,135,929
Value of total assets at beginning of year	2013-08-31	$1,340,151
Total interest from all sources	2013-08-31	$1,260
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-08-31	No
Was this plan covered by a fidelity bond	2013-08-31	Yes
Value of fidelity bond cover	2013-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-08-31	No
Contributions received from participants	2013-08-31	$311,125
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-08-31	$2,156,053
Other income not declared elsewhere	2013-08-31	$147,519
Total non interest bearing cash at end of year	2013-08-31	$177
Total non interest bearing cash at beginning of year	2013-08-31	$177
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-08-31	No
Value of net income/loss	2013-08-31	$-204,222
Value of net assets at end of year (total assets less liabilities)	2013-08-31	$1,135,929
Value of net assets at beginning of year (total assets less liabilities)	2013-08-31	$1,340,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-08-31	No
Were any leases to which the plan was party in default or uncollectible	2013-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-08-31	$1,135,752
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-08-31	$1,339,974
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-08-31	$1,339,974
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-08-31	$1,260
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-08-31	No
Was there a failure to transmit to the plan any participant contributions	2013-08-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-08-31	No
Contributions received in cash from employer	2013-08-31	$1,491,927
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	2013-08-31	No
Did the plan have assets held for investment	2013-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-08-31	No
Opinion of an independent qualified public accountant for this plan	2013-08-31	Unqualified
Accountancy firm name	2013-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2013-08-31	611064249
2012 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-08-31	$2,818,089
Total of all expenses incurred	2012-08-31	$1,920,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-08-31	$1,910,040
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-08-31	$2,648,948
Value of total assets at end of year	2012-08-31	$1,340,151
Value of total assets at beginning of year	2012-08-31	$442,302
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-08-31	$10,200
Total interest from all sources	2012-08-31	$1,233
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-08-31	No
Administrative expenses professional fees incurred	2012-08-31	$10,200
Was this plan covered by a fidelity bond	2012-08-31	Yes
Value of fidelity bond cover	2012-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-08-31	No
Contributions received from participants	2012-08-31	$306,902
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-08-31	$1,910,040
Other income not declared elsewhere	2012-08-31	$167,908
Total non interest bearing cash at end of year	2012-08-31	$177
Total non interest bearing cash at beginning of year	2012-08-31	$294,777
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-08-31	No
Value of net income/loss	2012-08-31	$897,849
Value of net assets at end of year (total assets less liabilities)	2012-08-31	$1,340,151
Value of net assets at beginning of year (total assets less liabilities)	2012-08-31	$442,302
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-08-31	No
Were any leases to which the plan was party in default or uncollectible	2012-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-08-31	$1,339,974
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-08-31	$147,525
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-08-31	$147,525
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-08-31	$1,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-08-31	No
Was there a failure to transmit to the plan any participant contributions	2012-08-31	No
Has the plan failed to provide any benefit when due under the plan	2012-08-31	No
Contributions received in cash from employer	2012-08-31	$2,342,046
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	2012-08-31	No
Did the plan have assets held for investment	2012-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-08-31	No
Opinion of an independent qualified public accountant for this plan	2012-08-31	Unqualified
Accountancy firm name	2012-08-31	DEMING, MALONE, LIVESAY & OSTROFF
Accountancy firm EIN	2012-08-31	611064249
2011 : CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-08-31	$2,708
Total income from all sources (including contributions)	2011-08-31	$2,117,677
Total of all expenses incurred	2011-08-31	$1,822,917
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-08-31	$1,822,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-08-31	$1,931,534
Value of total assets at end of year	2011-08-31	$442,302
Value of total assets at beginning of year	2011-08-31	$150,250
Total interest from all sources	2011-08-31	$955
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-08-31	No
Was this plan covered by a fidelity bond	2011-08-31	Yes
Value of fidelity bond cover	2011-08-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-08-31	No
Contributions received from participants	2011-08-31	$278,128
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-08-31	$1,822,917
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-08-31	$2,708
Other income not declared elsewhere	2011-08-31	$185,188
Total non interest bearing cash at end of year	2011-08-31	$294,777
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-08-31	No
Value of net income/loss	2011-08-31	$294,760
Value of net assets at end of year (total assets less liabilities)	2011-08-31	$442,302
Value of net assets at beginning of year (total assets less liabilities)	2011-08-31	$147,542
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-08-31	No
Were any leases to which the plan was party in default or uncollectible	2011-08-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-08-31	$147,525
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-08-31	$150,250
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-08-31	$150,250
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-08-31	$955
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-08-31	No
Was there a failure to transmit to the plan any participant contributions	2011-08-31	No
Has the plan failed to provide any benefit when due under the plan	2011-08-31	No
Contributions received in cash from employer	2011-08-31	$1,653,406
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	2011-08-31	No
Did the plan have assets held for investment	2011-08-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-08-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-08-31	No
Opinion of an independent qualified public accountant for this plan	2011-08-31	Unqualified
Accountancy firm name	2011-08-31	DEMING, MALONE LIVESAY & OSTROFF
Accountancy firm EIN	2011-08-31	611064249

Form 5500 Responses for CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN

2021: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-09-01	Type of plan entity	Single employer plan
2021-09-01	Plan funding arrangement – Insurance	Yes
2021-09-01	Plan funding arrangement – Trust	Yes
2021-09-01	Plan benefit arrangement – Insurance	Yes
2021-09-01	Plan benefit arrangement - Trust	Yes
2020: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-09-01	Type of plan entity	Single employer plan
2020-09-01	Plan funding arrangement – Insurance	Yes
2020-09-01	Plan funding arrangement – Trust	Yes
2020-09-01	Plan benefit arrangement – Insurance	Yes
2020-09-01	Plan benefit arrangement - Trust	Yes
2019: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-09-01	Type of plan entity	Single employer plan
2019-09-01	Plan funding arrangement – Insurance	Yes
2019-09-01	Plan funding arrangement – Trust	Yes
2019-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-09-01	Plan benefit arrangement – Insurance	Yes
2019-09-01	Plan benefit arrangement - Trust	Yes
2019-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-09-01	Type of plan entity	Single employer plan
2018-09-01	Plan funding arrangement – Insurance	Yes
2018-09-01	Plan funding arrangement – Trust	Yes
2018-09-01	Plan benefit arrangement – Insurance	Yes
2018-09-01	Plan benefit arrangement - Trust	Yes
2017: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-09-01	Type of plan entity	Single employer plan
2017-09-01	Plan funding arrangement – Insurance	Yes
2017-09-01	Plan funding arrangement – Trust	Yes
2017-09-01	Plan benefit arrangement – Insurance	Yes
2017-09-01	Plan benefit arrangement - Trust	Yes
2016: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-09-01	Type of plan entity	Single employer plan
2016-09-01	Plan funding arrangement – Insurance	Yes
2016-09-01	Plan funding arrangement – Trust	Yes
2016-09-01	Plan benefit arrangement – Insurance	Yes
2016-09-01	Plan benefit arrangement - Trust	Yes
2015: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan funding arrangement – Trust	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement - Trust	Yes
2014: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan funding arrangement – Trust	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement - Trust	Yes
2013: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-09-01	Type of plan entity	Single employer plan
2013-09-01	Plan funding arrangement – Insurance	Yes
2013-09-01	Plan funding arrangement – Trust	Yes
2013-09-01	Plan benefit arrangement – Insurance	Yes
2013-09-01	Plan benefit arrangement - Trust	Yes
2012: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-09-01	Type of plan entity	Single employer plan
2012-09-01	Plan funding arrangement – Insurance	Yes
2012-09-01	Plan funding arrangement – Trust	Yes
2012-09-01	Plan benefit arrangement – Insurance	Yes
2012-09-01	Plan benefit arrangement - Trust	Yes
2011: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan funding arrangement – Trust	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement - Trust	Yes
2009: CEDAR LAKE LODGE, INC. EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	This submission is the final filing	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan funding arrangement – Trust	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	234
Insurance policy start date	2021-09-01
Insurance policy end date	2022-08-31
Total amount of commissions paid to insurance broker	USD $42,199
Total amount of fees paid to insurance company	USD $1,519
Welfare Benefit Premiums Paid to Carrier	USD $530,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,199
Amount paid for insurance broker fees	1519
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	257
Insurance policy start date	2020-09-01
Insurance policy end date	2021-08-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $600,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	279
Insurance policy start date	2019-09-01
Insurance policy end date	2020-08-31
Total amount of commissions paid to insurance broker	USD $45,073
Total amount of fees paid to insurance company	USD $1,912
Welfare Benefit Premiums Paid to Carrier	USD $679,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,073
Amount paid for insurance broker fees	1912
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	287
Insurance policy start date	2018-09-01
Insurance policy end date	2019-08-31
Total amount of commissions paid to insurance broker	USD $53,688
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $773,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,398
Insurance broker organization code?	3

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	279
Insurance policy start date	2017-09-01
Insurance policy end date	2018-08-31
Total amount of commissions paid to insurance broker	USD $39,699
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $632,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	274
Insurance policy start date	2015-09-01
Insurance policy end date	2016-08-31
Total amount of commissions paid to insurance broker	USD $39,096
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $377,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $35,651
Insurance broker organization code?	3
Insurance broker name	USI MIDWEST INC. - LOUISVILLE

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	293
Insurance policy start date	2014-09-01
Insurance policy end date	2015-08-31
Total amount of commissions paid to insurance broker	USD $44,110
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $451,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,952
Insurance broker organization code?	3
Insurance broker name	WLA INSURANCE LLC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	328
Insurance policy start date	2013-09-01
Insurance policy end date	2014-08-31
Total amount of commissions paid to insurance broker	USD $46,796
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $504,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,899
Insurance broker organization code?	3
Insurance broker name	WLA INSURANCE LLC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

619276

Policy instance

Insurance contract or identification number	619276
Number of Individuals Covered	329
Insurance policy start date	2012-09-01
Insurance policy end date	2013-08-31
Total amount of commissions paid to insurance broker	USD $24,920
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $310,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,742
Insurance broker organization code?	3
Insurance broker name	WLA INSURANCE LLC

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

00210605

Policy instance

Insurance contract or identification number	00210605
Insurance policy start date	2012-09-01
Insurance policy end date	2013-08-31
Total amount of commissions paid to insurance broker	USD $3,221
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,221
Insurance broker organization code?	3
Insurance broker name	USI MIDWEST INC

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

00210605

Policy instance

Insurance contract or identification number	00210605
Number of Individuals Covered	298
Insurance policy start date	2011-09-01
Insurance policy end date	2012-08-31
Total amount of commissions paid to insurance broker	USD $38,447
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $388,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

00210605

Policy instance

Insurance contract or identification number	00210605
Number of Individuals Covered	296
Insurance policy start date	2010-09-01
Insurance policy end date	2011-08-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $312,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CEDAR LAKE LODGE, INC.
Employer identification number (EIN):	610713587
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1991-06-25
Company Identification Number:	1557491
Legal Registered Office Address:	43 WAYNE AVENUE Rockland STONY POINT United States of America (USA) 10980

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2021-09-01	MARGARET WAUGH	2023-03-30
501	2020-09-01	MARGARET WAUGH	2022-06-08
501	2019-09-01	MARGARET WAUGH	2021-03-17
501	2018-09-01	MARGARET WAUGH	2020-05-29
501	2017-09-01
501	2016-09-01
501	2015-09-01
501	2014-09-01
501	2013-09-01
501	2012-09-01	CLYDE LANG
501	2011-09-01	CLYDE D. LANG
501	2009-09-01	DIANA C. RAGSDALE