401k Plan data: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN plan

GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 401k Plan overview

Plan Name	GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN
Plan identification number	001

GUARDIAN HEALTH SERVICES, LLC 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

GUARDIAN HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: GUARDIAN HEALTH SERVICES, LLC

Employer identification number (EIN): 752950776

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-06-01 KATHERINE HALE 2021-03-07 KATHERINE HALE 2021-03-07
001 2018-06-01 KATHERINE HALE 2019-12-30 KATHERINE HALE 2019-12-30
001 2017-06-01 KATHERINE HALE 2018-11-14 KATHERINE HALE 2018-11-14
001 2016-06-01 KATHERINE HALE 2017-09-11 KATHERINE HALE 2017-09-11
001 2015-06-01 KATHERINE HALE 2016-09-13 KATHERINE HALE 2016-09-13
001 2014-06-01 KATHERINE HALE 2015-11-11 KATHERINE HALE 2015-11-11
001 2013-06-01 KATHERINE HALE 2014-09-11 KATHERINE HALE 2014-09-11
001 2012-06-01 KATHERINE HALE KATHERINE HALE 2014-03-14
001 2011-06-01 TAMMY GILBERT TAMMY GILBERT 2013-03-14
001 2009-06-01 TAMMY GILBERT TAMMY GILBERT 2011-03-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-06-01	KATHERINE HALE	2021-03-07	KATHERINE HALE	2021-03-07
001	2018-06-01	KATHERINE HALE	2019-12-30	KATHERINE HALE	2019-12-30
001	2017-06-01	KATHERINE HALE	2018-11-14	KATHERINE HALE	2018-11-14
001	2016-06-01	KATHERINE HALE	2017-09-11	KATHERINE HALE	2017-09-11
001	2015-06-01	KATHERINE HALE	2016-09-13	KATHERINE HALE	2016-09-13
001	2014-06-01	KATHERINE HALE	2015-11-11	KATHERINE HALE	2015-11-11
001	2013-06-01	KATHERINE HALE	2014-09-11	KATHERINE HALE	2014-09-11
001	2012-06-01	KATHERINE HALE		KATHERINE HALE	2014-03-14
001	2011-06-01	TAMMY GILBERT		TAMMY GILBERT	2013-03-14
001	2009-06-01	TAMMY GILBERT		TAMMY GILBERT	2011-03-01

Plan Statistics for GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN

401k plan membership statisitcs for GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN

Measure Date Value
2012: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-06-01 108
Total number of active participants reported on line 7a of the Form 5500 2012-06-01 38
Number of retired or separated participants receiving benefits 2012-06-01 0
Number of other retired or separated participants entitled to future benefits 2012-06-01 35
Total of all active and inactive participants 2012-06-01 73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-06-01 0
Total participants 2012-06-01 73
Number of participants with account balances 2012-06-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-06-01 0
2011: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-06-01 119
Total number of active participants reported on line 7a of the Form 5500 2011-06-01 40
Number of retired or separated participants receiving benefits 2011-06-01 0
Number of other retired or separated participants entitled to future benefits 2011-06-01 68
Total of all active and inactive participants 2011-06-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-06-01 0
Total participants 2011-06-01 108
Number of participants with account balances 2011-06-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-06-01 0
2009: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-06-01 109
Total number of active participants reported on line 7a of the Form 5500 2009-06-01 61
Number of retired or separated participants receiving benefits 2009-06-01 0
Number of other retired or separated participants entitled to future benefits 2009-06-01 59
Total of all active and inactive participants 2009-06-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-06-01 0
Total participants 2009-06-01 120
Number of participants with account balances 2009-06-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-06-01 0

Measure	Date	Value
2012: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-06-01	108
Total number of active participants reported on line 7a of the Form 5500	2012-06-01	38
Number of retired or separated participants receiving benefits	2012-06-01	0
Number of other retired or separated participants entitled to future benefits	2012-06-01	35
Total of all active and inactive participants	2012-06-01	73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-06-01	0
Total participants	2012-06-01	73
Number of participants with account balances	2012-06-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-06-01	0
2011: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-06-01	119
Total number of active participants reported on line 7a of the Form 5500	2011-06-01	40
Number of retired or separated participants receiving benefits	2011-06-01	0
Number of other retired or separated participants entitled to future benefits	2011-06-01	68
Total of all active and inactive participants	2011-06-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-06-01	0
Total participants	2011-06-01	108
Number of participants with account balances	2011-06-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-06-01	0
2009: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-06-01	109
Total number of active participants reported on line 7a of the Form 5500	2009-06-01	61
Number of retired or separated participants receiving benefits	2009-06-01	0
Number of other retired or separated participants entitled to future benefits	2009-06-01	59
Total of all active and inactive participants	2009-06-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-06-01	0
Total participants	2009-06-01	120
Number of participants with account balances	2009-06-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-06-01	0

Financial Data on GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN

Measure	Date	Value
2013 : GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-05-31	$0
Total transfer of assets to this plan	2013-05-31	$0
Total transfer of assets from this plan	2013-05-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-05-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-05-31	$0
Total income from all sources (including contributions)	2013-05-31	$327,000
Total loss/gain on sale of assets	2013-05-31	$0
Total of all expenses incurred	2013-05-31	$115,156
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-05-31	$114,176
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-05-31	$111,658
Value of total assets at end of year	2013-05-31	$1,684,660
Value of total assets at beginning of year	2013-05-31	$1,472,816
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-05-31	$980
Total interest from all sources	2013-05-31	$13,854
Total dividends received (eg from common stock, registered investment company shares)	2013-05-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-05-31	No
Was this plan covered by a fidelity bond	2013-05-31	No
If this is an individual account plan, was there a blackout period	2013-05-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-05-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-05-31	No
Contributions received from participants	2013-05-31	$82,297
Participant contributions at end of year	2013-05-31	$51,211
Participant contributions at beginning of year	2013-05-31	$38,126
Participant contributions at end of year	2013-05-31	$0
Participant contributions at beginning of year	2013-05-31	$0
Administrative expenses (other) incurred	2013-05-31	$980
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-05-31	No
Value of net income/loss	2013-05-31	$211,844
Value of net assets at end of year (total assets less liabilities)	2013-05-31	$1,684,660
Value of net assets at beginning of year (total assets less liabilities)	2013-05-31	$1,472,816
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-05-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-05-31	No
Were any leases to which the plan was party in default or uncollectible	2013-05-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-05-31	$1,186,115
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-05-31	$993,603
Interest on participant loans	2013-05-31	$1,585
Interest earned on other investments	2013-05-31	$12,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-05-31	$447,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-05-31	$441,087
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-05-31	$201,488
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-05-31	No
Was there a failure to transmit to the plan any participant contributions	2013-05-31	No
Has the plan failed to provide any benefit when due under the plan	2013-05-31	No
Contributions received in cash from employer	2013-05-31	$29,361
Employer contributions (assets) at end of year	2013-05-31	$0
Employer contributions (assets) at beginning of year	2013-05-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-05-31	$114,176
Did the plan have assets held for investment	2013-05-31	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	2013-05-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-05-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-05-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-05-31	Disclaimer
Accountancy firm name	2013-05-31	MARTIN, STARNES & ASSOC.,CPA'S,P.A.
Accountancy firm EIN	2013-05-31	561761202
2012 : GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-05-31	$0
Total transfer of assets to this plan	2012-05-31	$0
Total transfer of assets from this plan	2012-05-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-05-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-05-31	$0
Total income from all sources (including contributions)	2012-05-31	$131,791
Total loss/gain on sale of assets	2012-05-31	$0
Total of all expenses incurred	2012-05-31	$107,814
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-05-31	$106,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-05-31	$170,026
Value of total assets at end of year	2012-05-31	$1,472,816
Value of total assets at beginning of year	2012-05-31	$1,448,839
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-05-31	$881
Total interest from all sources	2012-05-31	$14,548
Total dividends received (eg from common stock, registered investment company shares)	2012-05-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-05-31	No
Was this plan covered by a fidelity bond	2012-05-31	No
If this is an individual account plan, was there a blackout period	2012-05-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-05-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-05-31	No
Contributions received from participants	2012-05-31	$65,882
Participant contributions at end of year	2012-05-31	$38,126
Participant contributions at beginning of year	2012-05-31	$50,089
Participant contributions at end of year	2012-05-31	$0
Participant contributions at beginning of year	2012-05-31	$3,377
Income. Received or receivable in cash from other sources (including rollovers)	2012-05-31	$41,632
Administrative expenses (other) incurred	2012-05-31	$881
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-05-31	No
Value of net income/loss	2012-05-31	$23,977
Value of net assets at end of year (total assets less liabilities)	2012-05-31	$1,472,816
Value of net assets at beginning of year (total assets less liabilities)	2012-05-31	$1,448,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-05-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-05-31	No
Were any leases to which the plan was party in default or uncollectible	2012-05-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-05-31	$993,603
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-05-31	$988,006
Interest on participant loans	2012-05-31	$1,547
Interest earned on other investments	2012-05-31	$13,001
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-05-31	$441,087
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-05-31	$404,453
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-05-31	$-52,783
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-05-31	No
Was there a failure to transmit to the plan any participant contributions	2012-05-31	No
Has the plan failed to provide any benefit when due under the plan	2012-05-31	No
Contributions received in cash from employer	2012-05-31	$62,512
Employer contributions (assets) at end of year	2012-05-31	$0
Employer contributions (assets) at beginning of year	2012-05-31	$2,914
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-05-31	$106,933
Did the plan have assets held for investment	2012-05-31	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	2012-05-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-05-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-05-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-05-31	Disclaimer
Accountancy firm name	2012-05-31	MARTIN, SRARNES & ASSOC.,CPA'S,P.A.
Accountancy firm EIN	2012-05-31	561761202
2011 : GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-05-31	$0
Total transfer of assets to this plan	2011-05-31	$0
Total transfer of assets from this plan	2011-05-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-05-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-05-31	$0
Total income from all sources (including contributions)	2011-05-31	$367,919
Total loss/gain on sale of assets	2011-05-31	$0
Total of all expenses incurred	2011-05-31	$170,565
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-05-31	$169,649
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-05-31	$179,115
Value of total assets at end of year	2011-05-31	$1,448,839
Value of total assets at beginning of year	2011-05-31	$1,251,485
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-05-31	$916
Total interest from all sources	2011-05-31	$15,149
Total dividends received (eg from common stock, registered investment company shares)	2011-05-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-05-31	No
Was this plan covered by a fidelity bond	2011-05-31	No
If this is an individual account plan, was there a blackout period	2011-05-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-05-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-05-31	No
Contributions received from participants	2011-05-31	$95,211
Participant contributions at end of year	2011-05-31	$50,089
Participant contributions at beginning of year	2011-05-31	$36,575
Participant contributions at end of year	2011-05-31	$3,377
Participant contributions at beginning of year	2011-05-31	$3,909
Administrative expenses (other) incurred	2011-05-31	$916
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-05-31	No
Value of net income/loss	2011-05-31	$197,354
Value of net assets at end of year (total assets less liabilities)	2011-05-31	$1,448,839
Value of net assets at beginning of year (total assets less liabilities)	2011-05-31	$1,251,485
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-05-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-05-31	No
Were any leases to which the plan was party in default or uncollectible	2011-05-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-05-31	$988,006
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-05-31	$811,396
Interest on participant loans	2011-05-31	$1,716
Interest earned on other investments	2011-05-31	$13,433
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-05-31	$404,453
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-05-31	$396,459
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-05-31	$173,655
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-05-31	No
Was there a failure to transmit to the plan any participant contributions	2011-05-31	No
Has the plan failed to provide any benefit when due under the plan	2011-05-31	No
Contributions received in cash from employer	2011-05-31	$83,904
Employer contributions (assets) at end of year	2011-05-31	$2,914
Employer contributions (assets) at beginning of year	2011-05-31	$3,146
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-05-31	$169,649
Did the plan have assets held for investment	2011-05-31	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	2011-05-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-05-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-05-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-05-31	Disclaimer
Accountancy firm name	2011-05-31	MARTIN, STARNES & ASSOC.,CPA'S,P.A.
Accountancy firm EIN	2011-05-31	561761202
2010 : GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-05-31	$0

Form 5500 Responses for GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN

2012: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2012 form 5500 responses
2012-06-01	Type of plan entity	Single employer plan
2012-06-01	Submission has been amended	No
2012-06-01	This submission is the final filing	No
2012-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-06-01	Plan is a collectively bargained plan	No
2012-06-01	Plan funding arrangement – Insurance	Yes
2012-06-01	Plan benefit arrangement – Insurance	Yes
2011: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2011 form 5500 responses
2011-06-01	Type of plan entity	Single employer plan
2011-06-01	Submission has been amended	No
2011-06-01	This submission is the final filing	No
2011-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-06-01	Plan is a collectively bargained plan	No
2011-06-01	Plan funding arrangement – Insurance	Yes
2011-06-01	Plan benefit arrangement – Insurance	Yes
2009: GUARDIAN HEALTH SERVICES, LLC RETIREMENT PLAN 2009 form 5500 responses
2009-06-01	Type of plan entity	Single employer plan
2009-06-01	Submission has been amended	No
2009-06-01	This submission is the final filing	No
2009-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-06-01	Plan is a collectively bargained plan	No
2009-06-01	Plan funding arrangement – Insurance	Yes
2009-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

64511

Policy instance

Insurance contract or identification number	64511
Number of Individuals Covered	73
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $1,792
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $1,615
Insurance broker organization code?	3
Insurance broker name	MICHAEL J. SCHULTZ

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

64511

Policy instance

Insurance contract or identification number	64511
Number of Individuals Covered	108
Insurance policy start date	2011-06-01
Insurance policy end date	2012-05-31
Total amount of commissions paid to insurance broker	USD $2,113
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

64511

Policy instance

Insurance contract or identification number	64511
Number of Individuals Covered	119
Insurance policy start date	2010-06-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $2,461
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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

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Company Name:	GUARDIAN HEALTH SERVICES, LLC
Employer identification number (EIN):	752950776
NAIC Classification:	621610
NAIC Description:	Home Health Care Services