401k Plan data: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN plan

GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN
Plan identification number	501

GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name: GOOD NEIGHBOR CARE CENTERS, LLC

Employer identification number (EIN): 931272851

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

Additional information about GOOD NEIGHBOR CARE CENTERS, LLC

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 1999-02-26

Company Identification Number: 67755083

Legal Registered Office Address: 1127 BROADWAY STREET NE STE 310

SALEM
United States of America (USA)
97301

More information about GOOD NEIGHBOR CARE CENTERS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-09-01
501 2016-09-01 KEVIN GROOMES 2019-02-07
501 2015-09-01 KEVIN GROOMES
501 2014-09-01 KEVIN GROOMES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2016-09-01
501	2016-09-01	KEVIN GROOMES	2019-02-07
501	2015-09-01	KEVIN GROOMES
501	2014-09-01	KEVIN GROOMES

Plan Statistics for GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN

Measure Date Value
2016: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-09-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-09-01 68
Number of retired or separated participants receiving benefits 2016-09-01 0
Number of other retired or separated participants entitled to future benefits 2016-09-01 0
Total of all active and inactive participants 2016-09-01 68
Number of employers contributing to the scheme 2016-09-01 0
2015: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-09-01 157
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 128
Number of retired or separated participants receiving benefits 2015-09-01 1
Number of other retired or separated participants entitled to future benefits 2015-09-01 0
Total of all active and inactive participants 2015-09-01 129
2014: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-09-01 265
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 150
Number of retired or separated participants receiving benefits 2014-09-01 7
Number of other retired or separated participants entitled to future benefits 2014-09-01 0
Total of all active and inactive participants 2014-09-01 157

Measure	Date	Value
2016: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-09-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-09-01	68
Number of retired or separated participants receiving benefits	2016-09-01	0
Number of other retired or separated participants entitled to future benefits	2016-09-01	0
Total of all active and inactive participants	2016-09-01	68
Number of employers contributing to the scheme	2016-09-01	0
2015: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-09-01	157
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	128
Number of retired or separated participants receiving benefits	2015-09-01	1
Number of other retired or separated participants entitled to future benefits	2015-09-01	0
Total of all active and inactive participants	2015-09-01	129
2014: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-09-01	265
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	150
Number of retired or separated participants receiving benefits	2014-09-01	7
Number of other retired or separated participants entitled to future benefits	2014-09-01	0
Total of all active and inactive participants	2014-09-01	157

Form 5500 Responses for GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN

2016: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-09-01	Type of plan entity	Single employer plan
2016-09-01	Submission has been amended	No
2016-09-01	This submission is the final filing	No
2016-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-09-01	Plan is a collectively bargained plan	No
2016-09-01	Plan funding arrangement – Insurance	Yes
2016-09-01	Plan benefit arrangement – Insurance	Yes
2015: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	Submission has been amended	No
2015-09-01	This submission is the final filing	No
2015-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-09-01	Plan is a collectively bargained plan	No
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2014: GOOD NEIGHBOR CARE CENTERS EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	Submission has been amended	No
2014-09-01	This submission is the final filing	No
2014-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-09-01	Plan is a collectively bargained plan	No
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	GOOD NEIGHBOR CARE CENTERS, LLC
Employer identification number (EIN):	931272851
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	1999-02-26
Company Identification Number:	67755083
Legal Registered Office Address:	1127 BROADWAY STREET NE STE 310 SALEM United States of America (USA) 97301