401k Plan data: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN plan

ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 401k Plan overview

Plan Name	ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN
Plan identification number	001

ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ELDERCARE OF MINNESOTA INC has sponsored the creation of one or more 401k plans.

Company Name: ELDERCARE OF MINNESOTA INC

Employer identification number (EIN): 203549819

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 TIM MATROS
001 2013-01-01 TIM MATROS
001 2012-01-01 TIM MATROS
001 2011-01-01 TIM MATROS
001 2009-01-01 JAMES BIRCHEM JAMES BIRCHEM 2010-08-24
001 2009-01-01 JAMES BIRCHEM JAMES BIRCHEM 2010-08-23
001 2007-01-01 TIM MATROS

Plan Statistics for ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN

401k plan membership statisitcs for ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN

Measure Date Value
2022: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 197
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 67
Total of all active and inactive participants 2022-01-01 265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 265
Number of participants with account balances 2022-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 206
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 64
Total of all active and inactive participants 2021-01-01 270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 270
Number of participants with account balances 2021-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 254
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 218
Number of retired or separated participants receiving benefits 2020-01-01 4
Number of other retired or separated participants entitled to future benefits 2020-01-01 64
Total of all active and inactive participants 2020-01-01 286
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 286
Number of participants with account balances 2020-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 362
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 204
Number of retired or separated participants receiving benefits 2019-01-01 6
Number of other retired or separated participants entitled to future benefits 2019-01-01 54
Total of all active and inactive participants 2019-01-01 264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 264
Number of participants with account balances 2019-01-01 141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 440
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 288
Number of retired or separated participants receiving benefits 2018-01-01 6
Number of other retired or separated participants entitled to future benefits 2018-01-01 68
Total of all active and inactive participants 2018-01-01 362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 362
Number of participants with account balances 2018-01-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 560
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 335
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 86
Total of all active and inactive participants 2017-01-01 421
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 421
Number of participants with account balances 2017-01-01 227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 5
2016: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 736
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 475
Number of retired or separated participants receiving benefits 2016-01-01 4
Number of other retired or separated participants entitled to future benefits 2016-01-01 83
Total of all active and inactive participants 2016-01-01 562
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 562
Number of participants with account balances 2016-01-01 235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 12
2015: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 847
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 675
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 83
Total of all active and inactive participants 2015-01-01 758
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 758
Number of participants with account balances 2015-01-01 295
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 4
2014: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,044
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 707
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 73
Total of all active and inactive participants 2014-01-01 781
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 781
Number of participants with account balances 2014-01-01 296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 14
2013: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,073
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 803
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 231
Total of all active and inactive participants 2013-01-01 1,036
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 1,036
Number of participants with account balances 2013-01-01 519
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 18
2012: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 978
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 857
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 207
Total of all active and inactive participants 2012-01-01 1,064
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1,064
Number of participants with account balances 2012-01-01 537
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 18
2011: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 870
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 945
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 33
Total of all active and inactive participants 2011-01-01 978
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 978
Number of participants with account balances 2011-01-01 363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 11
2009: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 844
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 768
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 47
Total of all active and inactive participants 2009-01-01 815
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 816
Number of participants with account balances 2009-01-01 339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 15
2007: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 289
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 16
Total of all active and inactive participants 2007-01-01 305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 305
Number of participants with account balances 2007-01-01 185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 3

Measure	Date	Value
2022: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	197
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	67
Total of all active and inactive participants	2022-01-01	265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	265
Number of participants with account balances	2022-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	206
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	64
Total of all active and inactive participants	2021-01-01	270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	270
Number of participants with account balances	2021-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	254
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	218
Number of retired or separated participants receiving benefits	2020-01-01	4
Number of other retired or separated participants entitled to future benefits	2020-01-01	64
Total of all active and inactive participants	2020-01-01	286
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	286
Number of participants with account balances	2020-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	362
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	204
Number of retired or separated participants receiving benefits	2019-01-01	6
Number of other retired or separated participants entitled to future benefits	2019-01-01	54
Total of all active and inactive participants	2019-01-01	264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	264
Number of participants with account balances	2019-01-01	141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	440
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	288
Number of retired or separated participants receiving benefits	2018-01-01	6
Number of other retired or separated participants entitled to future benefits	2018-01-01	68
Total of all active and inactive participants	2018-01-01	362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	362
Number of participants with account balances	2018-01-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	560
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	335
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	86
Total of all active and inactive participants	2017-01-01	421
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	421
Number of participants with account balances	2017-01-01	227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	5
2016: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	736
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	475
Number of retired or separated participants receiving benefits	2016-01-01	4
Number of other retired or separated participants entitled to future benefits	2016-01-01	83
Total of all active and inactive participants	2016-01-01	562
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	562
Number of participants with account balances	2016-01-01	235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	12
2015: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	847
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	675
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	83
Total of all active and inactive participants	2015-01-01	758
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	758
Number of participants with account balances	2015-01-01	295
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	4
2014: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,044
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	707
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	73
Total of all active and inactive participants	2014-01-01	781
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	781
Number of participants with account balances	2014-01-01	296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	14
2013: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,073
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	803
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	231
Total of all active and inactive participants	2013-01-01	1,036
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	1,036
Number of participants with account balances	2013-01-01	519
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	18
2012: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	978
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	857
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	207
Total of all active and inactive participants	2012-01-01	1,064
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1,064
Number of participants with account balances	2012-01-01	537
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	18
2011: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	870
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	945
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	33
Total of all active and inactive participants	2011-01-01	978
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	978
Number of participants with account balances	2011-01-01	363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	11
2009: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	844
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	768
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	47
Total of all active and inactive participants	2009-01-01	815
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	816
Number of participants with account balances	2009-01-01	339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	15
2007: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	289
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	16
Total of all active and inactive participants	2007-01-01	305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	305
Number of participants with account balances	2007-01-01	185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	3

Financial Data on ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN

Measure	Date	Value
2022 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$9,311
Total income from all sources (including contributions)	2022-12-31	$-342,451
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$425,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$421,953
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$329,026
Value of total assets at end of year	2022-12-31	$3,108,581
Value of total assets at beginning of year	2022-12-31	$3,885,774
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$3,478
Total interest from all sources	2022-12-31	$308
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$450,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$212,796
Participant contributions at end of year	2022-12-31	$4,409
Participant contributions at beginning of year	2022-12-31	$9,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-767,882
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,108,581
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,876,463
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in pooled separate accounts at end of year	2022-12-31	$3,093,415
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$3,872,229
Interest on participant loans	2022-12-31	$308
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$10,757
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$4,482
Net investment gain/loss from pooled separate accounts	2022-12-31	$-671,785
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$116,230
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$421,953
Contract administrator fees	2022-12-31	$3,478
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$9,311
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2022-12-31	411656121
2021 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 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	$9,311
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	$726,830
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$693,062
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$689,212
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$360,439
Value of total assets at end of year	2021-12-31	$3,885,774
Value of total assets at beginning of year	2021-12-31	$3,842,695
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$3,850
Total interest from all sources	2021-12-31	$852
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	$450,000
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	$227,305
Participant contributions at end of year	2021-12-31	$9,063
Participant contributions at beginning of year	2021-12-31	$20,261
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$33,768
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,876,463
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,842,695
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
Value of interest in pooled separate accounts at end of year	2021-12-31	$3,872,229
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,821,825
Interest on participant loans	2021-12-31	$852
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$4,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$609
Net investment gain/loss from pooled separate accounts	2021-12-31	$365,539
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	No
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	$133,134
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$689,212
Contract administrator fees	2021-12-31	$3,850
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$9,311
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
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	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2021-12-31	411656121
2020 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$733,641
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$752,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$750,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$303,116
Value of total assets at end of year	2020-12-31	$3,842,695
Value of total assets at beginning of year	2020-12-31	$3,861,821
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,220
Total interest from all sources	2020-12-31	$767
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$2,150
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$450,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$187,211
Participant contributions at end of year	2020-12-31	$20,261
Participant contributions at beginning of year	2020-12-31	$19,696
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	$-19,126
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,842,695
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,861,821
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	$3,821,825
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$3,841,565
Interest on participant loans	2020-12-31	$767
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$609
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$560
Net investment gain/loss from pooled separate accounts	2020-12-31	$429,758
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	No
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	$115,905
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$750,547
Contract administrator fees	2020-12-31	$70
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	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2020-12-31	411656121
2019 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$1,090
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$1,090
Total income from all sources (including contributions)	2019-12-31	$925,919
Total income from all sources (including contributions)	2019-12-31	$925,919
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$557,889
Total of all expenses incurred	2019-12-31	$557,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$548,699
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$548,699
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$322,832
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$322,832
Value of total assets at end of year	2019-12-31	$3,861,821
Value of total assets at end of year	2019-12-31	$3,861,821
Value of total assets at beginning of year	2019-12-31	$3,494,881
Value of total assets at beginning of year	2019-12-31	$3,494,881
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,190
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,190
Total interest from all sources	2019-12-31	$2,285
Total interest from all sources	2019-12-31	$2,285
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
Administrative expenses professional fees incurred	2019-12-31	$4,130
Administrative expenses professional fees incurred	2019-12-31	$4,130
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	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
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	$201,782
Contributions received from participants	2019-12-31	$201,782
Participant contributions at end of year	2019-12-31	$19,696
Participant contributions at end of year	2019-12-31	$19,696
Participant contributions at beginning of year	2019-12-31	$66,693
Participant contributions at beginning of year	2019-12-31	$66,693
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	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	$368,030
Value of net income/loss	2019-12-31	$368,030
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,861,821
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,861,821
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,493,791
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,493,791
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 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	$3,841,565
Value of interest in pooled separate accounts at end of year	2019-12-31	$3,841,565
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,423,385
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,423,385
Interest on participant loans	2019-12-31	$2,285
Interest on participant loans	2019-12-31	$2,285
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$560
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$560
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$4,803
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$4,803
Net investment gain/loss from pooled separate accounts	2019-12-31	$600,802
Net investment gain/loss from pooled separate accounts	2019-12-31	$600,802
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	$121,050
Contributions received in cash from employer	2019-12-31	$121,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$548,699
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$548,699
Contract administrator fees	2019-12-31	$5,060
Contract administrator fees	2019-12-31	$5,060
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$1,090
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$1,090
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	SCHLENNER WENNER AND CO.
Accountancy firm name	2019-12-31	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2019-12-31	411656121
Accountancy firm EIN	2019-12-31	411656121
2018 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$1,090
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$164,137
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,209,670
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,196,174
Value of total corrective distributions	2018-12-31	$3,773
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$362,259
Value of total assets at end of year	2018-12-31	$3,494,881
Value of total assets at beginning of year	2018-12-31	$4,539,324
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$9,723
Total interest from all sources	2018-12-31	$3,546
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
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
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	$213,164
Participant contributions at end of year	2018-12-31	$66,693
Participant contributions at beginning of year	2018-12-31	$84,823
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,337
Other income not declared elsewhere	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	$-1,045,533
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,493,791
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,539,324
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	$3,423,385
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$4,449,455
Interest on participant loans	2018-12-31	$3,546
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$4,803
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$5,046
Net investment gain/loss from pooled separate accounts	2018-12-31	$-201,668
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	No
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	$147,758
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,196,174
Contract administrator fees	2018-12-31	$9,723
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$1,090
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
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	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2018-12-31	411656121
2017 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$16,236
Total income from all sources (including contributions)	2017-12-31	$1,191,334
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$517,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$496,987
Expenses. Certain deemed distributions of participant loans	2017-12-31	$14,744
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$685,248
Value of total assets at end of year	2017-12-31	$4,539,324
Value of total assets at beginning of year	2017-12-31	$3,881,914
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,957
Total interest from all sources	2017-12-31	$5,141
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
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
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	$300,948
Participant contributions at end of year	2017-12-31	$84,823
Participant contributions at beginning of year	2017-12-31	$74,173
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$172,395
Other income not declared elsewhere	2017-12-31	$992
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	$673,646
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,539,324
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,865,678
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 pooled separate accounts at end of year	2017-12-31	$4,449,455
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$3,804,578
Interest on participant loans	2017-12-31	$5,141
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$5,046
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$3,163
Net investment gain/loss from pooled separate accounts	2017-12-31	$499,953
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	$211,905
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$496,987
Contract administrator fees	2017-12-31	$5,957
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$16,236
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	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2017-12-31	411656121
2016 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$16,236
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,112,397
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,432,264
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,405,536
Expenses. Certain deemed distributions of participant loans	2016-12-31	$953
Value of total corrective distributions	2016-12-31	$5,963
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$777,660
Value of total assets at end of year	2016-12-31	$3,881,914
Value of total assets at beginning of year	2016-12-31	$5,185,545
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$19,812
Total interest from all sources	2016-12-31	$5,118
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
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
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	$435,559
Participant contributions at end of year	2016-12-31	$74,173
Participant contributions at beginning of year	2016-12-31	$113,145
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$17,065
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	$-1,319,867
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,865,678
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$5,185,545
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
Value of interest in pooled separate accounts at end of year	2016-12-31	$3,804,578
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$5,069,878
Interest on participant loans	2016-12-31	$5,118
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$3,163
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,522
Net investment gain/loss from pooled separate accounts	2016-12-31	$329,619
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	$325,036
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,405,536
Contract administrator fees	2016-12-31	$19,812
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$16,236
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
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	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2016-12-31	411656121
2015 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$723,988
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$830,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$795,348
Expenses. Certain deemed distributions of participant loans	2015-12-31	$2,362
Value of total corrective distributions	2015-12-31	$8,312
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$816,455
Value of total assets at end of year	2015-12-31	$5,185,545
Value of total assets at beginning of year	2015-12-31	$5,291,927
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$24,348
Total interest from all sources	2015-12-31	$4,441
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$420,349
Participant contributions at end of year	2015-12-31	$113,145
Participant contributions at beginning of year	2015-12-31	$85,070
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$108,636
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-106,382
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,185,545
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,291,927
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$5,069,878
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$5,181,426
Interest on participant loans	2015-12-31	$4,441
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,522
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$25,431
Net investment gain/loss from pooled separate accounts	2015-12-31	$-96,908
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$287,470
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$795,348
Contract administrator fees	2015-12-31	$24,348
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	SCHLENNER WENNER AND CO.
Accountancy firm EIN	2015-12-31	411656121
2014 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,163,198
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,639,094
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,605,789
Value of total corrective distributions	2014-12-31	$2,383
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$875,696
Value of total assets at end of year	2014-12-31	$5,291,927
Value of total assets at beginning of year	2014-12-31	$5,767,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$30,922
Total interest from all sources	2014-12-31	$4,003
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$460,980
Participant contributions at end of year	2014-12-31	$85,070
Participant contributions at beginning of year	2014-12-31	$68,334
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$105,262
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-475,896
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,291,927
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,767,823
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$5,181,426
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$5,699,489
Interest on participant loans	2014-12-31	$4,003
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$25,431
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Net investment gain/loss from pooled separate accounts	2014-12-31	$283,499
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$309,454
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,605,789
Contract administrator fees	2014-12-31	$30,922
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	EIDE BAILLY
Accountancy firm EIN	2014-12-31	450250958
2013 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,379,292
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,183,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,172,634
Value of total corrective distributions	2013-12-31	$4,824
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$797,133
Value of total assets at end of year	2013-12-31	$5,767,823
Value of total assets at beginning of year	2013-12-31	$5,571,825
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$5,836
Total interest from all sources	2013-12-31	$4,231
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$468,675
Participant contributions at end of year	2013-12-31	$68,334
Participant contributions at beginning of year	2013-12-31	$94,149
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$3,593
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$195,998
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,767,823
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,571,825
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$5,699,489
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$5,477,676
Interest on participant loans	2013-12-31	$4,231
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$577,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$324,865
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,172,634
Contract administrator fees	2013-12-31	$5,836
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	EIDE BAILLY
Accountancy firm EIN	2013-12-31	450250958
2012 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,393,455
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$922,498
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$916,062
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$910,621
Value of total assets at end of year	2012-12-31	$5,571,825
Value of total assets at beginning of year	2012-12-31	$5,100,868
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,436
Total interest from all sources	2012-12-31	$3,795
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$529,475
Participant contributions at end of year	2012-12-31	$94,149
Participant contributions at beginning of year	2012-12-31	$74,702
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$60,583
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$470,957
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,571,825
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,100,868
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$5,477,676
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$4,953,427
Interest on participant loans	2012-12-31	$3,795
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$479,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$320,563
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$72,739
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$916,062
Contract administrator fees	2012-12-31	$6,436
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	EIDE BAILLY
Accountancy firm EIN	2012-12-31	450250958
2011 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$907,780
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$574,165
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$572,293
Value of total corrective distributions	2011-12-31	$1,629
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$896,673
Value of total assets at end of year	2011-12-31	$5,100,868
Value of total assets at beginning of year	2011-12-31	$4,767,253
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$243
Total interest from all sources	2011-12-31	$3,212
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$532,813
Participant contributions at end of year	2011-12-31	$74,702
Participant contributions at beginning of year	2011-12-31	$56,636
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$2,992
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$9,645
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$17,414
Liabilities. Value of operating payables at end of year	2011-12-31	$0
Liabilities. Value of operating payables at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$333,615
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,100,868
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,767,253
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$3,839,585
Value of interest in pooled separate accounts at end of year	2011-12-31	$4,953,427
Interest on participant loans	2011-12-31	$3,212
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$847,129
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$7,895
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$354,215
Employer contributions (assets) at end of year	2011-12-31	$72,739
Employer contributions (assets) at beginning of year	2011-12-31	$3,497
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$572,293
Contract administrator fees	2011-12-31	$243
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	EIDE BAILLY
Accountancy firm EIN	2011-12-31	450250958
2010 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2010 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$115,350
Total income from all sources (including contributions)	2010-12-31	$1,526,519
Total of all expenses incurred	2010-12-31	$136,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$134,781
Value of total corrective distributions	2010-12-31	$1,880
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,070,876
Value of total assets at end of year	2010-12-31	$4,767,253
Value of total assets at beginning of year	2010-12-31	$3,492,745
Total interest from all sources	2010-12-31	$33,139
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$559,983
Participant contributions at end of year	2010-12-31	$56,636
Participant contributions at beginning of year	2010-12-31	$33,138
Participant contributions at end of year	2010-12-31	$2,992
Participant contributions at beginning of year	2010-12-31	$49,148
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$124,629
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$17,414
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,389,858
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,767,253
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,377,395
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,839,585
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,650,095
Interest on participant loans	2010-12-31	$2,090
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$31,049
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$847,129
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$712,063
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$422,504
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$386,264
Employer contributions (assets) at end of year	2010-12-31	$3,497
Employer contributions (assets) at beginning of year	2010-12-31	$48,301
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$134,781
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$115,350
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2010-12-31	450250958
2009 : ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN

2022: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 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 funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
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: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
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: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
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: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
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: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2007: ELDERCARE OF MINNESOTA EMPLOYEES RETIREMENT PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	Yes
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	149
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,081
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
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2390
Additional information about fees paid to insurance broker	TPA FEES PAID
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	152
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,985
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
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	3090
Additional information about fees paid to insurance broker	TPA FEES PAID
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	161
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,911
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
Amount paid for insurance broker fees	3911
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	144
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $6,449
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
Amount paid for insurance broker fees	6449
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	171
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $9,252
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
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	9252
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	328
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,245
Total amount of fees paid to insurance company	USD $6,441
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
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	6441
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5
Insurance broker name	EDWARD D. JONES & COMPANY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	390
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $12,999
Total amount of fees paid to insurance company	USD $9,697
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Commission paid to Insurance Broker	USD $12,999
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	FINANCIAL ADVISOR
Insurance broker organization code?	3
Insurance broker name	UNIVERSAL RETIREMENT SOLUTIONS, INC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	393
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $31,183
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Amount paid for insurance broker fees	17273
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5
Insurance broker name	EDWARD D. JONES & COMPANY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	529
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $22,338
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Amount paid for insurance broker fees	14181
Additional information about fees paid to insurance broker	FINANCIAL ADVISOR
Insurance broker organization code?	3
Insurance broker name	UNIVERSAL RETIREMENT SOLUTIONS, INC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	542
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $13,572
Total amount of fees paid to insurance company	USD $23,436
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Amount paid for insurance broker fees	23436
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATOR
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $13,572
Insurance broker name	EDWARD D. JONES & COMPANY

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G91659

Policy instance

Insurance contract or identification number	G91659
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-05
Total amount of commissions paid to insurance broker	USD $13,643
Total amount of fees paid to insurance company	USD $4,827
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

103044

Policy instance

Insurance contract or identification number	103044
Number of Individuals Covered	380
Insurance policy start date	2011-11-28
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $49,362
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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?	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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G91659

Policy instance

Insurance contract or identification number	G91659
Number of Individuals Covered	339
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $19,076
Total amount of fees paid to insurance company	USD $3,709
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ELDERCARE OF MINNESOTA INC
Employer identification number (EIN):	203549819
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities