401k Plan data: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN plan

DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 401k Plan overview

Plan Name	DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN
Plan identification number	001

DAVE THOMAS FOUNDATION FOR ADOPTION 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 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
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

DAVE THOMAS FOUNDATION FOR ADOPTION 403B PLAN has sponsored the creation of one or more 401k plans.

Company Name: DAVE THOMAS FOUNDATION FOR ADOPTION 403B PLAN

Employer identification number (EIN): 311356151

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 RITA L. SORONEN
001 2013-01-01 RITA L. SORONEN
001 2012-01-01 RITA L. SORONEN
001 2011-01-01 RITA L. SORONEN
001 2010-01-01 RITA L. SORONEN
001 2009-01-01 RITA L. SORONEN

Plan Statistics for DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN

401k plan membership statisitcs for DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN

Measure Date Value
2014: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 17
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 18
Number of participants with account balances 2014-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 16
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 18
Number of participants with account balances 2013-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 18
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 19
Number of participants with account balances 2012-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 13
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 14
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 13
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 14
Number of participants with account balances 2010-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 11
Total of all active and inactive participants 2009-01-01 11
Total participants 2009-01-01 11
Number of participants with account balances 2009-01-01 11

Measure	Date	Value
2014: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	17
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	18
Number of participants with account balances	2014-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	16
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	18
Number of participants with account balances	2013-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	18
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	19
Number of participants with account balances	2012-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	13
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	14
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	13
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	14
Number of participants with account balances	2010-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	11
Total of all active and inactive participants	2009-01-01	11
Total participants	2009-01-01	11
Number of participants with account balances	2009-01-01	11

Financial Data on DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN

Measure	Date	Value
2014 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$191,422
Expenses. Total of all expenses incurred	2014-12-31	$347,177
Benefits paid (including direct rollovers)	2014-12-31	$347,177
Total plan assets at end of year	2014-12-31	$1,119,605
Total plan assets at beginning of year	2014-12-31	$1,275,360
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$106,151
Other income received	2014-12-31	$51,972
Net income (gross income less expenses)	2014-12-31	$-155,755
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,119,605
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,275,360
Total contributions received or receivable from employer(s)	2014-12-31	$33,299
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$381,069
Expenses. Total of all expenses incurred	2013-12-31	$12,346
Benefits paid (including direct rollovers)	2013-12-31	$12,346
Total plan assets at end of year	2013-12-31	$1,275,360
Total plan assets at beginning of year	2013-12-31	$906,637
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$114,804
Other income received	2013-12-31	$232,504
Net income (gross income less expenses)	2013-12-31	$368,723
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,275,360
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$906,637
Total contributions received or receivable from employer(s)	2013-12-31	$33,761
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$265,287
Expenses. Total of all expenses incurred	2012-12-31	$288,175
Benefits paid (including direct rollovers)	2012-12-31	$288,175
Total plan assets at end of year	2012-12-31	$906,637
Total plan assets at beginning of year	2012-12-31	$929,525
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$109,443
Other income received	2012-12-31	$124,834
Net income (gross income less expenses)	2012-12-31	$-22,888
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$906,637
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$929,525
Total contributions received or receivable from employer(s)	2012-12-31	$31,010
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$98,265
Expenses. Total of all expenses incurred	2011-12-31	$68,763
Benefits paid (including direct rollovers)	2011-12-31	$68,763
Total plan assets at end of year	2011-12-31	$929,525
Total plan assets at beginning of year	2011-12-31	$900,023
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$113,216
Other income received	2011-12-31	$-41,894
Net income (gross income less expenses)	2011-12-31	$29,502
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$929,525
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$900,023
Total contributions received or receivable from employer(s)	2011-12-31	$26,943
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$254,259
Expenses. Total of all expenses incurred	2010-12-31	$18,440
Benefits paid (including direct rollovers)	2010-12-31	$18,440
Total plan assets at end of year	2010-12-31	$900,023
Total plan assets at beginning of year	2010-12-31	$664,204
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$101,604
Other income received	2010-12-31	$126,959
Net income (gross income less expenses)	2010-12-31	$235,819
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$900,023
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$664,204
Total contributions received or receivable from employer(s)	2010-12-31	$25,696
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN

2014: DAVE THOMAS FOUNDATION FOR ADOPTION 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: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DAVE THOMAS FOUNDATION FOR ADOPTION 403(B) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-EJ9R

Policy instance

Insurance contract or identification number	GAP-B2-EJ9R
Number of Individuals Covered	17
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-EJ9R

Policy instance

Insurance contract or identification number	GAP-B2-EJ9R
Number of Individuals Covered	16
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $79
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $79
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	CAMBRIDGE INVESTMENT RESEARCH

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-EJ9R

Policy instance

Insurance contract or identification number	GAP-B2-EJ9R
Number of Individuals Covered	18
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $216
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $216
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	CAMBRIDGE INVESTMENT RESEARCH

Potentially related plans

DAVE THOMAS & ASSOCIATES, P.C. [EIN = 860967649]

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Company Name:	DAVE THOMAS FOUNDATION FOR ADOPTION 403B PLAN
Employer identification number (EIN):	311356151
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Plan id#	Filing Submission Date	Name of Administrator
001	2022-01-01
001	2021-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	RITA L. SORONEN
001	2013-01-01	RITA L. SORONEN
001	2012-01-01	RITA L. SORONEN
001	2011-01-01	RITA L. SORONEN
001	2010-01-01	RITA L. SORONEN
001	2009-01-01	RITA L. SORONEN