401k Plan data: LASELL VILLAGE 403(B) PLAN plan

LASELL VILLAGE 403(B) PLAN 401k Plan overview

Plan Name	LASELL VILLAGE 403(B) PLAN
Plan identification number	001

LASELL VILLAGE 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

LASELL VILLAGE, INC. has sponsored the creation of one or more 401k plans.

Company Name: LASELL VILLAGE, INC.

Employer identification number (EIN): 223042122

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LASELL VILLAGE 403(B) 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 MICHAEL J. HOYLE MICHAEL J. HOYLE 2018-09-20
001 2016-01-01 MICHAEL J. HOYLE MICHAEL J. HOYLE 2017-09-05
001 2015-01-01 MICHAEL J. HOYLE MICHAEL J. HOYLE 2016-10-07
001 2014-01-01 MICHAEL J. HOYLE
001 2013-01-01 PAULA PANCHUCK
001 2012-01-01 PAULA PANCHUCK 2013-06-27
001 2011-01-01 PAULA PANCHUCK 2012-08-30
001 2010-01-01 PAULA PANCHUCK 2011-09-19

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	MICHAEL J. HOYLE		MICHAEL J. HOYLE	2018-09-20
001	2016-01-01	MICHAEL J. HOYLE		MICHAEL J. HOYLE	2017-09-05
001	2015-01-01	MICHAEL J. HOYLE		MICHAEL J. HOYLE	2016-10-07
001	2014-01-01	MICHAEL J. HOYLE
001	2013-01-01	PAULA PANCHUCK
001	2012-01-01	PAULA PANCHUCK	2013-06-27
001	2011-01-01	PAULA PANCHUCK	2012-08-30
001	2010-01-01	PAULA PANCHUCK	2011-09-19

Plan Statistics for LASELL VILLAGE 403(B) PLAN

401k plan membership statisitcs for LASELL VILLAGE 403(B) PLAN

Measure Date Value
2022: LASELL VILLAGE 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 99
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 107
Total of all active and inactive participants 2022-01-01 206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 206
Number of participants with account balances 2022-01-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: LASELL VILLAGE 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 103
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 91
Total of all active and inactive participants 2021-01-01 194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 194
Number of participants with account balances 2021-01-01 193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: LASELL VILLAGE 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 93
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 74
Total of all active and inactive participants 2020-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 167
Number of participants with account balances 2020-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: LASELL VILLAGE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 106
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 63
Total of all active and inactive participants 2019-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 169
Number of participants with account balances 2019-01-01 162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: LASELL VILLAGE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 100
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 52
Total of all active and inactive participants 2018-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 152
Number of participants with account balances 2018-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: LASELL VILLAGE 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 127
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 38
Total of all active and inactive participants 2017-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 165
Number of participants with account balances 2017-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: LASELL VILLAGE 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 122
Number of retired or separated participants receiving benefits 2016-01-01 8
Number of other retired or separated participants entitled to future benefits 2016-01-01 36
Total of all active and inactive participants 2016-01-01 166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 166
Number of participants with account balances 2016-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: LASELL VILLAGE 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 116
Number of retired or separated participants receiving benefits 2015-01-01 7
Number of other retired or separated participants entitled to future benefits 2015-01-01 29
Total of all active and inactive participants 2015-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 152
Number of participants with account balances 2015-01-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: LASELL VILLAGE 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 195
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 31
Total of all active and inactive participants 2014-01-01 226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 226
Number of participants with account balances 2014-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: LASELL VILLAGE 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 134
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 25
Total of all active and inactive participants 2013-01-01 159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 159
Number of participants with account balances 2013-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2022: LASELL VILLAGE 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	99
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	107
Total of all active and inactive participants	2022-01-01	206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	206
Number of participants with account balances	2022-01-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: LASELL VILLAGE 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	103
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	91
Total of all active and inactive participants	2021-01-01	194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	194
Number of participants with account balances	2021-01-01	193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: LASELL VILLAGE 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	93
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	74
Total of all active and inactive participants	2020-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	167
Number of participants with account balances	2020-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: LASELL VILLAGE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	106
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	63
Total of all active and inactive participants	2019-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	169
Number of participants with account balances	2019-01-01	162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: LASELL VILLAGE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	100
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	52
Total of all active and inactive participants	2018-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	152
Number of participants with account balances	2018-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: LASELL VILLAGE 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	127
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	38
Total of all active and inactive participants	2017-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	165
Number of participants with account balances	2017-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: LASELL VILLAGE 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	122
Number of retired or separated participants receiving benefits	2016-01-01	8
Number of other retired or separated participants entitled to future benefits	2016-01-01	36
Total of all active and inactive participants	2016-01-01	166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	166
Number of participants with account balances	2016-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: LASELL VILLAGE 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	116
Number of retired or separated participants receiving benefits	2015-01-01	7
Number of other retired or separated participants entitled to future benefits	2015-01-01	29
Total of all active and inactive participants	2015-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	152
Number of participants with account balances	2015-01-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: LASELL VILLAGE 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	195
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	31
Total of all active and inactive participants	2014-01-01	226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	226
Number of participants with account balances	2014-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: LASELL VILLAGE 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	134
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	25
Total of all active and inactive participants	2013-01-01	159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	159
Number of participants with account balances	2013-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on LASELL VILLAGE 403(B) PLAN

Measure	Date	Value
2022 : LASELL VILLAGE 403(B) 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	$0
Total income from all sources (including contributions)	2022-12-31	$-452,945
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$285,400
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$282,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$662,445
Value of total assets at end of year	2022-12-31	$7,431,966
Value of total assets at beginning of year	2022-12-31	$8,170,311
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,426
Total interest from all sources	2022-12-31	$45,509
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$148,608
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$148,608
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
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	$402,661
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$10,050
Administrative expenses (other) incurred	2022-12-31	$2,426
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-738,345
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,431,966
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$8,170,311
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 registered invesment companies (eg mutual funds) at end of year	2022-12-31	$5,731,271
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$6,554,325
Value of interest in pooled separate accounts at end of year	2022-12-31	$545,947
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$512,197
Interest earned on other investments	2022-12-31	$45,509
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,154,748
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,103,789
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,351,286
Net investment gain/loss from pooled separate accounts	2022-12-31	$41,779
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	No
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	$249,734
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$282,974
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2022-12-31	431947695
2021 : LASELL VILLAGE 403(B) 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,596,349
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$633,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$630,798
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$639,508
Value of total assets at end of year	2021-12-31	$8,170,311
Value of total assets at beginning of year	2021-12-31	$7,207,558
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,798
Total interest from all sources	2021-12-31	$36,457
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$189,462
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$189,462
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
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	$369,965
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$41,599
Administrative expenses (other) incurred	2021-12-31	$2,798
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	$962,753
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$8,170,311
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,207,558
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 registered invesment companies (eg mutual funds) at end of year	2021-12-31	$6,554,325
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,715,319
Value of interest in pooled separate accounts at end of year	2021-12-31	$512,197
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$439,272
Interest earned on other investments	2021-12-31	$36,457
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,103,789
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,052,967
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$652,223
Net investment gain/loss from pooled separate accounts	2021-12-31	$78,699
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	$227,944
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$630,798
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2021-12-31	431947695
2020 : LASELL VILLAGE 403(B) 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	$1,453,094
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$485,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$483,564
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$540,089
Value of total assets at end of year	2020-12-31	$7,207,558
Value of total assets at beginning of year	2020-12-31	$6,239,854
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,826
Total interest from all sources	2020-12-31	$39,916
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$87,687
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$87,687
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
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	$309,400
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$12,194
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$15,139
Other income not declared elsewhere	2020-12-31	$374
Administrative expenses (other) incurred	2020-12-31	$1,826
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	$967,704
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,207,558
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,239,854
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 registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,715,319
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,712,490
Value of interest in pooled separate accounts at end of year	2020-12-31	$439,272
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$476,079
Interest earned on other investments	2020-12-31	$39,916
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,052,967
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,030,700
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$789,126
Net investment gain/loss from pooled separate accounts	2020-12-31	$-4,098
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	$215,550
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$8,391
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$483,564
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2020-12-31	431947695
2019 : LASELL VILLAGE 403(B) PLAN 2019 401k financial data
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 beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,458,595
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$487,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$486,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$511,186
Value of total assets at end of year	2019-12-31	$6,239,854
Value of total assets at beginning of year	2019-12-31	$5,269,118
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,708
Total interest from all sources	2019-12-31	$37,805
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$47,081
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$47,081
Was this plan covered by a fidelity bond	2019-12-31	Yes
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
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
Contributions received from participants	2019-12-31	$297,680
Participant contributions at end of year	2019-12-31	$12,194
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$844
Administrative expenses (other) incurred	2019-12-31	$1,708
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	$970,736
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,239,854
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,269,118
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,712,490
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,802,151
Value of interest in pooled separate accounts at end of year	2019-12-31	$476,079
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$499,701
Interest earned on other investments	2019-12-31	$37,805
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,030,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$967,266
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$837,122
Net investment gain/loss from pooled separate accounts	2019-12-31	$25,401
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	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	$212,662
Employer contributions (assets) at end of year	2019-12-31	$8,391
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$486,151
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2019-12-31	431947695
2018 : LASELL VILLAGE 403(B) 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	$0
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	$368,834
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$513,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$512,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$603,237
Value of total assets at end of year	2018-12-31	$5,269,118
Value of total assets at beginning of year	2018-12-31	$5,413,826
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,241
Total interest from all sources	2018-12-31	$36,740
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$53,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$53,770
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	$340,098
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$54,052
Administrative expenses (other) incurred	2018-12-31	$1,241
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	$-144,708
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$5,269,118
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,413,826
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$3,802,151
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,988,774
Value of interest in pooled separate accounts at end of year	2018-12-31	$499,701
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$475,641
Interest earned on other investments	2018-12-31	$36,740
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$967,266
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$949,411
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$55,963
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-347,891
Net investment gain/loss from pooled separate accounts	2018-12-31	$22,978
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$209,087
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$456,338
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2018-12-31	431947695
2017 : LASELL VILLAGE 403(B) 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	$0
Total income from all sources (including contributions)	2017-12-31	$1,227,072
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$642,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$641,838
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$485,745
Value of total assets at end of year	2017-12-31	$5,413,826
Value of total assets at beginning of year	2017-12-31	$4,829,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$934
Total interest from all sources	2017-12-31	$35,843
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$29,515
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$29,515
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	$289,926
Administrative expenses (other) incurred	2017-12-31	$934
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	$584,300
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,413,826
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,829,526
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$3,988,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,374,489
Value of interest in pooled separate accounts at end of year	2017-12-31	$475,641
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$447,768
Interest earned on other investments	2017-12-31	$35,843
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$949,411
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,007,269
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$656,065
Net investment gain/loss from pooled separate accounts	2017-12-31	$19,904
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	$195,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$641,838
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2017-12-31	431947695
2016 : LASELL VILLAGE 403(B) 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	$0
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	$679,897
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$27,744
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$27,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$408,018
Value of total assets at end of year	2016-12-31	$4,829,526
Value of total assets at beginning of year	2016-12-31	$4,177,373
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$616
Total interest from all sources	2016-12-31	$33,023
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$14,774
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$14,774
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	$235,397
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$7,973
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	$652,153
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,829,526
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,177,373
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,374,489
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,003,013
Value of interest in pooled separate accounts at end of year	2016-12-31	$447,768
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$409,149
Interest earned on other investments	2016-12-31	$33,023
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,007,269
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$750,413
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$202,601
Net investment gain/loss from pooled separate accounts	2016-12-31	$21,481
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	No
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	$172,621
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$6,825
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$27,128
Contract administrator fees	2016-12-31	$616
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2016-12-31	431947695
2015 : LASELL VILLAGE 403(B) 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	$454,538
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$76,879
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$76,036
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$393,675
Value of total assets at end of year	2015-12-31	$4,177,373
Value of total assets at beginning of year	2015-12-31	$3,799,714
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$843
Total interest from all sources	2015-12-31	$26,661
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$12,170
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$12,170
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	$218,933
Participant contributions at end of year	2015-12-31	$7,973
Participant contributions at beginning of year	2015-12-31	$7,746
Administrative expenses (other) incurred	2015-12-31	$843
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	$377,659
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,177,373
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,799,714
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,003,013
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,757,785
Value of interest in pooled separate accounts at end of year	2015-12-31	$409,149
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$364,314
Interest earned on other investments	2015-12-31	$26,661
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$750,413
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$663,165
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-8,481
Net investment gain/loss from pooled separate accounts	2015-12-31	$30,513
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	No
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	$174,742
Employer contributions (assets) at end of year	2015-12-31	$6,825
Employer contributions (assets) at beginning of year	2015-12-31	$6,704
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$76,036
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2015-12-31	431947695
2014 : LASELL VILLAGE 403(B) 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	$622,491
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$20,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$19,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$394,244
Value of total assets at end of year	2014-12-31	$3,799,714
Value of total assets at beginning of year	2014-12-31	$3,197,443
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$888
Total interest from all sources	2014-12-31	$24,136
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$3,431
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$3,431
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	$220,828
Participant contributions at end of year	2014-12-31	$7,746
Participant contributions at beginning of year	2014-12-31	$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	2014-12-31	No
Value of net income/loss	2014-12-31	$602,271
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,799,714
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,197,443
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,757,785
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,323,595
Value of interest in pooled separate accounts at end of year	2014-12-31	$364,314
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$300,106
Interest earned on other investments	2014-12-31	$24,136
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$663,165
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$573,742
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$162,386
Net investment gain/loss from pooled separate accounts	2014-12-31	$38,294
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	No
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	$173,416
Employer contributions (assets) at end of year	2014-12-31	$6,704
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$19,332
Contract administrator fees	2014-12-31	$888
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2014-12-31	431947695
2013 : LASELL VILLAGE 403(B) 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	$1,054,256
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$43,662
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$43,662
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$598,835
Value of total assets at end of year	2013-12-31	$3,197,443
Value of total assets at beginning of year	2013-12-31	$2,186,849
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$18,617
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
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	$194,142
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$249,669
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	$1,010,594
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,197,443
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,186,849
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 registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,323,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,546,006
Value of interest in pooled separate accounts at end of year	2013-12-31	$300,106
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$199,833
Interest earned on other investments	2013-12-31	$18,617
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$573,742
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$441,010
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$416,603
Net investment gain/loss from pooled separate accounts	2013-12-31	$20,201
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	No
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	$155,024
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$43,662
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	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2013-12-31	431947695

Form 5500 Responses for LASELL VILLAGE 403(B) PLAN

2022: LASELL VILLAGE 403(B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
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: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: LASELL VILLAGE 403(B) 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LASELL VILLAGE 403(B) 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 funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LASELL VILLAGE 403(B) 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 funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	65
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 $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	66
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 $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	66
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 $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	69
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 $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	75
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	77
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

500499

Policy instance

Insurance contract or identification number	500499
Number of Individuals Covered	89
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

358835

Policy instance

Insurance contract or identification number	358835
Number of Individuals Covered	22
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

358834

Policy instance

Insurance contract or identification number	358834
Number of Individuals Covered	55
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	Yes
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

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Company Name:	LASELL VILLAGE, INC.
Employer identification number (EIN):	223042122
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities