401k Plan data: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN plan

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 401k Plan overview

Plan Name	CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN
Plan identification number	002

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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.
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

CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC.

Employer identification number (EIN): 251203882

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 KATHERINE RADAKOVICH SUSAN COYLE 2018-10-09
002 2016-01-01 KATHERINE RADAKOVICH
002 2015-01-01 KATHERINE RADAKOVICH SUSAN COYLE 2016-10-11
002 2014-01-01 KATHERINE RADAKOVICH SUSAN COYLE 2015-10-13
002 2013-01-01
002 2012-01-01 SUSAN COYLE
002 2011-01-01 SUSAN COYLE
002 2009-01-01 BARBARA A KARPAN
002 2009-01-01 BARBARA A KARPAN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	KATHERINE RADAKOVICH	SUSAN COYLE	2018-10-09
002	2016-01-01	KATHERINE RADAKOVICH
002	2015-01-01	KATHERINE RADAKOVICH	SUSAN COYLE	2016-10-11
002	2014-01-01	KATHERINE RADAKOVICH	SUSAN COYLE	2015-10-13
002	2013-01-01
002	2012-01-01	SUSAN COYLE
002	2011-01-01	SUSAN COYLE
002	2009-01-01	BARBARA A KARPAN
002	2009-01-01	BARBARA A KARPAN

Plan Statistics for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN

401k plan membership statisitcs for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN

Measure Date Value
2022: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 212
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 51
Total of all active and inactive participants 2022-01-01 263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 1
Total participants 2022-01-01 264
Number of participants with account balances 2022-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 10
2021: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 153
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 49
Total of all active and inactive participants 2021-01-01 202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 204
Number of participants with account balances 2021-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 21
2020: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 121
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 41
Total of all active and inactive participants 2020-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 163
Number of participants with account balances 2020-01-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 131
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 33
Total of all active and inactive participants 2019-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 165
Number of participants with account balances 2019-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 13
2018: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 123
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 40
Total of all active and inactive participants 2018-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 163
Number of participants with account balances 2018-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 115
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 2017-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 153
Number of participants with account balances 2017-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 13
2016: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 110
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 51
Total of all active and inactive participants 2016-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 161
Number of participants with account balances 2016-01-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 13
2015: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 112
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 32
Total of all active and inactive participants 2015-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 145
Number of participants with account balances 2015-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 125
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 32
Total of all active and inactive participants 2014-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 158
Number of participants with account balances 2014-01-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 4
2013: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 126
Number of retired or separated participants receiving benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 126
Total participants 2013-01-01 126
Number of participants with account balances 2013-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 7
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 131
Number of retired or separated participants receiving benefits 2012-01-01 25
Total of all active and inactive participants 2012-01-01 156
Total participants 2012-01-01 156
Number of participants with account balances 2012-01-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 13
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 129
Number of retired or separated participants receiving benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 149
Total participants 2011-01-01 149
Number of participants with account balances 2011-01-01 39
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 126
Number of retired or separated participants receiving benefits 2009-01-01 17
Total of all active and inactive participants 2009-01-01 143
Total participants 2009-01-01 143
Number of participants with account balances 2009-01-01 63

Measure	Date	Value
2022: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	212
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	51
Total of all active and inactive participants	2022-01-01	263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	264
Number of participants with account balances	2022-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	10
2021: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	153
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	49
Total of all active and inactive participants	2021-01-01	202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	204
Number of participants with account balances	2021-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	21
2020: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	121
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	41
Total of all active and inactive participants	2020-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	163
Number of participants with account balances	2020-01-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	131
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	33
Total of all active and inactive participants	2019-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	165
Number of participants with account balances	2019-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	13
2018: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	123
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	40
Total of all active and inactive participants	2018-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	163
Number of participants with account balances	2018-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	115
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	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	153
Number of participants with account balances	2017-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	13
2016: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	110
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	51
Total of all active and inactive participants	2016-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	161
Number of participants with account balances	2016-01-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	13
2015: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	112
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	32
Total of all active and inactive participants	2015-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	145
Number of participants with account balances	2015-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	125
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	32
Total of all active and inactive participants	2014-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	158
Number of participants with account balances	2014-01-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	4
2013: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	126
Number of retired or separated participants receiving benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	126
Total participants	2013-01-01	126
Number of participants with account balances	2013-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	7
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	131
Number of retired or separated participants receiving benefits	2012-01-01	25
Total of all active and inactive participants	2012-01-01	156
Total participants	2012-01-01	156
Number of participants with account balances	2012-01-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	13
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	129
Number of retired or separated participants receiving benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	149
Total participants	2011-01-01	149
Number of participants with account balances	2011-01-01	39
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	126
Number of retired or separated participants receiving benefits	2009-01-01	17
Total of all active and inactive participants	2009-01-01	143
Total participants	2009-01-01	143
Number of participants with account balances	2009-01-01	63

Financial Data on CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN

Measure	Date	Value
2022 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$-225,461
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$684,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$623,587
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$619,185
Value of total assets at end of year	2022-12-31	$6,085,090
Value of total assets at beginning of year	2022-12-31	$6,994,899
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$60,761
Total interest from all sources	2022-12-31	$46,915
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$146,674
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	$146,674
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	$217,737
Participant contributions at end of year	2022-12-31	$2,013
Participant contributions at beginning of year	2022-12-31	$4,611
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$246,876
Other income not declared elsewhere	2022-12-31	$22,842
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	$-909,809
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$6,085,090
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,994,899
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
Investment advisory and management fees	2022-12-31	$13,714
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,659,360
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,413,456
Value of interest in pooled separate accounts at end of year	2022-12-31	$673,823
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$915,521
Interest on participant loans	2022-12-31	$496
Interest earned on other investments	2022-12-31	$46,419
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,749,894
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,661,311
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-843,542
Net investment gain/loss from pooled separate accounts	2022-12-31	$-217,535
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	$154,572
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$623,587
Contract administrator fees	2022-12-31	$47,047
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	MAHER DUESSEL
Accountancy firm EIN	2022-12-31	251622758
2021 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$1,001,957
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$279,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$218,194
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$344,667
Value of total assets at end of year	2021-12-31	$6,994,899
Value of total assets at beginning of year	2021-12-31	$6,272,875
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$61,739
Total interest from all sources	2021-12-31	$41,662
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$190,203
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	$190,203
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	$172,946
Participant contributions at end of year	2021-12-31	$4,611
Participant contributions at beginning of year	2021-12-31	$23,435
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$3,537
Other income not declared elsewhere	2021-12-31	$21,852
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	$722,024
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,994,899
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,272,875
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$13,112
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,413,456
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,606,169
Value of interest in pooled separate accounts at end of year	2021-12-31	$915,521
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$19,150
Interest on participant loans	2021-12-31	$591
Interest earned on other investments	2021-12-31	$41,071
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,661,311
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,624,121
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$264,670
Net investment gain/loss from pooled separate accounts	2021-12-31	$138,903
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	$168,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$218,194
Contract administrator fees	2021-12-31	$48,627
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	MAHER DUESSEL
Accountancy firm EIN	2021-12-31	251622758
2020 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$1,300,832
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$521,922
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$474,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$636,422
Value of total assets at end of year	2020-12-31	$6,272,875
Value of total assets at beginning of year	2020-12-31	$5,493,965
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$47,559
Total interest from all sources	2020-12-31	$43,498
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$84,612
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	$84,612
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	$157,448
Participant contributions at end of year	2020-12-31	$23,435
Participant contributions at beginning of year	2020-12-31	$26,610
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$304,940
Other income not declared elsewhere	2020-12-31	$17,101
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	$778,910
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,272,875
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$5,493,965
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
Investment advisory and management fees	2020-12-31	$10,260
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,606,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,251,385
Value of interest in pooled separate accounts at end of year	2020-12-31	$19,150
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$619,287
Interest on participant loans	2020-12-31	$1,474
Interest earned on other investments	2020-12-31	$42,024
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,624,121
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,596,683
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$519,366
Net investment gain/loss from pooled separate accounts	2020-12-31	$-167
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	$174,034
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$474,363
Contract administrator fees	2020-12-31	$37,299
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	Unqualified
Accountancy firm name	2020-12-31	MAHER DUESSEL
Accountancy firm EIN	2020-12-31	251622758
2019 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$1,084,460
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$364,566
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$317,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$374,426
Value of total assets at end of year	2019-12-31	$5,493,965
Value of total assets at beginning of year	2019-12-31	$4,774,071
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$46,657
Total interest from all sources	2019-12-31	$44,700
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$173,929
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	$173,929
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	$138,353
Participant contributions at end of year	2019-12-31	$26,610
Participant contributions at beginning of year	2019-12-31	$33,646
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$52,136
Other income not declared elsewhere	2019-12-31	$16,257
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	$719,894
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,493,965
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,774,071
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
Investment advisory and management fees	2019-12-31	$10,688
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,251,385
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,681,641
Value of interest in pooled separate accounts at end of year	2019-12-31	$619,287
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$491,299
Interest on participant loans	2019-12-31	$1,748
Interest earned on other investments	2019-12-31	$42,952
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,596,683
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,567,485
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$342,489
Net investment gain/loss from pooled separate accounts	2019-12-31	$132,659
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	$183,937
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$317,909
Contract administrator fees	2019-12-31	$35,969
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	MAHER DUESSEL
Accountancy firm EIN	2019-12-31	251622758
2018 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$183,948
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$205,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$164,341
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$290,702
Value of total assets at end of year	2018-12-31	$4,774,071
Value of total assets at beginning of year	2018-12-31	$4,796,041
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$41,577
Total interest from all sources	2018-12-31	$44,712
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$89,658
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	$89,658
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$100,000
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	$120,227
Participant contributions at end of year	2018-12-31	$33,646
Participant contributions at beginning of year	2018-12-31	$1,134
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$117
Other income not declared elsewhere	2018-12-31	$14,681
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	$-21,970
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,774,071
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,796,041
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
Investment advisory and management fees	2018-12-31	$9,484
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,681,641
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,721,480
Value of interest in pooled separate accounts at end of year	2018-12-31	$491,299
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$529,545
Interest on participant loans	2018-12-31	$1,247
Interest earned on other investments	2018-12-31	$43,465
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,567,485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,543,882
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-218,023
Net investment gain/loss from pooled separate accounts	2018-12-31	$-37,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$170,358
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$164,341
Contract administrator fees	2018-12-31	$32,093
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	MAHER DUESSEL
Accountancy firm EIN	2018-12-31	251622758
2017 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$744,847
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$243,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$190,104
Expenses. Certain deemed distributions of participant loans	2017-12-31	$3,714
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$271,083
Value of total assets at end of year	2017-12-31	$4,796,041
Value of total assets at beginning of year	2017-12-31	$4,294,929
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$49,917
Total interest from all sources	2017-12-31	$42,351
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$71,508
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	$71,508
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
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	$93,088
Participant contributions at end of year	2017-12-31	$1,134
Participant contributions at beginning of year	2017-12-31	$6,226
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$18,560
Other income not declared elsewhere	2017-12-31	$20,846
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	$501,112
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,796,041
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,294,929
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
Investment advisory and management fees	2017-12-31	$16,497
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,721,480
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,292,616
Value of interest in pooled separate accounts at end of year	2017-12-31	$529,545
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$444,714
Interest on participant loans	2017-12-31	$170
Interest earned on other investments	2017-12-31	$42,181
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,543,882
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,551,373
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$248,168
Net investment gain/loss from pooled separate accounts	2017-12-31	$90,891
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	No
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	$159,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$190,104
Contract administrator fees	2017-12-31	$33,420
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	MAHER DUESSEL
Accountancy firm EIN	2017-12-31	251622758
2016 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$516,700
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$264,913
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$221,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$277,500
Value of total assets at end of year	2016-12-31	$4,294,929
Value of total assets at beginning of year	2016-12-31	$4,043,142
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$43,798
Total interest from all sources	2016-12-31	$49,137
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$50,839
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	$50,839
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
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	$108,976
Participant contributions at end of year	2016-12-31	$6,226
Participant contributions at beginning of year	2016-12-31	$19,255
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$16,902
Other income not declared elsewhere	2016-12-31	$12,616
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	$251,787
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,294,929
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,043,142
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$11,811
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,292,616
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,060,517
Value of interest in pooled separate accounts at end of year	2016-12-31	$444,714
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$418,319
Interest on participant loans	2016-12-31	$467
Interest earned on other investments	2016-12-31	$48,670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,551,373
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,545,051
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$98,865
Net investment gain/loss from pooled separate accounts	2016-12-31	$27,743
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	$151,622
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$221,115
Contract administrator fees	2016-12-31	$31,987
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	MAHER DUESSEL
Accountancy firm EIN	2016-12-31	251622758
2015 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$319,473
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$368,154
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$327,379
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$261,155
Value of total assets at end of year	2015-12-31	$4,043,142
Value of total assets at beginning of year	2015-12-31	$4,091,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$40,775
Total interest from all sources	2015-12-31	$49,225
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$60,828
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	$60,828
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
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	$101,833
Participant contributions at end of year	2015-12-31	$19,255
Participant contributions at beginning of year	2015-12-31	$5,105
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$3,263
Other income not declared elsewhere	2015-12-31	$2,482
Administrative expenses (other) incurred	2015-12-31	$40,775
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	$-48,681
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,043,142
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,091,823
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	$2,060,517
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,118,986
Value of interest in pooled separate accounts at end of year	2015-12-31	$418,319
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$433,372
Interest on participant loans	2015-12-31	$245
Interest earned on other investments	2015-12-31	$48,980
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,545,051
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,534,360
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-59,405
Net investment gain/loss from pooled separate accounts	2015-12-31	$5,188
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	$156,059
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$327,379
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	MAHER DUESSEL
Accountancy firm EIN	2015-12-31	251622758
2014 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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	$514,836
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$454,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$426,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$305,750
Value of total assets at end of year	2014-12-31	$4,091,823
Value of total assets at beginning of year	2014-12-31	$4,031,737
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$27,921
Total interest from all sources	2014-12-31	$51,976
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$93,453
Participant contributions at end of year	2014-12-31	$5,105
Participant contributions at beginning of year	2014-12-31	$5,105
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$16,544
Administrative expenses (other) incurred	2014-12-31	$27,921
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	$60,086
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,091,823
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,031,737
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	$2,118,986
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,570,301
Value of interest in pooled separate accounts at end of year	2014-12-31	$433,372
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$425,040
Interest earned on other investments	2014-12-31	$51,976
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,534,360
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,031,291
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$125,254
Net investment gain/loss from pooled separate accounts	2014-12-31	$31,856
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	$195,753
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$426,829
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	MAHER DUESSEL, CPAS
Accountancy firm EIN	2014-12-31	251622758
2013 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$670,650
Total of all expenses incurred	2013-12-31	$512,447
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$484,470
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$300,558
Value of total assets at end of year	2013-12-31	$4,031,737
Value of total assets at beginning of year	2013-12-31	$3,873,534
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$27,977
Total interest from all sources	2013-12-31	$60,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$100,947
Participant contributions at end of year	2013-12-31	$5,105
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,915
Administrative expenses (other) incurred	2013-12-31	$27,977
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	$158,203
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,031,737
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,873,534
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	$1,570,301
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,412,788
Value of interest in pooled separate accounts at end of year	2013-12-31	$425,040
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$341,102
Interest on participant loans	2013-12-31	$105
Interest earned on other investments	2013-12-31	$60,732
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$6,671
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$6,671
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,031,291
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,112,973
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$225,148
Net investment gain/loss from pooled separate accounts	2013-12-31	$84,107
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	$197,696
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$484,470
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	2013-12-31	No
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	MAHER DUESSEL, CPAS
Accountancy firm EIN	2013-12-31	251622758
2012 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$2,067,715
Total of all expenses incurred	2012-12-31	$575,976
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$560,965
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,849,502
Value of total assets at end of year	2012-12-31	$3,873,534
Value of total assets at beginning of year	2012-12-31	$2,381,795
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$15,011
Total interest from all sources	2012-12-31	$57,963
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$110,826
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,593,387
Administrative expenses (other) incurred	2012-12-31	$15,011
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,491,739
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,873,534
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,381,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,412,788
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$530,033
Value of interest in pooled separate accounts at end of year	2012-12-31	$341,102
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$346,441
Interest earned on other investments	2012-12-31	$57,963
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$6,671
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,112,973
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,505,321
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$115,077
Net investment gain/loss from pooled separate accounts	2012-12-31	$45,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$145,289
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$560,965
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	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MAHER DUESSEL, CPAS
Accountancy firm EIN	2012-12-31	251622758
2011 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$176,579
Total of all expenses incurred	2011-12-31	$78,515
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$74,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$127,626
Value of total assets at end of year	2011-12-31	$2,381,795
Value of total assets at beginning of year	2011-12-31	$2,283,731
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$4,161
Total interest from all sources	2011-12-31	$50,993
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$127,626
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$4,883
Administrative expenses (other) incurred	2011-12-31	$4,161
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$98,064
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,381,795
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,283,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$530,033
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$489,672
Value of interest in pooled separate accounts at end of year	2011-12-31	$346,441
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$367,837
Interest earned on other investments	2011-12-31	$50,993
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,505,321
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,421,339
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$7,185
Net investment gain/loss from pooled separate accounts	2011-12-31	$-9,225
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$74,354
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	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MAHER DUESSEL, CPAS
Accountancy firm EIN	2011-12-31	251622758
2010 : CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$308,103
Total of all expenses incurred	2010-12-31	$17,570
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$16,637
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$166,629
Value of total assets at end of year	2010-12-31	$2,283,731
Value of total assets at beginning of year	2010-12-31	$1,993,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$933
Total interest from all sources	2010-12-31	$43,557
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$550,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$166,629
Participant contributions at end of year	2010-12-31	$4,883
Participant contributions at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$290,533
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,283,731
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,993,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$489,672
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$409,473
Value of interest in pooled separate accounts at end of year	2010-12-31	$367,837
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$328,467
Interest earned on other investments	2010-12-31	$43,557
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,421,339
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,255,258
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$53,375
Net investment gain/loss from pooled separate accounts	2010-12-31	$44,542
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$16,637
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	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MAHER DUESSEL, CPAS
Accountancy firm EIN	2010-12-31	251622758

Form 5500 Responses for CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN

2022: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 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: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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
2012: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC. 403(B) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	20
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	5
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	107
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	21
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	5
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	106
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	103
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	5
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	21
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	105
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	6
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	22
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	107
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	10
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	24
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	24
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	10
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	101
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	94
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,343
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,343
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	13
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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	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

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	31
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	13
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	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	104
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,825
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,825
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	27
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	103
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,327
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,327
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	14
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	33
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	36
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	106
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,975
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,975
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	14
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	15
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	20
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,308
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	42
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

007067-A

Policy instance

Insurance contract or identification number	007067-A
Number of Individuals Covered	18
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $41
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

893093-007

Policy instance

Insurance contract or identification number	893093-007
Number of Individuals Covered	21
Insurance policy start date	2010-10-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $9,609
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

358508

Policy instance

Insurance contract or identification number	358508
Number of Individuals Covered	43
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CHARTIERS COMMUNITY MENTAL HEALTH AND RETARDATION CENTER, INC.
Employer identification number (EIN):	251203882
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers