401k Plan data: RENAISSANCE VILLAGE 401K RETIREMENT PLAN plan

RENAISSANCE VILLAGE 401K RETIREMENT PLAN 401k Plan overview

Plan Name	RENAISSANCE VILLAGE 401K RETIREMENT PLAN
Plan identification number	001

RENAISSANCE VILLAGE 401K RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

RENAISSANCE HEALTH CARE L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: RENAISSANCE HEALTH CARE L.L.C.

Employer identification number (EIN): 351898894

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RENAISSANCE VILLAGE 401K RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 DENISE PORTER 2014-10-09 LADONNA BEARD 2014-10-09
001 2012-01-01 DENISE PORTER LADONNA BEARD 2013-10-08
001 2011-01-01 DENISE PORTER LADONNA BEARD 2012-10-15
001 2010-01-01 DENISE PORTER LADONNA BEARD 2011-10-11
001 2009-01-01 DENISE PORTER LADONNA BEARD 2010-10-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	DENISE PORTER	2014-10-09	LADONNA BEARD	2014-10-09
001	2012-01-01	DENISE PORTER		LADONNA BEARD	2013-10-08
001	2011-01-01	DENISE PORTER		LADONNA BEARD	2012-10-15
001	2010-01-01	DENISE PORTER		LADONNA BEARD	2011-10-11
001	2009-01-01	DENISE PORTER		LADONNA BEARD	2010-10-07

Plan Statistics for RENAISSANCE VILLAGE 401K RETIREMENT PLAN

401k plan membership statisitcs for RENAISSANCE VILLAGE 401K RETIREMENT PLAN

Measure Date Value
2012: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 76
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 12
Total of all active and inactive participants 2012-01-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 88
Number of participants with account balances 2012-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 88
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 24
Total of all active and inactive participants 2011-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 112
Number of participants with account balances 2011-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 5
2010: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 96
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 13
Total of all active and inactive participants 2010-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 109
Number of participants with account balances 2010-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 4
2009: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 89
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 14
Total of all active and inactive participants 2009-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 103
Number of participants with account balances 2009-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2012: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	76
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	12
Total of all active and inactive participants	2012-01-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	88
Number of participants with account balances	2012-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	88
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	24
Total of all active and inactive participants	2011-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	112
Number of participants with account balances	2011-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	5
2010: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	96
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	13
Total of all active and inactive participants	2010-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	109
Number of participants with account balances	2010-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	4
2009: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	89
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	14
Total of all active and inactive participants	2009-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	103
Number of participants with account balances	2009-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on RENAISSANCE VILLAGE 401K RETIREMENT PLAN

Measure	Date	Value
2012 : RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$149,087
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$276,415
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$276,415
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$65,558
Value of total assets at end of year	2012-12-31	$900,621
Value of total assets at beginning of year	2012-12-31	$1,027,949
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$11,618
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$0
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Administrative expenses professional fees incurred	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$100,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$54,748
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Participant contributions at end of year	2012-12-31	$16
Participant contributions at beginning of year	2012-12-31	$2,509
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$0
Liabilities. Value of operating payables at end of year	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$-127,328
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$900,621
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,027,949
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
Assets. partnership/joint venture interests at end of year	2012-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$613,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$667,721
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Interest on participant loans	2012-12-31	$0
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in master investment trust accounts at end of year	2012-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$11,618
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$286,590
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$357,261
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$71,911
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
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
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Assets. Value of employer real property at end of year	2012-12-31	$0
Assets. Value of employer real property at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$10,810
Employer contributions (assets) at end of year	2012-12-31	$44
Employer contributions (assets) at beginning of year	2012-12-31	$458
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$276,415
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	BKD, LLP
Accountancy firm EIN	2012-12-31	440160260
2011 : RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Expenses. Interest paid	2011-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$63,575
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$22,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$22,762
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$78,821
Value of total assets at end of year	2011-12-31	$1,027,949
Value of total assets at beginning of year	2011-12-31	$987,136
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$13,248
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$0
Assets. Real estate other than employer real property at end of year	2011-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Administrative expenses professional fees incurred	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$100,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$67,072
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Participant contributions at end of year	2011-12-31	$2,509
Participant contributions at beginning of year	2011-12-31	$2,800
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Assets. Loans (other than to participants) at end of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$0
Liabilities. Value of operating payables at end of year	2011-12-31	$0
Liabilities. Value of operating payables at beginning of year	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$40,813
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,027,949
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$987,136
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
Assets. partnership/joint venture interests at end of year	2011-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Investment advisory and management fees	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$667,721
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$664,340
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$0
Interest on participant loans	2011-12-31	$0
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$0
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$13,248
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$357,261
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$319,438
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-28,494
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at end of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$11,749
Employer contributions (assets) at end of year	2011-12-31	$458
Employer contributions (assets) at beginning of year	2011-12-31	$558
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$22,762
Asset. Corporate debt instrument preferred debt at end of year	2011-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
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
Aggregate proceeds on sale of assets	2011-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	BKD, LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$147,465
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$45,157
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$45,157
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$70,662
Value of total assets at end of year	2010-12-31	$987,136
Value of total assets at beginning of year	2010-12-31	$884,828
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$11,441
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
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	$100,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$59,473
Participant contributions at end of year	2010-12-31	$2,800
Participant contributions at beginning of year	2010-12-31	$2,166
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	$102,308
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$987,136
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$884,828
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	$664,340
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$593,870
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$11,441
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$319,438
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$288,348
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$65,362
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
Contributions received in cash from employer	2010-12-31	$11,189
Employer contributions (assets) at end of year	2010-12-31	$558
Employer contributions (assets) at beginning of year	2010-12-31	$444
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$45,157
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	BKD, LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for RENAISSANCE VILLAGE 401K RETIREMENT PLAN

2012: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RENAISSANCE VILLAGE 401K RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: RENAISSANCE VILLAGE 401K RETIREMENT 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 – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: RENAISSANCE VILLAGE 401K RETIREMENT 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

G91599

Policy instance

Insurance contract or identification number	G91599
Number of Individuals Covered	49
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,380
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 $1,380
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	ONEAMERICA SECURITIES INC

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

Policy contract number

G91599

Policy instance

Insurance contract or identification number	G91599
Number of Individuals Covered	64
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,603
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

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

Policy contract number

G91599

Policy instance

Insurance contract or identification number	G91599
Number of Individuals Covered	58
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,412
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 $1,412
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	ONEAMERICA SECURITIES INC

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Company Name:	RENAISSANCE HEALTH CARE L.L.C.
Employer identification number (EIN):	351898894
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities