401k Plan data: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN plan

FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 401k Plan overview

Plan Name	FOUNTAIN HOUSE 403(B) RETIREMENT PLAN
Plan identification number	002

FOUNTAIN HOUSE 403(B) 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(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.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

FOUNTAIN HOUSE, INC. has sponsored the creation of one or more 401k plans.

Company Name: FOUNTAIN HOUSE, INC.

Employer identification number (EIN): 131624009

NAIC Classification: 624200

Additional information about FOUNTAIN HOUSE, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1948-06-25

Company Identification Number: 71832

Legal Registered Office Address: 425 W. 47TH ST.
New York
NEW YORK
United States of America (USA)
10036

More information about FOUNTAIN HOUSE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUNTAIN HOUSE 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-07-01 LINDA NOSKEWICZ 2023-04-12
002 2020-07-01 LINDA NOSKEWICZ 2022-04-11
002 2019-07-01 PATRICIA LUKAS 2021-04-14
002 2019-07-01 PATRICIA LUKAS 2021-07-16
002 2018-07-01 ANDREW SCHONEBAUM 2020-05-11
002 2017-07-01 KENNETH DUDEK 2019-04-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2021-07-01	LINDA NOSKEWICZ	2023-04-12
002	2020-07-01	LINDA NOSKEWICZ	2022-04-11
002	2019-07-01	PATRICIA LUKAS	2021-04-14
002	2019-07-01	PATRICIA LUKAS	2021-07-16
002	2018-07-01	ANDREW SCHONEBAUM	2020-05-11
002	2017-07-01	KENNETH DUDEK	2019-04-12

Plan Statistics for FOUNTAIN HOUSE 403(B) RETIREMENT PLAN

401k plan membership statisitcs for FOUNTAIN HOUSE 403(B) RETIREMENT PLAN

Measure Date Value
2021: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 249
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 222
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 82
Total of all active and inactive participants 2021-07-01 304
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 304
Number of participants with account balances 2021-07-01 223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 18
2020: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 220
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 193
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 53
Total of all active and inactive participants 2020-07-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 246
Number of participants with account balances 2020-07-01 202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 195
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 184
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 36
Total of all active and inactive participants 2019-07-01 220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 220
Number of participants with account balances 2019-07-01 185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 7
2018: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 172
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 166
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 29
Total of all active and inactive participants 2018-07-01 195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 195
Number of participants with account balances 2018-07-01 159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 12
2017: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 149
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 160
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 12
Total of all active and inactive participants 2017-07-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 172
Number of participants with account balances 2017-07-01 149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 9

Measure	Date	Value
2021: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	249
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	222
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	82
Total of all active and inactive participants	2021-07-01	304
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	304
Number of participants with account balances	2021-07-01	223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	18
2020: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	220
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	193
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	53
Total of all active and inactive participants	2020-07-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	246
Number of participants with account balances	2020-07-01	202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	195
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	184
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	36
Total of all active and inactive participants	2019-07-01	220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	220
Number of participants with account balances	2019-07-01	185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	7
2018: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	172
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	166
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	29
Total of all active and inactive participants	2018-07-01	195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	195
Number of participants with account balances	2018-07-01	159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	12
2017: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	149
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	160
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	12
Total of all active and inactive participants	2017-07-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	172
Number of participants with account balances	2017-07-01	149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	9

Financial Data on FOUNTAIN HOUSE 403(B) RETIREMENT PLAN

Measure	Date	Value
2022 : FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$75,511
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$592,298
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$516,891
Expenses. Certain deemed distributions of participant loans	2022-06-30	$3,682
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$1,250,039
Value of total assets at end of year	2022-06-30	$8,332,924
Value of total assets at beginning of year	2022-06-30	$8,849,711
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$71,725
Total interest from all sources	2022-06-30	$4,646
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$309,809
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$309,809
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$426,788
Participant contributions at end of year	2022-06-30	$19,686
Participant contributions at beginning of year	2022-06-30	$10,178
Participant contributions at end of year	2022-06-30	$20,473
Participant contributions at beginning of year	2022-06-30	$10,940
Income. Received or receivable in cash from other sources (including rollovers)	2022-06-30	$50,158
Other income not declared elsewhere	2022-06-30	$17,996
Administrative expenses (other) incurred	2022-06-30	$71,725
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-516,787
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$8,332,924
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$8,849,711
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$7,763,658
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$8,415,823
Interest on participant loans	2022-06-30	$612
Interest earned on other investments	2022-06-30	$4,034
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$392,051
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$344,217
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-1,506,979
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$773,093
Employer contributions (assets) at end of year	2022-06-30	$137,056
Employer contributions (assets) at beginning of year	2022-06-30	$68,553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$516,891
Did the plan have assets held for investment	2022-06-30	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	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	BDO USA, LLP
Accountancy firm EIN	2022-06-30	135381590
2021 : FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$2,767,403
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$926,700
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$853,030
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$899,231
Value of total assets at end of year	2021-06-30	$8,849,711
Value of total assets at beginning of year	2021-06-30	$7,009,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$73,670
Total interest from all sources	2021-06-30	$4,720
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$196,827
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-06-30	$196,827
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$850,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$206,555
Participant contributions at end of year	2021-06-30	$10,178
Participant contributions at beginning of year	2021-06-30	$7,788
Participant contributions at end of year	2021-06-30	$10,940
Participant contributions at beginning of year	2021-06-30	$7,284
Administrative expenses (other) incurred	2021-06-30	$73,670
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$1,840,703
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$8,849,711
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$7,009,008
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$8,415,823
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$6,609,694
Interest on participant loans	2021-06-30	$441
Interest earned on other investments	2021-06-30	$4,279
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$344,217
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$328,038
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$1,666,625
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$692,676
Employer contributions (assets) at end of year	2021-06-30	$68,553
Employer contributions (assets) at beginning of year	2021-06-30	$56,204
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$853,030
Did the plan have assets held for investment	2021-06-30	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	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	BDO USA, LLP
Accountancy firm EIN	2021-06-30	135381590
2020 : FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$5,588,067
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$156,076
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$123,187
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$5,609,070
Value of total assets at end of year	2020-06-30	$7,009,008
Value of total assets at beginning of year	2020-06-30	$1,577,017
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$32,889
Total interest from all sources	2020-06-30	$2,973
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$65,627
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$65,627
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$850,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$161,285
Participant contributions at end of year	2020-06-30	$7,788
Participant contributions at beginning of year	2020-06-30	$590
Participant contributions at end of year	2020-06-30	$7,284
Participant contributions at beginning of year	2020-06-30	$5,282
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$4,742,791
Administrative expenses (other) incurred	2020-06-30	$32,889
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$5,431,991
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$7,009,008
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$1,577,017
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$6,609,694
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$1,479,677
Interest on participant loans	2020-06-30	$234
Interest earned on other investments	2020-06-30	$2,739
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$328,038
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$65,288
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$-89,603
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$704,994
Employer contributions (assets) at end of year	2020-06-30	$56,204
Employer contributions (assets) at beginning of year	2020-06-30	$26,180
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$123,187
Did the plan have assets held for investment	2020-06-30	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	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	BDO USA, LLP
Accountancy firm EIN	2020-06-30	135381590
2019 : FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$877,149
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$76,786
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$59,561
Expenses. Certain deemed distributions of participant loans	2019-06-30	$3,474
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$785,785
Value of total assets at end of year	2019-06-30	$1,577,017
Value of total assets at beginning of year	2019-06-30	$776,654
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$13,751
Total interest from all sources	2019-06-30	$836
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$35,845
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-06-30	$35,845
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$119,016
Participant contributions at end of year	2019-06-30	$590
Participant contributions at beginning of year	2019-06-30	$0
Participant contributions at end of year	2019-06-30	$5,282
Participant contributions at beginning of year	2019-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$4,321
Administrative expenses (other) incurred	2019-06-30	$13,751
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$800,363
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$1,577,017
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$776,654
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$1,479,677
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$740,630
Interest on participant loans	2019-06-30	$169
Interest earned on other investments	2019-06-30	$667
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$65,288
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$36,024
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$54,683
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$662,448
Employer contributions (assets) at end of year	2019-06-30	$26,180
Employer contributions (assets) at beginning of year	2019-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$59,561
Did the plan have assets held for investment	2019-06-30	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	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	BDO USA, LLP
Accountancy firm EIN	2019-06-30	135381590
2018 : FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$790,511
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$13,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$11,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$777,098
Value of total assets at end of year	2018-06-30	$776,654
Value of total assets at beginning of year	2018-06-30	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$2,721
Total interest from all sources	2018-06-30	$218
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$9,826
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$9,826
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$95,997
Administrative expenses (other) incurred	2018-06-30	$2,721
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$776,654
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$776,654
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$740,630
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$0
Interest earned on other investments	2018-06-30	$218
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$36,024
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$3,369
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$681,101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$11,136
Did the plan have assets held for investment	2018-06-30	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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	BDO USA, LLP
Accountancy firm EIN	2018-06-30	135381590

Form 5500 Responses for FOUNTAIN HOUSE 403(B) RETIREMENT PLAN

2021: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: FOUNTAIN HOUSE 403(B) RETIREMENT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	First time form 5500 has been submitted	Yes
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590146-01

Policy instance

Insurance contract or identification number	590146-01
Number of Individuals Covered	223
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
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	0
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?	Yes
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590146-01

Policy instance

Insurance contract or identification number	590146-01
Number of Individuals Covered	202
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
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	0
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?	Yes
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590146-01

Policy instance

Insurance contract or identification number	590146-01
Number of Individuals Covered	185
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
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	0
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?	Yes
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590146-01

Policy instance

Insurance contract or identification number	590146-01
Number of Individuals Covered	159
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
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	0
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?	Yes
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590146-01

Policy instance

Insurance contract or identification number	590146-01
Number of Individuals Covered	149
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
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	0
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?	Yes
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:	FOUNTAIN HOUSE, INC.
Employer identification number (EIN):	131624009
NAIC Classification:	624200

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1948-06-25
Company Identification Number:	71832
Legal Registered Office Address:	425 W. 47TH ST. New York NEW YORK United States of America (USA) 10036