401k Plan data: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST plan

LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

LANTERN COMMUNITY SERVICES has sponsored the creation of one or more 401k plans.

Company Name: LANTERN COMMUNITY SERVICES

Employer identification number (EIN): 133910692

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about LANTERN COMMUNITY SERVICES

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1996-04-10

Company Identification Number: 2018684

Legal Registered Office Address: LAURA LAZARUS
494 EIGHTH AVENUE, 20TH FLOOR
NEW YORK
United States of America (USA)
10001

More information about LANTERN COMMUNITY SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2018-01-01
001 2017-01-01 LISA STEIN
001 2016-01-01 LISA STEIN
001 2015-01-01 LAURA LAZARUS 2016-05-09
001 2014-01-01 PETER MATARAZZO 2015-07-28
001 2013-01-01 PETER MATARAZZO-LANTERN COMM. SVC. 2014-10-09
001 2012-01-01 LANTERN COMMUNITY SERVICES INC 2013-07-08
001 2011-01-01 LANTERN COMMUNITY SERVICES INC 2012-07-26
001 2010-01-01 LANTERN COMMUNITY SERVICES INC 2012-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2018-01-01
001	2017-01-01	LISA STEIN
001	2016-01-01	LISA STEIN
001	2015-01-01	LAURA LAZARUS	2016-05-09
001	2014-01-01	PETER MATARAZZO	2015-07-28
001	2013-01-01	PETER MATARAZZO-LANTERN COMM. SVC.	2014-10-09
001	2012-01-01	LANTERN COMMUNITY SERVICES INC	2013-07-08
001	2011-01-01	LANTERN COMMUNITY SERVICES INC	2012-07-26
001	2010-01-01	LANTERN COMMUNITY SERVICES INC	2012-07-26

Plan Statistics for LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2021: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 247
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 104
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 43
Total of all active and inactive participants 2021-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 147
Number of participants with account balances 2021-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 211
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 35
Total of all active and inactive participants 2020-01-01 247
Total participants 2020-01-01 247
Number of participants with account balances 2020-01-01 114
2019: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 168
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 33
Total of all active and inactive participants 2019-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 201
Number of participants with account balances 2019-01-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 116
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 28
Total of all active and inactive participants 2018-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 144
Number of participants with account balances 2018-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 114
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 27
Total of all active and inactive participants 2017-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 141
Number of participants with account balances 2017-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 119
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 18
Total of all active and inactive participants 2016-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 137
Number of participants with account balances 2016-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2021: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	247
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	104
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	43
Total of all active and inactive participants	2021-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	147
Number of participants with account balances	2021-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	211
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	35
Total of all active and inactive participants	2020-01-01	247
Total participants	2020-01-01	247
Number of participants with account balances	2020-01-01	114
2019: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	168
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	33
Total of all active and inactive participants	2019-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	201
Number of participants with account balances	2019-01-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	116
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	28
Total of all active and inactive participants	2018-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	144
Number of participants with account balances	2018-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	114
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	27
Total of all active and inactive participants	2017-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	141
Number of participants with account balances	2017-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	119
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	18
Total of all active and inactive participants	2016-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	137
Number of participants with account balances	2016-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2021 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,187,460
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$446,015
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$412,191
Expenses. Certain deemed distributions of participant loans	2021-12-31	$6,764
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$842,866
Value of total assets at end of year	2021-12-31	$3,255,489
Value of total assets at beginning of year	2021-12-31	$2,514,044
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$27,060
Total interest from all sources	2021-12-31	$3,717
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$181,376
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$372,314
Participant contributions at end of year	2021-12-31	$82,818
Participant contributions at beginning of year	2021-12-31	$70,371
Participant contributions at end of year	2021-12-31	$33,867
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$291,613
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$3,556
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$2,104
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$741,445
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,255,489
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,514,044
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$1,018
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$3,008,258
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$2,434,019
Interest on participant loans	2021-12-31	$3,452
Interest earned on other investments	2021-12-31	$265
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$9,654
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$9,654
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$114,107
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$218,826
Net investment gain/loss from pooled separate accounts	2021-12-31	$122,051
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$178,939
Employer contributions (assets) at end of year	2021-12-31	$16,439
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$408,635
Contract administrator fees	2021-12-31	$23,938
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2021-12-31	141567343
2020 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$863,621
Total of all expenses incurred	2020-12-31	$163,339
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$138,304
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$541,962
Value of total assets at end of year	2020-12-31	$2,514,044
Value of total assets at beginning of year	2020-12-31	$1,813,762
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$25,035
Total interest from all sources	2020-12-31	$3,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$181,376
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$357,387
Participant contributions at end of year	2020-12-31	$70,371
Participant contributions at beginning of year	2020-12-31	$69,435
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$13,233
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$700,282
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,514,044
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,813,762
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$2,434,019
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,734,686
Interest on participant loans	2020-12-31	$3,736
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$9,654
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$9,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$9,641
Net investment gain/loss from pooled separate accounts	2020-12-31	$317,923
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$171,342
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$138,304
Contract administrator fees	2020-12-31	$25,035
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2020-12-31	141567343
2019 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$826,888
Total income from all sources (including contributions)	2019-12-31	$826,888
Total of all expenses incurred	2019-12-31	$36,468
Total of all expenses incurred	2019-12-31	$36,468
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$18,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$18,581
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$566,590
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$566,590
Value of total assets at end of year	2019-12-31	$1,813,762
Value of total assets at end of year	2019-12-31	$1,813,762
Value of total assets at beginning of year	2019-12-31	$1,023,342
Value of total assets at beginning of year	2019-12-31	$1,023,342
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$17,887
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$17,887
Total interest from all sources	2019-12-31	$2,189
Total interest from all sources	2019-12-31	$2,189
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$200,000
Value of fidelity bond cover	2019-12-31	$200,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$285,324
Contributions received from participants	2019-12-31	$285,324
Participant contributions at end of year	2019-12-31	$69,435
Participant contributions at end of year	2019-12-31	$69,435
Participant contributions at beginning of year	2019-12-31	$36,383
Participant contributions at beginning of year	2019-12-31	$36,383
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$156,221
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$156,221
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$790,420
Value of net income/loss	2019-12-31	$790,420
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,813,762
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,813,762
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,023,342
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,023,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,734,686
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,734,686
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$977,318
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$977,318
Interest on participant loans	2019-12-31	$2,189
Interest on participant loans	2019-12-31	$2,189
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$9,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$9,641
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$9,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$9,641
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$9,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$9,641
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$258,109
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$258,109
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$125,045
Contributions received in cash from employer	2019-12-31	$125,045
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$18,581
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$18,581
Contract administrator fees	2019-12-31	$17,887
Contract administrator fees	2019-12-31	$17,887
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MARVIN AND COMPANY P.C.
Accountancy firm name	2019-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2019-12-31	141567343
Accountancy firm EIN	2019-12-31	141567343
2018 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$288,849
Total of all expenses incurred	2018-12-31	$295,450
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$286,018
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$357,661
Value of total assets at end of year	2018-12-31	$1,023,342
Value of total assets at beginning of year	2018-12-31	$1,029,943
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$9,432
Total interest from all sources	2018-12-31	$3,110
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$200,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$213,852
Participant contributions at end of year	2018-12-31	$36,383
Participant contributions at beginning of year	2018-12-31	$67,700
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$10,539
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$41,374
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-6,601
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,023,342
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,029,943
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$977,318
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$938,789
Interest on participant loans	2018-12-31	$3,110
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$9,641
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$8,285
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$8,285
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-71,922
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$102,435
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$4,630
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$286,018
Contract administrator fees	2018-12-31	$9,432
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2018-12-31	141567343
2017 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$510,704
Total of all expenses incurred	2017-12-31	$327,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$327,013
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$397,404
Value of total assets at end of year	2017-12-31	$1,029,943
Value of total assets at beginning of year	2017-12-31	$846,252
Total interest from all sources	2017-12-31	$2,635
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$216,713
Participant contributions at end of year	2017-12-31	$67,700
Participant contributions at beginning of year	2017-12-31	$31,809
Participant contributions at end of year	2017-12-31	$10,539
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$74,593
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$183,691
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,029,943
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$846,252
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$938,789
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$806,158
Interest on participant loans	2017-12-31	$2,635
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$8,285
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$8,285
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$8,285
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$110,665
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$106,098
Employer contributions (assets) at end of year	2017-12-31	$4,630
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$327,013
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2017-12-31	141567343
2016 : LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$430,215
Total of all expenses incurred	2016-12-31	$237,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$214,912
Expenses. Certain deemed distributions of participant loans	2016-12-31	$4,773
Value of total corrective distributions	2016-12-31	$15,283
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$369,050
Value of total assets at end of year	2016-12-31	$846,252
Value of total assets at beginning of year	2016-12-31	$653,861
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,856
Total interest from all sources	2016-12-31	$1,178
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$152,001
Participant contributions at end of year	2016-12-31	$31,809
Participant contributions at beginning of year	2016-12-31	$30,782
Participant contributions at end of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$91,811
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$8,285
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$192,391
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$846,252
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$653,861
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$2,856
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Value of interest in pooled separate accounts at end of year	2016-12-31	$806,158
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$623,079
Interest on participant loans	2016-12-31	$1,178
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$8,285
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$51,702
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$125,238
Employer contributions (assets) at end of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$214,912
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MARVIN AND COMPANY P.C.
Accountancy firm EIN	2016-12-31	141567343

Form 5500 Responses for LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST

2021: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: LANTERN COMMUNITY SERVICES INC 401(K) PROFIT SHARING PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

062664H

Policy instance

Insurance contract or identification number	062664H
Number of Individuals Covered	147
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

Policy instance

Number of Individuals Covered	128
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $9,468
Total amount of fees paid to insurance company	USD $2,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,468
Insurance broker organization code?	3
Amount paid for insurance broker fees	2634

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $6,758
Total amount of fees paid to insurance company	USD $1,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,758
Insurance broker organization code?	3
Amount paid for insurance broker fees	1958

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

Policy instance

Number of Individuals Covered	93
Total amount of commissions paid to insurance broker	USD $5,367
Total amount of fees paid to insurance company	USD $950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,194
Insurance broker organization code?	3
Amount paid for insurance broker fees	950

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

Policy instance

Number of Individuals Covered	89
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,304
Total amount of fees paid to insurance company	USD $1,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,304
Insurance broker organization code?	3
Amount paid for insurance broker fees	1881
Insurance broker name	INTAC ACTUARIAL SERVICES,

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Company Name:	LANTERN COMMUNITY SERVICES
Employer identification number (EIN):	133910692
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1996-04-10
Company Identification Number:	2018684
Legal Registered Office Address:	LAURA LAZARUS 494 EIGHTH AVENUE, 20TH FLOOR NEW YORK United States of America (USA) 10001