403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 401k Plan overview

Plan Name	403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER
Plan identification number	002

403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1. Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations. Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations. Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account. Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers. Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year. Life insurance

401k Sponsoring company profile

LIFECARE MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:	LIFECARE MEDICAL CENTER
Employer identification number (EIN):	411804205
NAIC Classification:	622000
NAIC Description:	Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	CATHERINE HUSS		CATHERINE HUSS	2018-10-15
002	2016-01-01	CATHERINE A HUSS
002	2015-01-01	CATHERINE HUSS
002	2014-01-01	CATHERINE HUSS
002	2013-01-01	CATHERINE HUSS
002	2012-01-01	CATHERINE HUSS
002	2011-01-01	CAROL KLOTZ
002	2010-01-01	CAROL KLOTZ
002	2009-01-01	CAROL KLOTZ
002	2009-01-01	CAROL KLOTZ
002	2009-01-01	CAROL KLOTZ

Plan Statistics for 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER

401k plan membership statisitcs for 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER

Measure	Date	Value
2022: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year	2022-01-01	543
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	453
Number of retired or separated participants receiving benefits	2022-01-01	8
Number of other retired or separated participants entitled to future benefits	2022-01-01	98
Total of all active and inactive participants	2022-01-01	559
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	560
Number of participants with account balances	2022-01-01	462
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	37
2021: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year	2021-01-01	536
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	439
Number of retired or separated participants receiving benefits	2021-01-01	8
Number of other retired or separated participants entitled to future benefits	2021-01-01	76
Total of all active and inactive participants	2021-01-01	523
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	524
Number of participants with account balances	2021-01-01	384
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	8
2020: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year	2020-01-01	539
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	470
Number of retired or separated participants receiving benefits	2020-01-01	8
Number of other retired or separated participants entitled to future benefits	2020-01-01	73
Total of all active and inactive participants	2020-01-01	551
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	553
Number of participants with account balances	2020-01-01	379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	7
2019: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year	2019-01-01	529
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	455
Number of retired or separated participants receiving benefits	2019-01-01	8
Number of other retired or separated participants entitled to future benefits	2019-01-01	72
Total of all active and inactive participants	2019-01-01	535
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	535
Number of participants with account balances	2019-01-01	371
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	5
2018: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year	2018-01-01	530
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	502
Number of retired or separated participants receiving benefits	2018-01-01	10
Number of other retired or separated participants entitled to future benefits	2018-01-01	72
Total of all active and inactive participants	2018-01-01	584
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	584
Number of participants with account balances	2018-01-01	365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year	2017-01-01	501
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	494
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	2
Total of all active and inactive participants	2017-01-01	496
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	496
Number of participants with account balances	2017-01-01	249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year	2016-01-01	517
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	451
Number of retired or separated participants receiving benefits	2016-01-01	21
Number of other retired or separated participants entitled to future benefits	2016-01-01	64
Total of all active and inactive participants	2016-01-01	536
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	536
Number of participants with account balances	2016-01-01	381
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	11
2015: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2015 401k membership
Total participants, beginning-of-year	2015-01-01	513
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	423
Number of retired or separated participants receiving benefits	2015-01-01	18
Number of other retired or separated participants entitled to future benefits	2015-01-01	71
Total of all active and inactive participants	2015-01-01	512
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	512
Number of participants with account balances	2015-01-01	367
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	14
2014: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2014 401k membership
Total participants, beginning-of-year	2014-01-01	512
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	431
Number of retired or separated participants receiving benefits	2014-01-01	15
Number of other retired or separated participants entitled to future benefits	2014-01-01	67
Total of all active and inactive participants	2014-01-01	513
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	513
Number of participants with account balances	2014-01-01	378
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	17
2013: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2013 401k membership
Total participants, beginning-of-year	2013-01-01	487
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	448
Number of retired or separated participants receiving benefits	2013-01-01	12
Number of other retired or separated participants entitled to future benefits	2013-01-01	43
Total of all active and inactive participants	2013-01-01	503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	503
Number of participants with account balances	2013-01-01	315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	74
2012: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2012 401k membership
Total participants, beginning-of-year	2012-01-01	506
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	440
Number of retired or separated participants receiving benefits	2012-01-01	7
Number of other retired or separated participants entitled to future benefits	2012-01-01	34
Total of all active and inactive participants	2012-01-01	481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	481
Number of participants with account balances	2012-01-01	318
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	58
2011: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2011 401k membership
Total participants, beginning-of-year	2011-01-01	509
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	439
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	53
Total of all active and inactive participants	2011-01-01	496
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	496
Number of participants with account balances	2011-01-01	345
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	50
2010: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2010 401k membership
Total participants, beginning-of-year	2010-01-01	492
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	462
Number of retired or separated participants receiving benefits	2010-01-01	2
Number of other retired or separated participants entitled to future benefits	2010-01-01	45
Total of all active and inactive participants	2010-01-01	509
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	509
Number of participants with account balances	2010-01-01	330
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	46
2009: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2009 401k membership
Total participants, beginning-of-year	2009-01-01	452
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	453
Number of retired or separated participants receiving benefits	2009-01-01	3
Number of other retired or separated participants entitled to future benefits	2009-01-01	33
Total of all active and inactive participants	2009-01-01	489
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	489
Number of participants with account balances	2009-01-01	287
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	48

Financial Data on 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER

Measure	Date	Value
2022 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-3,965,684
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$5,248,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$5,151,191
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,634,536
Value of total assets at end of year	2022-12-31	$35,345,341
Value of total assets at beginning of year	2022-12-31	$44,559,090
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$96,874
Total interest from all sources	2022-12-31	$152,188
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$420,633
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$420,633
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,769,000
Participant contributions at end of year	2022-12-31	$299,320
Participant contributions at beginning of year	2022-12-31	$314,395
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$36,977
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$37,307
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$15,486
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$44,676
Other income not declared elsewhere	2022-12-31	$7,797
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-9,213,749
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$35,345,341
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$44,559,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$26,754,381
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$34,450,884
Interest on participant loans	2022-12-31	$15,233
Interest earned on other investments	2022-12-31	$136,955
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$8,254,663
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$9,066,502
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-7,180,838
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$850,050
Employer contributions (assets) at beginning of year	2022-12-31	$690,002
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$5,106,515
Contract administrator fees	2022-12-31	$96,874
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Disclaimer
Accountancy firm name	2022-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2022-12-31	450250958
2021 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$7,163,720
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,182,900
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,068,164
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,520,708
Value of total assets at end of year	2021-12-31	$44,559,090
Value of total assets at beginning of year	2021-12-31	$39,578,270
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$114,736
Total interest from all sources	2021-12-31	$158,255
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$359,076
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$359,076
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,671,836
Participant contributions at end of year	2021-12-31	$314,395
Participant contributions at beginning of year	2021-12-31	$426,837
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$37,307
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$38,744
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$158,870
Other income not declared elsewhere	2021-12-31	$7,334
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$4,980,820
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$44,559,090
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$39,578,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$34,450,884
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$31,026,913
Interest on participant loans	2021-12-31	$21,599
Interest earned on other investments	2021-12-31	$136,656
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$9,066,502
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$7,395,351
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$4,118,347
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$690,002
Employer contributions (assets) at end of year	2021-12-31	$690,002
Employer contributions (assets) at beginning of year	2021-12-31	$690,425
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,068,164
Contract administrator fees	2021-12-31	$114,736
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2021-12-31	450250958
2020 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$7,479,627
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,632,815
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,513,614
Expenses. Certain deemed distributions of participant loans	2020-12-31	$20,642
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,597,219
Value of total assets at end of year	2020-12-31	$39,578,270
Value of total assets at beginning of year	2020-12-31	$34,731,458
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$98,559
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$158,875
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$323,118
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$323,118
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Amount of non-exempt transactions with any party-in-interest	2020-12-31	$0
Contributions received from participants	2020-12-31	$1,550,580
Participant contributions at end of year	2020-12-31	$426,837
Participant contributions at beginning of year	2020-12-31	$478,092
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$38,744
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$44,310
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$356,214
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$2,540
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$4,846,812
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$39,578,270
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$34,731,458
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2020-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$31,026,913
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$26,048,302
Interest on participant loans	2020-12-31	$25,831
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$133,044
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$7,395,351
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$7,506,737
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$4,397,875
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$690,425
Employer contributions (assets) at end of year	2020-12-31	$690,425
Employer contributions (assets) at beginning of year	2020-12-31	$654,017
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$2,513,614
Contract administrator fees	2020-12-31	$98,559
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2020-12-31	450250958
2019 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$7,356,571
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,668,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,565,486
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$1,382
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,349,320
Value of total assets at end of year	2019-12-31	$34,731,458
Value of total assets at beginning of year	2019-12-31	$29,043,429
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$101,674
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$160,237
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$398,160
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	$398,160
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Amount of non-exempt transactions with any party-in-interest	2019-12-31	$0
Contributions received from participants	2019-12-31	$1,505,112
Participant contributions at end of year	2019-12-31	$478,092
Participant contributions at beginning of year	2019-12-31	$350,172
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$44,310
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$50,576
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$190,191
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$3,084
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	2019-12-31	No
Value of net income/loss	2019-12-31	$5,688,029
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$34,731,458
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$29,043,429
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2019-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$26,048,302
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$20,029,931
Interest on participant loans	2019-12-31	$21,762
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$138,475
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$7,506,737
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$7,990,507
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$4,445,770
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$654,017
Employer contributions (assets) at end of year	2019-12-31	$654,017
Employer contributions (assets) at beginning of year	2019-12-31	$622,243
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,565,486
Contract administrator fees	2019-12-31	$101,674
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
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
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2019-12-31	450250958
2018 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$1,237,180
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,613,841
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,506,785
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$14,656
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$2,191,221
Value of total assets at end of year	2018-12-31	$29,043,429
Value of total assets at beginning of year	2018-12-31	$30,420,090
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$92,400
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$157,774
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$304,508
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$304,508
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Amount of non-exempt transactions with any party-in-interest	2018-12-31	$0
Contributions received from participants	2018-12-31	$1,349,572
Participant contributions at end of year	2018-12-31	$350,172
Participant contributions at beginning of year	2018-12-31	$261,327
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$40,458
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$50,576
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$117,343
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$219,406
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$58,029
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$1,260,650
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
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-1,376,661
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$29,043,429
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$30,420,090
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2018-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$20,029,931
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$18,176,419
Interest on participant loans	2018-12-31	$14,063
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$143,711
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$7,990,507
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$10,333,660
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,474,352
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
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	$622,243
Employer contributions (assets) at end of year	2018-12-31	$622,243
Employer contributions (assets) at beginning of year	2018-12-31	$230,233
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,506,785
Contract administrator fees	2018-12-31	$92,400
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2018-12-31	450250958
2017 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$133,945
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$5,521,071
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,895,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,885,850
Expenses. Certain deemed distributions of participant loans	2017-12-31	$3,588
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,057,449
Value of total assets at end of year	2017-12-31	$30,420,090
Value of total assets at beginning of year	2017-12-31	$26,660,533
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$6,021
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$313,611
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$362,602
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$362,602
Administrative expenses professional fees incurred	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
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
Amount of non-exempt transactions with any party-in-interest	2017-12-31	$0
Contributions received from participants	2017-12-31	$1,104,951
Participant contributions at end of year	2017-12-31	$261,327
Participant contributions at beginning of year	2017-12-31	$235,038
Participant contributions at end of year	2017-12-31	$40,458
Participant contributions at beginning of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$117,343
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$797,656
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$66,706
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
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
Administrative expenses (other) incurred	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$1,260,650
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$3,625,612
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$30,420,090
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$26,660,533
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2017-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$18,176,419
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$14,772,826
Interest on participant loans	2017-12-31	$10,884
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$302,727
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$10,333,660
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$10,855,013
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,787,409
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$885,792
Employer contributions (assets) at end of year	2017-12-31	$230,233
Employer contributions (assets) at beginning of year	2017-12-31	$0
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,885,850
Contract administrator fees	2017-12-31	$6,021
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	2017-12-31	Yes
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
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
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2017-12-31	450250958
2016 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$0
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
Expenses. Interest paid	2016-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$3,291,309
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$916,257
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$901,023
Expenses. Certain deemed distributions of participant loans	2016-12-31	$-864
Value of total corrective distributions	2016-12-31	$14,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,836,575
Value of total assets at end of year	2016-12-31	$26,660,533
Value of total assets at beginning of year	2016-12-31	$24,285,481
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,060
Total income from rents	2016-12-31	$0
Total interest from all sources	2016-12-31	$311,373
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$605,252
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	$605,252
Assets. Real estate other than employer real property at end of year	2016-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,112,615
Participant contributions at end of year	2016-12-31	$235,038
Participant contributions at beginning of year	2016-12-31	$201,158
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$797,656
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$805,073
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$87,904
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$104,394
Administrative expenses (other) incurred	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$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	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$2,375,052
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$26,660,533
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$24,285,481
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
Assets. partnership/joint venture interests at end of year	2016-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$14,772,826
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$13,257,354
Interest on participant loans	2016-12-31	$8,055
Income. Interest from loans (other than to participants)	2016-12-31	$0
Interest earned on other investments	2016-12-31	$303,318
Income. Interest from US Government securities	2016-12-31	$0
Income. Interest from corporate debt instruments	2016-12-31	$0
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$10,855,013
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$10,021,896
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$6,474
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$433,715
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
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
Assets. Invements in employer securities at end of year	2016-12-31	$0
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at end of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$636,056
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Income. Dividends from preferred stock	2016-12-31	$0
Income. Dividends from common stock	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$894,549
Asset. Corporate debt instrument preferred debt at end of year	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$2,060
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	2016-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
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
Aggregate proceeds on sale of assets	2016-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2016-12-31	450250958
2015 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
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
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,769,345
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,775,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,762,874
Expenses. Certain deemed distributions of participant loans	2015-12-31	$-1,163
Value of total corrective distributions	2015-12-31	$11,798
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,375,705
Value of total assets at end of year	2015-12-31	$24,285,481
Value of total assets at beginning of year	2015-12-31	$24,291,820
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,175
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$297,857
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$756,444
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	$756,444
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$990,778
Participant contributions at end of year	2015-12-31	$201,158
Participant contributions at beginning of year	2015-12-31	$248,680
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$805,073
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$1,672,074
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$6,976
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$-19,658
Administrative expenses (other) incurred	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$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	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$-6,339
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$24,285,481
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$24,291,820
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
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$13,257,354
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$12,537,953
Interest on participant loans	2015-12-31	$7,052
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$290,805
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$10,021,896
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$9,833,113
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$6,543
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-641,003
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
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
Assets. Invements in employer securities at end of year	2015-12-31	$0
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at end of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$377,951
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,756,331
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Contract administrator fees	2015-12-31	$2,175
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	2015-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
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
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2015-12-31	450250958
2014 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$517,608
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
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$2,751,494
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$634,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$620,551
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$11,615
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,606,770
Value of total assets at end of year	2014-12-31	$24,291,820
Value of total assets at beginning of year	2014-12-31	$21,657,128
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,244
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$280,385
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$544,498
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	$544,498
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$916,160
Participant contributions at end of year	2014-12-31	$248,680
Participant contributions at beginning of year	2014-12-31	$220,579
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$1,672,074
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$1,831,721
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$114,757
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$124,884
Administrative expenses (other) incurred	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$2,117,084
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$24,291,820
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$21,657,128
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
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$12,537,953
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$10,735,351
Interest on participant loans	2014-12-31	$9,041
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$271,344
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$9,833,113
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$8,869,477
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$6,175
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$194,957
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
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
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$575,853
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$614,376
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$2,244
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
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
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2014-12-31	450250958
2013 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
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
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$4,271,828
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$845,795
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$824,779
Expenses. Certain deemed distributions of participant loans	2013-12-31	$6,320
Value of total corrective distributions	2013-12-31	$8,977
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,496,768
Value of total assets at end of year	2013-12-31	$21,657,128
Value of total assets at beginning of year	2013-12-31	$18,231,095
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$5,719
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$244,013
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$299,756
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	$299,756
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Administrative expenses professional fees incurred	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$904,628
Participant contributions at end of year	2013-12-31	$220,579
Participant contributions at beginning of year	2013-12-31	$187,582
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$1,831,721
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$1,522,468
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$18,996
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$400,166
Administrative expenses (other) incurred	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$3,426,033
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$21,657,128
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$18,231,095
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
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$10,735,351
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$8,389,529
Interest on participant loans	2013-12-31	$8,322
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$235,691
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$8,869,477
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$8,131,516
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$7,241
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,831,125
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
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
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$573,144
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$817,538
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$5,719
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
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
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
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	EIDE BAILLY
Accountancy firm EIN	2013-12-31	450250958
2012 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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 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	$9,379
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	$2,993,198
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$741,300
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$738,562
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$62
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,479,014
Value of total assets at end of year	2012-12-31	$18,231,095
Value of total assets at beginning of year	2012-12-31	$15,988,576
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,676
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$218,965
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$144,669
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	$144,669
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	$500,000
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	$883,708
Participant contributions at end of year	2012-12-31	$187,582
Participant contributions at beginning of year	2012-12-31	$132,104
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$1,522,468
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$1,486,594
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$38,043
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	$9,379
Other income not declared elsewhere	2012-12-31	$199,745
Administrative expenses (other) incurred	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	$2,251,898
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$18,231,095
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$15,979,197
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	$8,389,529
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$7,108,168
Interest on participant loans	2012-12-31	$7,281
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$211,684
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	$0
Assets. Value of investments in 103.12 investment entities at end of year	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$8,131,516
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$7,093,119
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$9,263
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	$950,805
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	$557,263
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$168,591
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	$729,299
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	$2,676
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	EIDE BAILLY
Accountancy firm EIN	2012-12-31	450250958
2011 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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	$9,379
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$8,359
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	$1,514,430
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$874,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$868,257
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	$1,464,087
Value of total assets at end of year	2011-12-31	$15,988,576
Value of total assets at beginning of year	2011-12-31	$15,347,215
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$5,832
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$201,818
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$92,693
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	$92,693
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	$500,000
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	$878,335
Participant contributions at end of year	2011-12-31	$132,104
Participant contributions at beginning of year	2011-12-31	$121,743
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$1,486,594
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$1,578,920
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$53,116
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	$9,379
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$8,359
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	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	$640,341
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$15,979,197
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$15,338,856
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	$7,108,168
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$7,333,416
Interest on participant loans	2011-12-31	$5,442
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$196,376
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	$0
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	$7,093,119
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$6,313,136
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	$-244,168
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	$532,636
Employer contributions (assets) at end of year	2011-12-31	$168,591
Employer contributions (assets) at beginning of year	2011-12-31	$0
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	$868,257
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	$5,832
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
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	EIDE BAILLY
Accountancy firm EIN	2011-12-31	450250958
2010 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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	$8,359
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	$3,201,378
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$845,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$820,776
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,904,286
Value of total assets at end of year	2010-12-31	$15,347,215
Value of total assets at beginning of year	2010-12-31	$12,983,250
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$24,996
Total interest from all sources	2010-12-31	$184,648
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$95,603
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$95,603
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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	$842,231
Participant contributions at end of year	2010-12-31	$121,743
Participant contributions at beginning of year	2010-12-31	$113,148
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$1,578,920
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$1,823,998
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$563,428
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$8,359
Other income not declared elsewhere	2010-12-31	$250,955
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	$2,355,606
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$15,338,856
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$12,983,250
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	$7,333,416
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,456,804
Value of interest in pooled separate accounts at end of year	2010-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$0
Interest on participant loans	2010-12-31	$6,202
Interest earned on other investments	2010-12-31	$178,446
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$6,313,136
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$5,418,286
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$10,520
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$765,886
Net investment gain/loss from pooled separate accounts	2010-12-31	$0
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	$498,627
Employer contributions (assets) at beginning of year	2010-12-31	$171,014
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$810,256
Contract administrator fees	2010-12-31	$24,996
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	EIDE BAILLY
Accountancy firm EIN	2010-12-31	450250958
2009 : 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER

2022: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 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 funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: 403(B) RETIREMENT PLAN OF LIFECARE MEDICAL CENTER 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	3
Insurance contract or identification number 613953 Number of Individuals Covered 560 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	6456
Policy instance	2
Insurance contract or identification number 6456 Number of Individuals Covered 5 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	05849
Policy instance	1
Insurance contract or identification number 05849 Number of Individuals Covered 7 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	1
Insurance contract or identification number 613953 Number of Individuals Covered 524 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	05849
Policy instance	2
Insurance contract or identification number 05849 Number of Individuals Covered 8 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	6456
Policy instance	3
Insurance contract or identification number 6456 Number of Individuals Covered 5 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	3
Insurance contract or identification number 613953 Number of Individuals Covered 553 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	05849
Policy instance	1
Insurance contract or identification number 05849 Number of Individuals Covered 9 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $50,953 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	6456
Policy instance	2
Insurance contract or identification number 6456 Number of Individuals Covered 5 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	05849
Policy instance	1
Insurance contract or identification number 05849 Number of Individuals Covered 11 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	3
Insurance contract or identification number 613953 Number of Individuals Covered 535 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	6456
Policy instance	2
Insurance contract or identification number 6456 Number of Individuals Covered 5 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 0 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	935512
Policy instance	4
Insurance contract or identification number 935512 Number of Individuals Covered 0 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	1
Insurance contract or identification number 613953 Number of Individuals Covered 584 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 0 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	3
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2017-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $129 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,200 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $129 Amount paid for insurance broker fees 0 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 4 Insurance broker name CITISTREET ASSOCIATES LLC
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	935512
Policy instance	6
Insurance contract or identification number 935512 Number of Individuals Covered 496 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	5
Insurance contract or identification number 919486 Number of Individuals Covered 0 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	4
Insurance contract or identification number 5849 Number of Individuals Covered 11 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $2,641 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $56,457 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 2641 Additional information about fees paid to insurance broker COMMISSION/SERVICE FEES Insurance broker organization code? 3 Insurance broker name WILLIAM J WESTIN
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	613953
Policy instance	1
Insurance contract or identification number 613953 Number of Individuals Covered 496 Insurance policy start date 2017-12-15 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	2
Insurance contract or identification number 1013446-01 Number of Individuals Covered 0 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 0 Insurance policy start date 2015-01-01 Insurance policy end date 2015-04-16 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	4
Insurance contract or identification number 919486 Number of Individuals Covered 59 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $3,406 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 $3,406 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 11 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes 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 Welfare Benefit Premiums Paid to Carrier USD $2,716 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $154 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $3,827 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $154 Insurance broker organization code? 3 Insurance broker name CITISTREET ASSOCIATES, LLC
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	1
Insurance contract or identification number 1013446-01 Number of Individuals Covered 248 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $2,861 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,861 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	1
Insurance contract or identification number 1013446-01 Number of Individuals Covered 246 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $5,536 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 $5,536 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $156 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $3,875 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $156 Insurance broker organization code? 3 Insurance broker name CITISTREET ASSOCIATES, LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	4
Insurance contract or identification number 919486 Number of Individuals Covered 59 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $3,734 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 $3,734 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 24 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 11 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes 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 Welfare Benefit Premiums Paid to Carrier USD $2,300 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	1
Insurance contract or identification number 1013446-01 Number of Individuals Covered 230 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $2,983 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,983 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 24 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	4
Insurance contract or identification number 919486 Number of Individuals Covered 67 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $3,179 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 $3,179 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 16 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $3,187 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 14 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $163 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $4,054 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $163 Insurance broker organization code? 3 Insurance broker name CITISTREET ASSOCIATES, LLC
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $164 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $4,079 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $164 Insurance broker organization code? 3 Insurance broker name CITISTREET ASSOCIATES, LLC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 24 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $474 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 $474 Insurance broker organization code? 3 Insurance broker name NATIONWIDE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	4
Insurance contract or identification number 919486 Number of Individuals Covered 71 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $3,203 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 $3,203 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 18 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes 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 Welfare Benefit Premiums Paid to Carrier USD $5,184 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	1
Insurance contract or identification number 1013446-01 Number of Individuals Covered 233 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $7,195 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 $7,195 Insurance broker organization code? 3 Insurance broker name METLIFE SECURITIES INC.
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number	1013446-01
Policy instance	1
Insurance contract or identification number 1013446-01 Number of Individuals Covered 345 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $5,844 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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 27 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	4
Insurance contract or identification number 919486 Number of Individuals Covered 71 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $3,160 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
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	2
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $188 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $4,682 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	3
Insurance contract or identification number 5849 Number of Individuals Covered 16 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $5,419 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1013446-01
Policy instance	2
Insurance contract or identification number 1013446-01 Number of Individuals Covered 330 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $3,382 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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	COPE0101CC35
Policy instance	5
Insurance contract or identification number COPE0101CC35 Number of Individuals Covered 44 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5849
Policy instance	4
Insurance contract or identification number 5849 Number of Individuals Covered 18 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $5,535 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	5781
Policy instance	3
Insurance contract or identification number 5781 Number of Individuals Covered 15 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 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 Yes 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 Welfare Benefit Premiums Paid to Carrier USD $4,985 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	919486
Policy instance	1
Insurance contract or identification number 919486 Number of Individuals Covered 73 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $3,018 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

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