401k Plan data: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN plan

NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN
Plan identification number	001

NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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.
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

NORTHERN HABILITATIVE SERVICES, INC has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN HABILITATIVE SERVICES, INC

Employer identification number (EIN): 411708020

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01 JESSICA MARSON
001 2016-01-01 THOMAS RUPER
001 2015-01-01
001 2014-01-01 THOMAS RUPER
001 2013-01-01 JOHN BRISKI
001 2012-01-01 JOHN BRISKI
001 2011-01-01 JOHN BRISKI
001 2010-01-01 JOHN BRISKI
001 2009-01-01 JOHN BRISKI
001 2009-01-01 JOHN BRISKI
001 2009-01-01 JOHN BRISKI

Plan Statistics for NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2019: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 214
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 163
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 21
Total of all active and inactive participants 2019-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 184
Number of participants with account balances 2019-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 241
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 196
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 16
Total of all active and inactive participants 2018-01-01 212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 212
Number of participants with account balances 2018-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 224
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 17
Total of all active and inactive participants 2017-01-01 241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 241
Number of participants with account balances 2017-01-01 104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 5
2016: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 202
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 99
Total of all active and inactive participants 2016-01-01 301
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 301
Number of participants with account balances 2016-01-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 310
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 191
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 92
Total of all active and inactive participants 2015-01-01 283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 283
Number of participants with account balances 2015-01-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 280
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 164
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 121
Total of all active and inactive participants 2014-01-01 285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 285
Number of participants with account balances 2014-01-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 136
Number of retired or separated participants receiving benefits 2013-01-01 15
Number of other retired or separated participants entitled to future benefits 2013-01-01 100
Total of all active and inactive participants 2013-01-01 251
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 251
Number of participants with account balances 2013-01-01 195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 10
2012: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 137
Number of retired or separated participants receiving benefits 2012-01-01 9
Number of other retired or separated participants entitled to future benefits 2012-01-01 102
Total of all active and inactive participants 2012-01-01 248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 248
Number of participants with account balances 2012-01-01 213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 15
2011: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 256
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 140
Number of retired or separated participants receiving benefits 2011-01-01 8
Number of other retired or separated participants entitled to future benefits 2011-01-01 95
Total of all active and inactive participants 2011-01-01 243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 243
Number of participants with account balances 2011-01-01 231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 164
Number of retired or separated participants receiving benefits 2010-01-01 16
Number of other retired or separated participants entitled to future benefits 2010-01-01 77
Total of all active and inactive participants 2010-01-01 257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 257
Number of participants with account balances 2010-01-01 254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 33
2009: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 249
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 168
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 93
Total of all active and inactive participants 2009-01-01 261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 261
Number of participants with account balances 2009-01-01 257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 15

Measure	Date	Value
2019: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	214
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	163
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	21
Total of all active and inactive participants	2019-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	184
Number of participants with account balances	2019-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	241
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	196
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	16
Total of all active and inactive participants	2018-01-01	212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	212
Number of participants with account balances	2018-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	224
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	17
Total of all active and inactive participants	2017-01-01	241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	241
Number of participants with account balances	2017-01-01	104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	5
2016: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	202
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	99
Total of all active and inactive participants	2016-01-01	301
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	301
Number of participants with account balances	2016-01-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	310
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	191
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	92
Total of all active and inactive participants	2015-01-01	283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	283
Number of participants with account balances	2015-01-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	280
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	164
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	121
Total of all active and inactive participants	2014-01-01	285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	285
Number of participants with account balances	2014-01-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	136
Number of retired or separated participants receiving benefits	2013-01-01	15
Number of other retired or separated participants entitled to future benefits	2013-01-01	100
Total of all active and inactive participants	2013-01-01	251
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	251
Number of participants with account balances	2013-01-01	195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	10
2012: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	137
Number of retired or separated participants receiving benefits	2012-01-01	9
Number of other retired or separated participants entitled to future benefits	2012-01-01	102
Total of all active and inactive participants	2012-01-01	248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	248
Number of participants with account balances	2012-01-01	213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	15
2011: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	256
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	140
Number of retired or separated participants receiving benefits	2011-01-01	8
Number of other retired or separated participants entitled to future benefits	2011-01-01	95
Total of all active and inactive participants	2011-01-01	243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	243
Number of participants with account balances	2011-01-01	231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	164
Number of retired or separated participants receiving benefits	2010-01-01	16
Number of other retired or separated participants entitled to future benefits	2010-01-01	77
Total of all active and inactive participants	2010-01-01	257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	257
Number of participants with account balances	2010-01-01	254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	33
2009: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	249
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	168
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	93
Total of all active and inactive participants	2009-01-01	261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	261
Number of participants with account balances	2009-01-01	257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	15

Financial Data on NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN

Measure	Date	Value
2019 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$2,509
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	$398,966
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$155,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$138,827
Expenses. Certain deemed distributions of participant loans	2019-12-31	$3,489
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$112,058
Value of total assets at end of year	2019-12-31	$1,762,415
Value of total assets at beginning of year	2019-12-31	$1,516,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$13,516
Total interest from all sources	2019-12-31	$4,539
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$53,213
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	$53,213
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,180,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
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	$112,058
Participant contributions at end of year	2019-12-31	$92,724
Participant contributions at beginning of year	2019-12-31	$68,905
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$24,096
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$3,536
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$2,509
Administrative expenses (other) incurred	2019-12-31	$13,516
Total non interest bearing cash at end of year	2019-12-31	$34
Total non interest bearing cash at beginning of year	2019-12-31	$49,968
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	$243,134
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,759,906
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,516,772
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,591,644
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,397,899
Income. Interest from loans (other than to participants)	2019-12-31	$4,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$53,917
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$229,156
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$135,291
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	2019-12-31	Yes
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	REDPATH AND COMPANY, LTD.
Accountancy firm EIN	2019-12-31	410975573
2018 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$20,652
Total income from all sources (including contributions)	2018-12-31	$59,050
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$256,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$225,338
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$147,898
Value of total assets at end of year	2018-12-31	$1,516,772
Value of total assets at beginning of year	2018-12-31	$1,734,725
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$31,013
Total interest from all sources	2018-12-31	$2,772
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$180,000
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	$111,834
Participant contributions at end of year	2018-12-31	$68,905
Participant contributions at beginning of year	2018-12-31	$52,548
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$35,737
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$20,652
Total non interest bearing cash at end of year	2018-12-31	$49,968
Total non interest bearing cash at beginning of year	2018-12-31	$45,072
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	$-197,301
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,516,772
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,714,073
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$1,397,899
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,637,105
Interest on participant loans	2018-12-31	$2,772
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-91,620
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	$327
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$225,338
Contract administrator fees	2018-12-31	$31,013
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	REDPATH AND COMPANY, LTD.
Accountancy firm EIN	2018-12-31	410975573
2017 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$20,652
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	$439,956
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$278,614
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$239,040
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$206,132
Value of total assets at end of year	2017-12-31	$1,734,725
Value of total assets at beginning of year	2017-12-31	$1,552,731
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$39,574
Total interest from all sources	2017-12-31	$5,092
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$180,000
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	$144,616
Participant contributions at end of year	2017-12-31	$52,548
Participant contributions at beginning of year	2017-12-31	$56,606
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$22,098
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$20,652
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$45,072
Total non interest bearing cash at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$161,342
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,714,073
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,552,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,310,446
Value of interest in pooled separate accounts at end of year	2017-12-31	$1,637,105
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$2,233
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$161,491
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$161,491
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$2,859
Net investment gain/loss from pooled separate accounts	2017-12-31	$228,732
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$61,516
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$2,090
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$239,040
Contract administrator fees	2017-12-31	$39,574
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	REDPATH AND COMPANY, LTD.
Accountancy firm EIN	2017-12-31	410975573
2016 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$333,926
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$241,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$235,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$222,523
Value of total assets at end of year	2016-12-31	$1,528,543
Value of total assets at beginning of year	2016-12-31	$1,435,631
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,109
Total interest from all sources	2016-12-31	$1,955
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$41,401
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	$41,401
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$180,000
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	$139,217
Participant contributions at end of year	2016-12-31	$56,606
Participant contributions at beginning of year	2016-12-31	$35,826
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$23,129
Administrative expenses (other) incurred	2016-12-31	$5,109
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	$92,912
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,528,543
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,435,631
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,310,446
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,244,617
Interest on participant loans	2016-12-31	$1,955
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$161,491
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$155,188
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$155,188
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$68,047
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	$60,177
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$235,905
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2016-12-31	411532347
2015 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$191,187
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$540,771
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$534,799
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$219,628
Value of total assets at end of year	2015-12-31	$1,435,631
Value of total assets at beginning of year	2015-12-31	$1,785,215
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$5,972
Total interest from all sources	2015-12-31	$1,808
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$90,562
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	$90,562
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$180,000
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	$165,612
Participant contributions at end of year	2015-12-31	$35,826
Participant contributions at beginning of year	2015-12-31	$37,215
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,928
Administrative expenses (other) incurred	2015-12-31	$5,972
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	$-349,584
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,435,631
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,785,215
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	$1,244,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,588,811
Interest on participant loans	2015-12-31	$1,808
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$155,188
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$159,189
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$159,189
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-120,811
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	$52,088
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$534,799
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2015-12-31	411532347
2014 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$409,832
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$416,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$410,043
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$292,370
Value of total assets at end of year	2014-12-31	$1,785,215
Value of total assets at beginning of year	2014-12-31	$1,791,812
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$6,386
Total interest from all sources	2014-12-31	$1,357
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$121,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$121,905
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$180,000
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	$58,303
Participant contributions at end of year	2014-12-31	$37,215
Participant contributions at beginning of year	2014-12-31	$41,930
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$1,769
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$195,198
Administrative expenses (other) incurred	2014-12-31	$6,386
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	$-6,597
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,785,215
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,791,812
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	$1,588,811
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,571,771
Interest on participant loans	2014-12-31	$1,357
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$159,189
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$175,070
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$175,070
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-5,800
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	$38,869
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$1,272
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$410,043
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2014-12-31	411532347
2013 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$442,985
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$591,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$573,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$142,656
Value of total assets at end of year	2013-12-31	$1,791,812
Value of total assets at beginning of year	2013-12-31	$1,940,802
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$18,975
Total interest from all sources	2013-12-31	$1,354
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$98,613
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$98,613
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$250,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$83,470
Participant contributions at end of year	2013-12-31	$41,930
Participant contributions at beginning of year	2013-12-31	$18,583
Participant contributions at end of year	2013-12-31	$1,769
Participant contributions at beginning of year	2013-12-31	$4,376
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$19,148
Administrative expenses (other) incurred	2013-12-31	$18,975
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	$-148,990
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,791,812
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,940,802
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	$1,571,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,720,107
Interest on participant loans	2013-12-31	$1,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$175,070
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$195,942
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$195,942
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$200,362
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	$40,038
Employer contributions (assets) at end of year	2013-12-31	$1,272
Employer contributions (assets) at beginning of year	2013-12-31	$1,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$573,000
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2013-12-31	411532347
2012 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2012-12-31	$466,387
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$898,894
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$878,197
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$159,600
Value of total assets at end of year	2012-12-31	$1,940,802
Value of total assets at beginning of year	2012-12-31	$2,373,309
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$20,697
Total interest from all sources	2012-12-31	$846
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$51,042
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	$51,042
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
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	$113,113
Participant contributions at end of year	2012-12-31	$18,583
Participant contributions at beginning of year	2012-12-31	$20,596
Participant contributions at end of year	2012-12-31	$4,376
Participant contributions at beginning of year	2012-12-31	$4,183
Administrative expenses (other) incurred	2012-12-31	$20,697
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	$-432,507
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,940,802
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,373,309
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	$1,720,107
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,125,812
Interest on participant loans	2012-12-31	$846
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$195,942
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$221,064
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$221,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$254,899
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	$46,487
Employer contributions (assets) at end of year	2012-12-31	$1,794
Employer contributions (assets) at beginning of year	2012-12-31	$1,654
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$878,197
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2012-12-31	411532347
2011 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2011-12-31	$199,363
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$121,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$102,907
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$176,623
Value of total assets at end of year	2011-12-31	$2,373,309
Value of total assets at beginning of year	2011-12-31	$2,295,736
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$18,883
Total interest from all sources	2011-12-31	$818
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$49,579
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	$49,579
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
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	$121,274
Participant contributions at end of year	2011-12-31	$20,596
Participant contributions at beginning of year	2011-12-31	$16,557
Participant contributions at end of year	2011-12-31	$4,183
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$4,118
Administrative expenses (other) incurred	2011-12-31	$18,883
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	$77,573
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,373,309
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,295,736
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	$2,125,812
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,149,179
Interest on participant loans	2011-12-31	$818
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$221,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-27,657
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
Contributions received in cash from employer	2011-12-31	$51,231
Employer contributions (assets) at end of year	2011-12-31	$1,654
Employer contributions (assets) at beginning of year	2011-12-31	$130,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$102,907
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	HARRINGTON LANGER & ASSOCIATES
Accountancy firm EIN	2011-12-31	411532347
2010 : NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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	$408,107
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$358,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$350,381
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$181,497
Value of total assets at end of year	2010-12-31	$2,295,736
Value of total assets at beginning of year	2010-12-31	$2,245,938
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,928
Total interest from all sources	2010-12-31	$41,677
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	$250,000
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	$51,497
Participant contributions at end of year	2010-12-31	$16,557
Participant contributions at beginning of year	2010-12-31	$40,954
Administrative expenses (other) incurred	2010-12-31	$7,928
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	$49,798
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,295,736
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,245,938
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	$2,149,179
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,004,984
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$41,677
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$184,933
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	$130,000
Employer contributions (assets) at end of year	2010-12-31	$130,000
Employer contributions (assets) at beginning of year	2010-12-31	$200,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$350,381
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	EIKILL & SCHILLING
Accountancy firm EIN	2010-12-31	411308137

Form 5500 Responses for NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING PLAN

2019: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 - Trust	Yes
2018: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 - Trust	Yes
2017: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 - Trust	Yes
2016: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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: NORTHERN HABILITATIVE SERVICES, INC. 401K PROFIT SHARING 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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

127729

Policy instance

Insurance contract or identification number	127729
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-01-14
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

127729

Policy instance

Insurance contract or identification number	127729
Number of Individuals Covered	97
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,321
Total amount of fees paid to insurance company	USD $12,213
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	12213
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

127729

Policy instance

Insurance contract or identification number	127729
Number of Individuals Covered	103
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $16,835
Total amount of fees paid to insurance company	USD $15,377
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?	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 $16,835
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	GOLDLEAF PARTNERS

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Company Name:	NORTHERN HABILITATIVE SERVICES, INC
Employer identification number (EIN):	411708020
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities