401k Plan data: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST plan

EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST
Plan identification number	001

EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

EVERGREEN HEALTHCARE MANAGEMEN has sponsored the creation of one or more 401k plans.

Company Name: EVERGREEN HEALTHCARE MANAGEMEN

Employer identification number (EIN): 611430460

NAIC Classification: 561490

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 WHITNEY FINKELSTEIN 2018-07-11
001 2016-01-01 WHITNEY FINKELSTEIN 2017-05-31
001 2015-01-01 WHITNEY FINKELSTEIN 2016-05-16
001 2014-01-01 WHITNEY FINKELSTEIN 2015-07-13
001 2013-01-01 KENNETH FINKELSTEIN 2014-07-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	WHITNEY FINKELSTEIN	2018-07-11
001	2016-01-01	WHITNEY FINKELSTEIN	2017-05-31
001	2015-01-01	WHITNEY FINKELSTEIN	2016-05-16
001	2014-01-01	WHITNEY FINKELSTEIN	2015-07-13
001	2013-01-01	KENNETH FINKELSTEIN	2014-07-11

Plan Statistics for EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2022: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 50
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 7
Total of all active and inactive participants 2022-01-01 57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 57
Number of participants with account balances 2022-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 86
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 49
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 7
Total of all active and inactive participants 2021-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 56
Number of participants with account balances 2021-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 89
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 56
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 28
Total of all active and inactive participants 2020-01-01 84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 85
Number of participants with account balances 2020-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 78
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 34
Total of all active and inactive participants 2019-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 112
Number of participants with account balances 2019-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 79
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 42
Total of all active and inactive participants 2018-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 121
Number of participants with account balances 2018-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2022: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	50
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	7
Total of all active and inactive participants	2022-01-01	57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	57
Number of participants with account balances	2022-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	86
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	49
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	7
Total of all active and inactive participants	2021-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	56
Number of participants with account balances	2021-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	89
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	56
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	28
Total of all active and inactive participants	2020-01-01	84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	85
Number of participants with account balances	2020-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	78
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	34
Total of all active and inactive participants	2019-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	112
Number of participants with account balances	2019-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	79
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	42
Total of all active and inactive participants	2018-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	121
Number of participants with account balances	2018-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2022 : EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-382,369
Expenses. Total of all expenses incurred	2022-12-31	$54,002
Benefits paid (including direct rollovers)	2022-12-31	$25,934
Total plan assets at end of year	2022-12-31	$4,295,437
Total plan assets at beginning of year	2022-12-31	$4,731,808
Value of fidelity bond covering the plan	2022-12-31	$473,181
Total contributions received or receivable from participants	2022-12-31	$276,919
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-777,275
Net income (gross income less expenses)	2022-12-31	$-436,371
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$4,295,437
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$4,731,808
Assets. Value of participant loans	2022-12-31	$59,476
Total contributions received or receivable from employer(s)	2022-12-31	$117,987
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$28,068
2021 : EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$1,043,104
Expenses. Total of all expenses incurred	2021-12-31	$1,666,457
Benefits paid (including direct rollovers)	2021-12-31	$1,635,395
Total plan assets at end of year	2021-12-31	$4,731,808
Total plan assets at beginning of year	2021-12-31	$5,355,161
Value of fidelity bond covering the plan	2021-12-31	$500,000
Total contributions received or receivable from participants	2021-12-31	$255,196
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$124,539
Other income received	2021-12-31	$546,710
Net income (gross income less expenses)	2021-12-31	$-623,353
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$4,731,808
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$5,355,161
Assets. Value of participant loans	2021-12-31	$55,360
Total contributions received or receivable from employer(s)	2021-12-31	$116,659
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$31,062
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2021-12-31	$0
Minimum employer required contribution for this plan year	2021-12-31	$0
Amount contributed by the employer to the plan for this plan year	2021-12-31	$0
2020 : EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$1,061,995
Expenses. Total of all expenses incurred	2020-12-31	$173,467
Benefits paid (including direct rollovers)	2020-12-31	$144,368
Total plan assets at end of year	2020-12-31	$5,355,161
Total plan assets at beginning of year	2020-12-31	$4,466,633
Value of fidelity bond covering the plan	2020-12-31	$446,663
Total contributions received or receivable from participants	2020-12-31	$275,474
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$24,204
Other income received	2020-12-31	$638,988
Net income (gross income less expenses)	2020-12-31	$888,528
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$5,355,161
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$4,466,633
Assets. Value of participant loans	2020-12-31	$76,605
Total contributions received or receivable from employer(s)	2020-12-31	$123,329
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$29,099
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2020-12-31	$0
Minimum employer required contribution for this plan year	2020-12-31	$0
Amount contributed by the employer to the plan for this plan year	2020-12-31	$0
2019 : EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,242,458
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,724,717
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,671,759
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$25,539
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$465,986
Value of total assets at end of year	2019-12-31	$4,466,633
Value of total assets at beginning of year	2019-12-31	$4,948,892
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$27,419
Total interest from all sources	2019-12-31	$7,336
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$145,891
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$145,891
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$494,889
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$194,647
Participant contributions at end of year	2019-12-31	$65,612
Participant contributions at beginning of year	2019-12-31	$73,938
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$167,683
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash 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	$-482,259
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,466,633
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,948,892
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
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$21,464
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,200,901
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,687,483
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$3,296
Value of interest in master investment trust accounts at end of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$200,120
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$187,471
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$187,471
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$4,040
Assets. Value of investments in 103.12 investment entities at end of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$623,245
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
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
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$103,656
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,671,759
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Contract administrator fees	2019-12-31	$5,955
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	2019-12-31	No
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
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
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
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	MUELLER & CO., LLP
Accountancy firm EIN	2019-12-31	362658780
2018 : EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$567,950
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$211,742
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$71,794
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$109,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$781,745
Value of total assets at end of year	2018-12-31	$4,948,892
Value of total assets at beginning of year	2018-12-31	$4,592,684
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$30,750
Total interest from all sources	2018-12-31	$7,268
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$252,712
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$252,712
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$40,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$248,804
Participant contributions at end of year	2018-12-31	$73,938
Participant contributions at beginning of year	2018-12-31	$98,397
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$532,941
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$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	2018-12-31	No
Value of net income/loss	2018-12-31	$356,208
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,948,892
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,592,684
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
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$4,687,483
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,480,779
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$4,378
Value of interest in master investment trust accounts at end of year	2018-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$187,471
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$13,508
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$13,508
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$2,890
Assets. Value of investments in 103.12 investment entities at end of year	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-473,775
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Assets. Value of employer real property at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$0
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$71,794
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$30,750
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$0
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
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	MUELLER & CO., LLP
Accountancy firm EIN	2018-12-31	362658780

Form 5500 Responses for EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST

2022: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 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 – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 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 – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 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
2018: EVERGREEN HEALTHCARE MANAGEMEN 401 K PROFIT SHARING PLAN TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	EVERGREEN HEALTHCARE MANAGEMEN
Employer identification number (EIN):	611430460
NAIC Classification:	561490