401k Plan data: F & G PROPERTIES RETIREMENT PLAN plan

F & G PROPERTIES RETIREMENT PLAN 401k Plan overview

Plan Name	F & G PROPERTIES RETIREMENT PLAN
Plan identification number	001

F & G PROPERTIES RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

RIVERBEND NURSING & REHABILITATION CENTER has sponsored the creation of one or more 401k plans.

Company Name: RIVERBEND NURSING & REHABILITATION CENTER

Employer identification number (EIN): 721399324

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan F & G PROPERTIES RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 MARY LYNN LEACH 2023-07-30
001 2021-01-01 MARY LYNN LEACH 2022-08-22
001 2020-01-01 MARY LYNN LEACH 2021-10-06
001 2019-01-01 MARY LYNN LEACH 2020-10-07
001 2018-01-01 MARY LYNN LEACH 2019-10-06
001 2017-01-01
001 2016-01-01
001 2015-01-01 MARY LYNN LEACH 2016-07-28
001 2014-01-01 MARY LYNN LEACH 2015-07-23
001 2013-01-01 MARY LYNN LEACH 2014-07-28
001 2012-01-01 MIKE FORD 2013-10-01
001 2011-01-01 MIKE FORD 2012-09-17
001 2010-01-01 MIKE FORD 2011-07-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	MARY LYNN LEACH	2023-07-30
001	2021-01-01	MARY LYNN LEACH	2022-08-22
001	2020-01-01	MARY LYNN LEACH	2021-10-06
001	2019-01-01	MARY LYNN LEACH	2020-10-07
001	2018-01-01	MARY LYNN LEACH	2019-10-06
001	2017-01-01
001	2016-01-01
001	2015-01-01	MARY LYNN LEACH	2016-07-28
001	2014-01-01	MARY LYNN LEACH	2015-07-23
001	2013-01-01	MARY LYNN LEACH	2014-07-28
001	2012-01-01	MIKE FORD	2013-10-01
001	2011-01-01	MIKE FORD	2012-09-17
001	2010-01-01	MIKE FORD	2011-07-27

Plan Statistics for F & G PROPERTIES RETIREMENT PLAN

401k plan membership statisitcs for F & G PROPERTIES RETIREMENT PLAN

Measure Date Value
2022: F & G PROPERTIES RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 724
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 466
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 10
Total of all active and inactive participants 2022-01-01 476
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 476
Number of participants with account balances 2022-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: F & G PROPERTIES RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,057
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 627
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 13
Total of all active and inactive participants 2021-01-01 640
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 641
Number of participants with account balances 2021-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: F & G PROPERTIES RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,090
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 956
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 12
Total of all active and inactive participants 2020-01-01 968
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 968
Number of participants with account balances 2020-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: F & G PROPERTIES RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 980
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 834
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 8
Total of all active and inactive participants 2019-01-01 842
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 842
Number of participants with account balances 2019-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: F & G PROPERTIES RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 776
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 754
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 13
Total of all active and inactive participants 2018-01-01 767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 767
Number of participants with account balances 2018-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: F & G PROPERTIES RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 576
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 11
Total of all active and inactive participants 2017-01-01 587
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 587
Number of participants with account balances 2017-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: F & G PROPERTIES RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 166
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 13
Total of all active and inactive participants 2016-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 2
Total participants 2016-01-01 181
Number of participants with account balances 2016-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1

Measure	Date	Value
2022: F & G PROPERTIES RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	724
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	466
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	10
Total of all active and inactive participants	2022-01-01	476
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	476
Number of participants with account balances	2022-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: F & G PROPERTIES RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,057
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	627
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	13
Total of all active and inactive participants	2021-01-01	640
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	641
Number of participants with account balances	2021-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: F & G PROPERTIES RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,090
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	956
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	12
Total of all active and inactive participants	2020-01-01	968
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	968
Number of participants with account balances	2020-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: F & G PROPERTIES RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	980
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	834
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	8
Total of all active and inactive participants	2019-01-01	842
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	842
Number of participants with account balances	2019-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: F & G PROPERTIES RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	776
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	754
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	13
Total of all active and inactive participants	2018-01-01	767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	767
Number of participants with account balances	2018-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: F & G PROPERTIES RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	576
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	11
Total of all active and inactive participants	2017-01-01	587
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	587
Number of participants with account balances	2017-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: F & G PROPERTIES RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	166
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	13
Total of all active and inactive participants	2016-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	2
Total participants	2016-01-01	181
Number of participants with account balances	2016-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1

Financial Data on F & G PROPERTIES RETIREMENT PLAN

Measure	Date	Value
2022 : F & G PROPERTIES RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-153,669
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$206,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$204,790
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$136,869
Value of total assets at end of year	2022-12-31	$1,365,820
Value of total assets at beginning of year	2022-12-31	$1,726,306
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,027
Total interest from all sources	2022-12-31	$1,490
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$136,869
Participant contributions at end of year	2022-12-31	$33,307
Participant contributions at beginning of year	2022-12-31	$36,848
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-360,486
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,365,820
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,726,306
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in pooled separate accounts at end of year	2022-12-31	$1,201,458
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$1,541,994
Interest on participant loans	2022-12-31	$1,323
Interest earned on other investments	2022-12-31	$167
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$131,055
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$147,464
Net investment gain/loss from pooled separate accounts	2022-12-31	$-292,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$204,790
Contract administrator fees	2022-12-31	$2,027
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2022-12-31	721042866
2021 : F & G PROPERTIES RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$364,505
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$43,707
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$40,319
Value of total corrective distributions	2021-12-31	$2,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$146,149
Value of total assets at end of year	2021-12-31	$1,726,306
Value of total assets at beginning of year	2021-12-31	$1,405,508
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$1,383
Total interest from all sources	2021-12-31	$1,769
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$146,149
Participant contributions at end of year	2021-12-31	$36,848
Participant contributions at beginning of year	2021-12-31	$41,820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$320,798
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,726,306
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,405,508
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$1,541,994
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,231,302
Interest on participant loans	2021-12-31	$1,471
Interest earned on other investments	2021-12-31	$298
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$147,464
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$132,386
Net investment gain/loss from pooled separate accounts	2021-12-31	$216,587
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$40,319
Contract administrator fees	2021-12-31	$1,383
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2021-12-31	721042866
2020 : F & G PROPERTIES RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$321,757
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$141,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$140,210
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$167,329
Value of total assets at end of year	2020-12-31	$1,405,508
Value of total assets at beginning of year	2020-12-31	$1,225,210
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,249
Total interest from all sources	2020-12-31	$2,426
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$167,329
Participant contributions at end of year	2020-12-31	$41,820
Participant contributions at beginning of year	2020-12-31	$54,930
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$180,298
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,405,508
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,225,210
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,231,302
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,094,344
Interest on participant loans	2020-12-31	$1,947
Interest earned on other investments	2020-12-31	$479
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$132,386
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$75,936
Net investment gain/loss from pooled separate accounts	2020-12-31	$152,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$140,210
Contract administrator fees	2020-12-31	$1,249
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2020-12-31	721042866
2019 : F & G PROPERTIES RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$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	$354,903
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$153,404
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$151,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$148,900
Value of total assets at end of year	2019-12-31	$1,225,210
Value of total assets at beginning of year	2019-12-31	$1,023,711
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,094
Total interest from all sources	2019-12-31	$2,912
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$148,900
Participant contributions at end of year	2019-12-31	$54,930
Participant contributions at beginning of year	2019-12-31	$59,522
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	$201,499
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,225,210
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,023,711
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,094,344
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$807,156
Interest on participant loans	2019-12-31	$2,158
Interest earned on other investments	2019-12-31	$754
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$75,936
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$157,033
Net investment gain/loss from pooled separate accounts	2019-12-31	$203,091
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	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$151,310
Contract administrator fees	2019-12-31	$2,094
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2019-12-31	721042866
2018 : F & G PROPERTIES RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$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	$68,021
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$68,312
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$66,365
Value of total corrective distributions	2018-12-31	$986
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$137,957
Value of total assets at end of year	2018-12-31	$1,023,711
Value of total assets at beginning of year	2018-12-31	$1,024,002
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$961
Total interest from all sources	2018-12-31	$3,762
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$137,957
Participant contributions at end of year	2018-12-31	$59,522
Participant contributions at beginning of year	2018-12-31	$86,786
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	$-291
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,023,711
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,024,002
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$807,156
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$755,907
Interest on participant loans	2018-12-31	$3,303
Interest earned on other investments	2018-12-31	$459
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$157,033
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$181,309
Net investment gain/loss from pooled separate accounts	2018-12-31	$-73,698
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$66,365
Contract administrator fees	2018-12-31	$961
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2018-12-31	721042866
2017 : F & G PROPERTIES RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$224,024
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$115,042
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$112,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$85,991
Value of total assets at end of year	2017-12-31	$1,024,002
Value of total assets at beginning of year	2017-12-31	$915,020
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,069
Total interest from all sources	2017-12-31	$2,304
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$85,991
Participant contributions at end of year	2017-12-31	$86,786
Participant contributions at beginning of year	2017-12-31	$49,601
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$108,982
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,024,002
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$915,020
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$755,907
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$680,707
Interest on participant loans	2017-12-31	$2,132
Interest earned on other investments	2017-12-31	$172
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$181,309
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$184,712
Net investment gain/loss from pooled separate accounts	2017-12-31	$135,729
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$112,973
Contract administrator fees	2017-12-31	$2,069
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	KUSHNER LAGRAIZE, LLC
Accountancy firm EIN	2017-12-31	721042866
2016 : F & G PROPERTIES RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$149,136
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$32,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$25,058
Expenses. Certain deemed distributions of participant loans	2016-12-31	$5,360
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$94,243
Value of total assets at end of year	2016-12-31	$915,020
Value of total assets at beginning of year	2016-12-31	$798,274
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,972
Total interest from all sources	2016-12-31	$1,894
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$94,243
Participant contributions at end of year	2016-12-31	$49,601
Participant contributions at beginning of year	2016-12-31	$52,947
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$116,746
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$915,020
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$798,274
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$680,707
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$577,514
Interest on participant loans	2016-12-31	$1,631
Interest earned on other investments	2016-12-31	$263
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$184,712
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$167,813
Net investment gain/loss from pooled separate accounts	2016-12-31	$52,999
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$25,058
Contract administrator fees	2016-12-31	$1,972
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	KUSHNER LAGRAIZE LLC
Accountancy firm EIN	2016-12-31	721042866

Form 5500 Responses for F & G PROPERTIES RETIREMENT PLAN

2022: F & G PROPERTIES RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: F & G PROPERTIES RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: F & G PROPERTIES RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Mulitple employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: F & G PROPERTIES RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Mulitple employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: F & G PROPERTIES RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: F & G PROPERTIES RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: F & G PROPERTIES RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	476
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,335
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,335
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	641
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,660
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,660
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	968
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,536
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,536
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	842
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,269
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,269
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	767
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,970
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,970
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806540

Policy instance

Insurance contract or identification number	806540
Number of Individuals Covered	587
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,777
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,777
Insurance broker organization code?	3
Insurance broker name	PROEQUITIES INC

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Company Name:	RIVERBEND NURSING & REHABILITATION CENTER
Employer identification number (EIN):	721399324
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities