401k Plan data: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. plan

401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 401k Plan overview

Plan Name	401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.
Plan identification number	003

401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

VISITING HEALTH SERVICES OF NEW JER SEY, INC. has sponsored the creation of one or more 401k plans.

Company Name: VISITING HEALTH SERVICES OF NEW JER SEY, INC.

Employer identification number (EIN): 222003429

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-07-01 MARYANNE VOAG 2019-04-01
003 2016-07-01 MARYANNE VOAG, DIRECTOR OF HR MARYANNE VOAG, DIRECTOR OF HR 2018-04-17
003 2015-07-01 MARYANNE VOAG
003 2014-07-01 MARYANNE VOAG
003 2014-07-01 MARYANNE VOAG
003 2013-07-01 MARYANNE VOAG ARTHUR KLEPPER 2015-04-15
003 2012-07-01 MARYANNE VOAG ARTHUR KLEPPER 2014-03-24
003 2011-07-01 MARYANNE VOAG ARTHUR KLEPPER 2013-02-25
003 2010-07-01 MARYANNE VOAG ARTHUR KLEPPER 2012-04-06
003 2009-07-01 MARYANNE VOAG ARTHUR KLEPPER 2011-02-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2017-07-01	MARYANNE VOAG	2019-04-01
003	2016-07-01	MARYANNE VOAG, DIRECTOR OF HR		MARYANNE VOAG, DIRECTOR OF HR	2018-04-17
003	2015-07-01	MARYANNE VOAG
003	2014-07-01	MARYANNE VOAG
003	2014-07-01	MARYANNE VOAG
003	2013-07-01	MARYANNE VOAG		ARTHUR KLEPPER	2015-04-15
003	2012-07-01	MARYANNE VOAG		ARTHUR KLEPPER	2014-03-24
003	2011-07-01	MARYANNE VOAG		ARTHUR KLEPPER	2013-02-25
003	2010-07-01	MARYANNE VOAG		ARTHUR KLEPPER	2012-04-06
003	2009-07-01	MARYANNE VOAG		ARTHUR KLEPPER	2011-02-07

Plan Statistics for 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.

401k plan membership statisitcs for 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.

Measure Date Value
2016: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2016 401k membership
Total participants, beginning-of-year 2016-07-01 129
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 16
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 49
Total of all active and inactive participants 2016-07-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 65
Number of participants with account balances 2016-07-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 29
2015: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2015 401k membership
Total participants, beginning-of-year 2015-07-01 119
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 95
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 34
Total of all active and inactive participants 2015-07-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 129
Number of participants with account balances 2015-07-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 9
2014: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2014 401k membership
Total participants, beginning-of-year 2014-07-01 129
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 82
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 37
Total of all active and inactive participants 2014-07-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 119
Number of participants with account balances 2014-07-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 11
2013: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2013 401k membership
Total participants, beginning-of-year 2013-07-01 133
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 88
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 41
Total of all active and inactive participants 2013-07-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 129
Number of participants with account balances 2013-07-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 5
2012: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2012 401k membership
Total participants, beginning-of-year 2012-07-01 133
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 92
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 41
Total of all active and inactive participants 2012-07-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 133
Number of participants with account balances 2012-07-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 6
2011: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2011 401k membership
Total participants, beginning-of-year 2011-07-01 127
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 93
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 40
Total of all active and inactive participants 2011-07-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 133
Number of participants with account balances 2011-07-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 5
2010: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2010 401k membership
Total participants, beginning-of-year 2010-07-01 134
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 89
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 37
Total of all active and inactive participants 2010-07-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 1
Total participants 2010-07-01 127
Number of participants with account balances 2010-07-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 7
2009: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2009 401k membership
Total participants, beginning-of-year 2009-07-01 137
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 96
Number of retired or separated participants receiving benefits 2009-07-01 1
Number of other retired or separated participants entitled to future benefits 2009-07-01 36
Total of all active and inactive participants 2009-07-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 1
Total participants 2009-07-01 134
Number of participants with account balances 2009-07-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 4

Measure	Date	Value
2016: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2016 401k membership
Total participants, beginning-of-year	2016-07-01	129
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	16
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	49
Total of all active and inactive participants	2016-07-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	65
Number of participants with account balances	2016-07-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	29
2015: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2015 401k membership
Total participants, beginning-of-year	2015-07-01	119
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	95
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	34
Total of all active and inactive participants	2015-07-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	129
Number of participants with account balances	2015-07-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	9
2014: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2014 401k membership
Total participants, beginning-of-year	2014-07-01	129
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	82
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	37
Total of all active and inactive participants	2014-07-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	119
Number of participants with account balances	2014-07-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	11
2013: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2013 401k membership
Total participants, beginning-of-year	2013-07-01	133
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	88
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	41
Total of all active and inactive participants	2013-07-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	129
Number of participants with account balances	2013-07-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	5
2012: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2012 401k membership
Total participants, beginning-of-year	2012-07-01	133
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	92
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	41
Total of all active and inactive participants	2012-07-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	133
Number of participants with account balances	2012-07-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	6
2011: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2011 401k membership
Total participants, beginning-of-year	2011-07-01	127
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	93
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	40
Total of all active and inactive participants	2011-07-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	133
Number of participants with account balances	2011-07-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	5
2010: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2010 401k membership
Total participants, beginning-of-year	2010-07-01	134
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	89
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	37
Total of all active and inactive participants	2010-07-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	1
Total participants	2010-07-01	127
Number of participants with account balances	2010-07-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	7
2009: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2009 401k membership
Total participants, beginning-of-year	2009-07-01	137
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	96
Number of retired or separated participants receiving benefits	2009-07-01	1
Number of other retired or separated participants entitled to future benefits	2009-07-01	36
Total of all active and inactive participants	2009-07-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	1
Total participants	2009-07-01	134
Number of participants with account balances	2009-07-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	4

Financial Data on 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.

Measure	Date	Value
2017 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$261,889
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$1,653,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$1,652,472
Expenses. Certain deemed distributions of participant loans	2017-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$94,723
Value of total assets at end of year	2017-06-30	$723,958
Value of total assets at beginning of year	2017-06-30	$2,115,310
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$769
Total interest from all sources	2017-06-30	$11,669
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-06-30	$0
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$0
Other income not declared elsewhere	2017-06-30	$2,715
Administrative expenses (other) incurred	2017-06-30	$769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$-1,391,352
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$723,958
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$2,115,310
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$315,145
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$1,005,984
Interest on participant loans	2017-06-30	$0
Interest earned on other investments	2017-06-30	$11,669
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$408,813
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$1,109,326
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$0
Net investment gain/loss from pooled separate accounts	2017-06-30	$152,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$94,723
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$1,652,472
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	CULLARI CARRICO, LLC
Accountancy firm EIN	2017-06-30	270623664
2016 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$83,735
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$143,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$142,711
Expenses. Certain deemed distributions of participant loans	2016-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$96,536
Value of total assets at end of year	2016-06-30	$2,115,310
Value of total assets at beginning of year	2016-06-30	$2,175,156
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$870
Total interest from all sources	2016-06-30	$11,151
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$0
Other income not declared elsewhere	2016-06-30	$16
Administrative expenses (other) incurred	2016-06-30	$870
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$-59,846
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$2,115,310
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,175,156
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$1,005,984
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$1,045,802
Interest on participant loans	2016-06-30	$0
Interest earned on other investments	2016-06-30	$11,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$1,109,326
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$1,129,354
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$0
Net investment gain/loss from pooled separate accounts	2016-06-30	$-23,968
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$96,536
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$142,711
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	CULLARI CARRICO LLC
Accountancy firm EIN	2016-06-30	270623664
2015 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$149,672
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$237,858
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$237,432
Expenses. Certain deemed distributions of participant loans	2015-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$91,536
Value of total assets at end of year	2015-06-30	$2,175,156
Value of total assets at beginning of year	2015-06-30	$2,263,342
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$426
Total interest from all sources	2015-06-30	$12,213
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$0
Other income not declared elsewhere	2015-06-30	$0
Administrative expenses (other) incurred	2015-06-30	$426
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$-88,186
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,175,156
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,263,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$1,045,802
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$972,592
Interest on participant loans	2015-06-30	$0
Interest earned on other investments	2015-06-30	$12,213
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$1,129,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$1,290,750
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$0
Net investment gain/loss from pooled separate accounts	2015-06-30	$45,923
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$91,536
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$237,432
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	CULLARI CARRICO LLC
Accountancy firm EIN	2015-06-30	270623664
2014 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$291,465
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$146,990
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$129,840
Expenses. Certain deemed distributions of participant loans	2014-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$94,690
Value of total assets at end of year	2014-06-30	$2,263,342
Value of total assets at beginning of year	2014-06-30	$2,118,867
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$17,150
Total interest from all sources	2014-06-30	$12,941
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$0
Other income not declared elsewhere	2014-06-30	$8,406
Administrative expenses (other) incurred	2014-06-30	$17,150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$144,475
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,263,342
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$2,118,867
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$972,592
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$828,464
Interest on participant loans	2014-06-30	$0
Interest earned on other investments	2014-06-30	$12,941
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$1,290,750
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$1,290,403
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$0
Net investment gain/loss from pooled separate accounts	2014-06-30	$175,428
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$94,690
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$129,840
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	CULLARI CARRICO LLC
Accountancy firm EIN	2014-06-30	270623664
2013 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$255,843
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$148,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$127,040
Expenses. Certain deemed distributions of participant loans	2013-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$115,295
Value of total assets at end of year	2013-06-30	$2,118,867
Value of total assets at beginning of year	2013-06-30	$2,011,375
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$21,311
Total interest from all sources	2013-06-30	$17,515
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$0
Other income not declared elsewhere	2013-06-30	$10,189
Administrative expenses (other) incurred	2013-06-30	$21,311
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$107,492
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$2,118,867
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$2,011,375
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in pooled separate accounts at end of year	2013-06-30	$828,464
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$736,075
Interest on participant loans	2013-06-30	$0
Interest earned on other investments	2013-06-30	$17,515
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$1,290,403
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$1,275,300
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$0
Net investment gain/loss from pooled separate accounts	2013-06-30	$112,844
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$115,295
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$127,040
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	CULLARI,CARRICO,SOOJIAN,BURKE LLC
Accountancy firm EIN	2013-06-30	270623664
2012 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2012 401k financial data
Total income from all sources (including contributions)	2012-06-30	$130,524
Total of all expenses incurred	2012-06-30	$79,123
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$78,873
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$110,175
Value of total assets at end of year	2012-06-30	$2,019,776
Value of total assets at beginning of year	2012-06-30	$1,968,375
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$250
Total interest from all sources	2012-06-30	$23,813
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-06-30	$7,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$51,401
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$2,019,776
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,968,375
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in pooled separate accounts at end of year	2012-06-30	$736,075
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$755,594
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$23,813
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$1,275,300
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$1,212,781
Net investment gain/loss from pooled separate accounts	2012-06-30	$-3,464
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$110,175
Employer contributions (assets) at end of year	2012-06-30	$8,401
Employer contributions (assets) at beginning of year	2012-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$71,691
Contract administrator fees	2012-06-30	$250
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-06-30	No
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	CULLARI,CARRICO,SOOJIAN,BURKE LLC
Accountancy firm EIN	2012-06-30	270623664
2011 : 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2011 401k financial data
Total income from all sources (including contributions)	2011-06-30	$330,278
Total of all expenses incurred	2011-06-30	$107,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$106,828
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$113,311
Value of total assets at end of year	2011-06-30	$1,968,375
Value of total assets at beginning of year	2011-06-30	$1,745,325
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$400
Total interest from all sources	2011-06-30	$24,773
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	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	2011-06-30	No
Value of net income/loss	2011-06-30	$223,050
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$1,968,375
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,745,325
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in pooled separate accounts at end of year	2011-06-30	$755,594
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$670,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$24,773
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$1,212,781
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$1,062,184
Net investment gain/loss from pooled separate accounts	2011-06-30	$192,194
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$113,311
Employer contributions (assets) at end of year	2011-06-30	$0
Employer contributions (assets) at beginning of year	2011-06-30	$13,141
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$106,828
Contract administrator fees	2011-06-30	$400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-06-30	No
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	CULLARI,CARRICO,SOOJIAN,BURKE LLC.
Accountancy firm EIN	2011-06-30	270623664

Form 5500 Responses for 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC.

2016: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2010: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2009: 401(A) THRIFT PLAN OF VISITING HEALTH SERVICES OF NEW JERSEY, INC. 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

014765E

Policy instance

Insurance contract or identification number	014765E
Number of Individuals Covered	129
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $105
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	105
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	PARSIPPANY REGIONAL OFFICE

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

Policy contract number

014765E

Policy instance

Insurance contract or identification number	014765E
Number of Individuals Covered	119
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $94
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	94
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	PARSIPPANY REGIONAL OFFICE

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

Policy contract number

014765E

Policy instance

Insurance contract or identification number	014765E
Number of Individuals Covered	129
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $159
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	159
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	PARSIPPANY REGIONAL OFFICE

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

Policy contract number

014765E

Policy instance

Insurance contract or identification number	014765E
Number of Individuals Covered	133
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $254
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	69
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	SCOTT RITCHIE

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

Policy contract number

014765-E

Policy instance

Insurance contract or identification number	014765-E
Number of Individuals Covered	133
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $434
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

014765-E

Policy instance

Insurance contract or identification number	014765-E
Number of Individuals Covered	127
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $103
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	VISITING HEALTH SERVICES OF NEW JER SEY, INC.
Employer identification number (EIN):	222003429
NAIC Classification:	621610
NAIC Description:	Home Health Care Services