401k Plan data: SRG OPERATING, INC. HEALTH AND WELFARE PLAN plan

SRG OPERATING, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	SRG OPERATING, INC. HEALTH AND WELFARE PLAN
Plan identification number	501

SRG OPERATING, INC. HEALTH AND WELFARE 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) Other welfare benefit cover

401k Sponsoring company profile

SENIOR RESOURCE GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: SENIOR RESOURCE GROUP, LLC

Employer identification number (EIN): 953310115

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

Additional information about SENIOR RESOURCE GROUP, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 3225289

More information about SENIOR RESOURCE GROUP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SRG OPERATING, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-05-01 FRANK V. LEVETT FRANK V. LEVETT 2015-12-29
501 2013-05-01 FRANK LEVETT FRANK LEVETT 2015-02-02
501 2012-05-01 FRANK LEVETT
501 2011-05-01 FRANK LEVETT
501 2009-05-01 FRANK LEVETT
501 2008-05-01 FRANK LEVETT
501 2007-05-01 FRANK LEVETT
501 2006-05-01 FRANK LEVETT

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-05-01	FRANK V. LEVETT	FRANK V. LEVETT	2015-12-29
501	2013-05-01	FRANK LEVETT	FRANK LEVETT	2015-02-02
501	2012-05-01	FRANK LEVETT
501	2011-05-01	FRANK LEVETT
501	2009-05-01	FRANK LEVETT
501	2008-05-01	FRANK LEVETT
501	2007-05-01	FRANK LEVETT
501	2006-05-01	FRANK LEVETT

Plan Statistics for SRG OPERATING, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for SRG OPERATING, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2014: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-05-01 1,194
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 1,062
Number of retired or separated participants receiving benefits 2014-05-01 6
Number of other retired or separated participants entitled to future benefits 2014-05-01 0
Total of all active and inactive participants 2014-05-01 1,068
2013: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-05-01 1,055
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 1,076
Number of retired or separated participants receiving benefits 2013-05-01 0
Number of other retired or separated participants entitled to future benefits 2013-05-01 0
Total of all active and inactive participants 2013-05-01 1,076
2012: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-05-01 970
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 1,048
Number of retired or separated participants receiving benefits 2012-05-01 7
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 1,055
2011: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-05-01 1,081
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 967
Number of retired or separated participants receiving benefits 2011-05-01 3
Number of other retired or separated participants entitled to future benefits 2011-05-01 0
Total of all active and inactive participants 2011-05-01 970
2009: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-05-01 887
Total number of active participants reported on line 7a of the Form 5500 2009-05-01 909
Number of retired or separated participants receiving benefits 2009-05-01 4
Number of other retired or separated participants entitled to future benefits 2009-05-01 0
Total of all active and inactive participants 2009-05-01 913
2008: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year 2008-05-01 754
Total number of active participants reported on line 7a of the Form 5500 2008-05-01 886
Number of retired or separated participants receiving benefits 2008-05-01 1
Number of other retired or separated participants entitled to future benefits 2008-05-01 0
Total of all active and inactive participants 2008-05-01 887
2007: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year 2007-05-01 418
Total number of active participants reported on line 7a of the Form 5500 2007-05-01 754
Number of retired or separated participants receiving benefits 2007-05-01 0
Number of other retired or separated participants entitled to future benefits 2007-05-01 0
Total of all active and inactive participants 2007-05-01 754
2006: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year 2006-05-01 429
Total number of active participants reported on line 7a of the Form 5500 2006-05-01 418
Number of retired or separated participants receiving benefits 2006-05-01 0
Number of other retired or separated participants entitled to future benefits 2006-05-01 0
Total of all active and inactive participants 2006-05-01 418

Measure	Date	Value
2014: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-05-01	1,194
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	1,062
Number of retired or separated participants receiving benefits	2014-05-01	6
Number of other retired or separated participants entitled to future benefits	2014-05-01	0
Total of all active and inactive participants	2014-05-01	1,068
2013: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-05-01	1,055
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	1,076
Number of retired or separated participants receiving benefits	2013-05-01	0
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	1,076
2012: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-05-01	970
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	1,048
Number of retired or separated participants receiving benefits	2012-05-01	7
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	1,055
2011: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-05-01	1,081
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	967
Number of retired or separated participants receiving benefits	2011-05-01	3
Number of other retired or separated participants entitled to future benefits	2011-05-01	0
Total of all active and inactive participants	2011-05-01	970
2009: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-05-01	887
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	909
Number of retired or separated participants receiving benefits	2009-05-01	4
Number of other retired or separated participants entitled to future benefits	2009-05-01	0
Total of all active and inactive participants	2009-05-01	913
2008: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year	2008-05-01	754
Total number of active participants reported on line 7a of the Form 5500	2008-05-01	886
Number of retired or separated participants receiving benefits	2008-05-01	1
Number of other retired or separated participants entitled to future benefits	2008-05-01	0
Total of all active and inactive participants	2008-05-01	887
2007: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year	2007-05-01	418
Total number of active participants reported on line 7a of the Form 5500	2007-05-01	754
Number of retired or separated participants receiving benefits	2007-05-01	0
Number of other retired or separated participants entitled to future benefits	2007-05-01	0
Total of all active and inactive participants	2007-05-01	754
2006: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year	2006-05-01	429
Total number of active participants reported on line 7a of the Form 5500	2006-05-01	418
Number of retired or separated participants receiving benefits	2006-05-01	0
Number of other retired or separated participants entitled to future benefits	2006-05-01	0
Total of all active and inactive participants	2006-05-01	418

Form 5500 Responses for SRG OPERATING, INC. HEALTH AND WELFARE PLAN

2014: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	No
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2013: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-05-01	Type of plan entity	Single employer plan
2009-05-01	Submission has been amended	No
2009-05-01	This submission is the final filing	No
2009-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-05-01	Plan is a collectively bargained plan	No
2009-05-01	Plan funding arrangement – Insurance	Yes
2009-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-05-01	Plan benefit arrangement – Insurance	Yes
2009-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2008 form 5500 responses
2008-05-01	Type of plan entity	Single employer plan
2008-05-01	Submission has been amended	No
2008-05-01	This submission is the final filing	No
2008-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-05-01	Plan is a collectively bargained plan	No
2008-05-01	Plan funding arrangement – Insurance	Yes
2008-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2008-05-01	Plan benefit arrangement – Insurance	Yes
2008-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2007: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2007 form 5500 responses
2007-05-01	Type of plan entity	Single employer plan
2007-05-01	Submission has been amended	No
2007-05-01	This submission is the final filing	No
2007-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-05-01	Plan is a collectively bargained plan	No
2007-05-01	Plan funding arrangement – Insurance	Yes
2007-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2007-05-01	Plan benefit arrangement – Insurance	Yes
2007-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2006: SRG OPERATING, INC. HEALTH AND WELFARE PLAN 2006 form 5500 responses
2006-05-01	Type of plan entity	Single employer plan
2006-05-01	First time form 5500 has been submitted	Yes
2006-05-01	Submission has been amended	No
2006-05-01	This submission is the final filing	No
2006-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-05-01	Plan is a collectively bargained plan	No
2006-05-01	Plan funding arrangement – Insurance	Yes
2006-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2006-05-01	Plan benefit arrangement – Insurance	Yes
2006-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Potentially related plans

SRG OPERATING, INC. HEALTH AND WELFARE PLAN [EIN = 912160583]

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Company Name:	SENIOR RESOURCE GROUP, LLC
Employer identification number (EIN):	953310115
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	3225289