401k Plan data: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR plan

TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR
Plan identification number	002

TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

SUNRISE MANOR has sponsored the creation of one or more 401k plans.

Company Name: SUNRISE MANOR

Employer identification number (EIN): 420805391

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

Additional information about SUNRISE MANOR

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1956-07-13

Company Identification Number: 078180

Legal Registered Office Address: 5501 GORDON DR

SIOUX CITY
United States of America (USA)
51106

More information about SUNRISE MANOR

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 KRISTI LOOFE 2023-10-09 KRISTI LOOFE 2023-10-09
002 2021-01-01 KRISTI LOOFE 2022-10-04
002 2020-01-01 JULIE KLEIN 2021-09-22 JULIE KLEIN 2021-09-22
002 2019-01-01 JULIE KLEIN 2020-08-31 JULIE KLEIN 2020-08-31
002 2018-01-01 JULIE KLEIN 2019-08-30 JULIE KLEIN 2019-08-30
002 2017-01-01
002 2016-01-01 JULIE KLEIN JULIE KLEIN 2017-07-25
002 2015-01-01 JULIE KLEIN JULIE KLEIN 2016-07-22
002 2014-01-01 HALLIE SALMEN HALLIE SALMEN 2015-07-29
002 2013-01-01 HALLIE SALMEN HALLIE SALMEN 2014-10-14
002 2012-01-01 HALLIE SALMEN HALLIE SALMEN 2013-10-11
002 2011-01-01 HALLIE SALMEN HALLIE SALMEN 2012-10-12
002 2009-01-01 HALLIE SALMEN HALLIE SALMEN 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	KRISTI LOOFE	2023-10-09	KRISTI LOOFE	2023-10-09
002	2021-01-01	KRISTI LOOFE	2022-10-04
002	2020-01-01	JULIE KLEIN	2021-09-22	JULIE KLEIN	2021-09-22
002	2019-01-01	JULIE KLEIN	2020-08-31	JULIE KLEIN	2020-08-31
002	2018-01-01	JULIE KLEIN	2019-08-30	JULIE KLEIN	2019-08-30
002	2017-01-01
002	2016-01-01	JULIE KLEIN		JULIE KLEIN	2017-07-25
002	2015-01-01	JULIE KLEIN		JULIE KLEIN	2016-07-22
002	2014-01-01	HALLIE SALMEN		HALLIE SALMEN	2015-07-29
002	2013-01-01	HALLIE SALMEN		HALLIE SALMEN	2014-10-14
002	2012-01-01	HALLIE SALMEN		HALLIE SALMEN	2013-10-11
002	2011-01-01	HALLIE SALMEN		HALLIE SALMEN	2012-10-12
002	2009-01-01	HALLIE SALMEN		HALLIE SALMEN	2010-10-14

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR

Measure Date Value
2022: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2022 401k membership
Total participants, beginning-of-year 2022-01-01 227
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 237
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 9
Total of all active and inactive participants 2022-01-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 246
Number of participants with account balances 2022-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2021 401k membership
Total participants, beginning-of-year 2021-01-01 239
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 235
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 11
Total of all active and inactive participants 2021-01-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 246
Number of participants with account balances 2021-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2020 401k membership
Total participants, beginning-of-year 2020-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 222
Number of other retired or separated participants entitled to future benefits 2020-01-01 17
Total of all active and inactive participants 2020-01-01 239
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 239
Number of participants with account balances 2020-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 8
2019: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2019 401k membership
Total participants, beginning-of-year 2019-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 222
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 11
Total of all active and inactive participants 2019-01-01 233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 233
Number of participants with account balances 2019-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2018 401k membership
Total participants, beginning-of-year 2018-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 215
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 29
Total of all active and inactive participants 2018-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 244
Number of participants with account balances 2018-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 11
2017: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2017 401k membership
Total participants, beginning-of-year 2017-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 212
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 20
Total of all active and inactive participants 2017-01-01 232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 232
Number of participants with account balances 2017-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 7
2016: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2016 401k membership
Total participants, beginning-of-year 2016-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 206
Number of other retired or separated participants entitled to future benefits 2016-01-01 14
Total of all active and inactive participants 2016-01-01 220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 220
Number of participants with account balances 2016-01-01 42
2015: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2015 401k membership
Total participants, beginning-of-year 2015-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 178
Number of other retired or separated participants entitled to future benefits 2015-01-01 10
Total of all active and inactive participants 2015-01-01 188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 189
Number of participants with account balances 2015-01-01 35
2014: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2014 401k membership
Total participants, beginning-of-year 2014-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 171
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 14
Total of all active and inactive participants 2014-01-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 186
Number of participants with account balances 2014-01-01 35
2013: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2013 401k membership
Total participants, beginning-of-year 2013-01-01 217
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 164
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 11
Total of all active and inactive participants 2013-01-01 175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 176
Number of participants with account balances 2013-01-01 32
2012: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2012 401k membership
Total participants, beginning-of-year 2012-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 217
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 227
Number of participants with account balances 2012-01-01 30
2011: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2011 401k membership
Total participants, beginning-of-year 2011-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 197
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 7
Total of all active and inactive participants 2011-01-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 2
Total participants 2011-01-01 206
Number of participants with account balances 2011-01-01 24
2009: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2009 401k membership
Total participants, beginning-of-year 2009-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 172
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 179
Number of participants with account balances 2009-01-01 18

Measure	Date	Value
2022: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2022 401k membership
Total participants, beginning-of-year	2022-01-01	227
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	237
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	9
Total of all active and inactive participants	2022-01-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	246
Number of participants with account balances	2022-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2021 401k membership
Total participants, beginning-of-year	2021-01-01	239
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	235
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	11
Total of all active and inactive participants	2021-01-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	246
Number of participants with account balances	2021-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2020 401k membership
Total participants, beginning-of-year	2020-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	222
Number of other retired or separated participants entitled to future benefits	2020-01-01	17
Total of all active and inactive participants	2020-01-01	239
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	239
Number of participants with account balances	2020-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	8
2019: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2019 401k membership
Total participants, beginning-of-year	2019-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	222
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	11
Total of all active and inactive participants	2019-01-01	233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	233
Number of participants with account balances	2019-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2018 401k membership
Total participants, beginning-of-year	2018-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	215
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	29
Total of all active and inactive participants	2018-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	244
Number of participants with account balances	2018-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	11
2017: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2017 401k membership
Total participants, beginning-of-year	2017-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	212
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	20
Total of all active and inactive participants	2017-01-01	232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	232
Number of participants with account balances	2017-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	7
2016: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2016 401k membership
Total participants, beginning-of-year	2016-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	206
Number of other retired or separated participants entitled to future benefits	2016-01-01	14
Total of all active and inactive participants	2016-01-01	220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	220
Number of participants with account balances	2016-01-01	42
2015: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2015 401k membership
Total participants, beginning-of-year	2015-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	178
Number of other retired or separated participants entitled to future benefits	2015-01-01	10
Total of all active and inactive participants	2015-01-01	188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	189
Number of participants with account balances	2015-01-01	35
2014: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2014 401k membership
Total participants, beginning-of-year	2014-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	171
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	14
Total of all active and inactive participants	2014-01-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	186
Number of participants with account balances	2014-01-01	35
2013: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2013 401k membership
Total participants, beginning-of-year	2013-01-01	217
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	164
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	11
Total of all active and inactive participants	2013-01-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	176
Number of participants with account balances	2013-01-01	32
2012: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2012 401k membership
Total participants, beginning-of-year	2012-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	217
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	227
Number of participants with account balances	2012-01-01	30
2011: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2011 401k membership
Total participants, beginning-of-year	2011-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	197
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	7
Total of all active and inactive participants	2011-01-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	2
Total participants	2011-01-01	206
Number of participants with account balances	2011-01-01	24
2009: TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2009 401k membership
Total participants, beginning-of-year	2009-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	172
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	179
Number of participants with account balances	2009-01-01	18

Financial Data on TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR

Measure	Date	Value
2022 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 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	$-24,682
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$217,525
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$206,121
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$110,047
Value of total assets at end of year	2022-12-31	$652,565
Value of total assets at beginning of year	2022-12-31	$894,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$11,404
Total interest from all sources	2022-12-31	$266
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$18,126
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	$18,126
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	$90,832
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,750
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	$-242,207
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$652,565
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$894,772
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	$627,728
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$869,377
Interest earned on other investments	2022-12-31	$266
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$24,837
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$25,395
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-153,121
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	$16,465
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$206,121
Contract administrator fees	2022-12-31	$11,404
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2022-12-31	420941961
2021 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 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	$214,003
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$145,547
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$134,942
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$116,522
Value of total assets at end of year	2021-12-31	$894,772
Value of total assets at beginning of year	2021-12-31	$826,316
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$10,605
Total interest from all sources	2021-12-31	$298
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$106,287
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	$106,287
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	$98,419
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	$68,456
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$894,772
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$826,316
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	$869,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$797,224
Interest earned on other investments	2021-12-31	$298
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$25,395
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$29,092
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$-9,698
Net investment gain/loss from pooled separate accounts	2021-12-31	$594
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	$18,103
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$134,942
Contract administrator fees	2021-12-31	$10,605
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2021-12-31	420941961
2020 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$222,593
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$67,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$59,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$113,904
Value of total assets at end of year	2020-12-31	$826,316
Value of total assets at beginning of year	2020-12-31	$671,130
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$8,372
Total interest from all sources	2020-12-31	$384
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$21,982
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	$21,982
Administrative expenses professional fees incurred	2020-12-31	$375
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$91,574
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$5,249
Other income not declared elsewhere	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	$155,186
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$826,316
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$671,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$473
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$797,224
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$644,972
Interest earned on other investments	2020-12-31	$384
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$29,092
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$26,158
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$86,057
Net investment gain/loss from pooled separate accounts	2020-12-31	$266
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	$17,081
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$59,035
Contract administrator fees	2020-12-31	$7,524
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2020-12-31	420941961
2019 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$219,417
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$56,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$48,872
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$114,227
Value of total assets at end of year	2019-12-31	$671,130
Value of total assets at beginning of year	2019-12-31	$508,580
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$7,995
Total interest from all sources	2019-12-31	$387
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$16,462
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	$16,462
Administrative expenses professional fees incurred	2019-12-31	$569
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$70,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$76,670
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$24,576
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	$162,550
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$671,130
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$508,580
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$644,972
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$475,971
Interest earned on other investments	2019-12-31	$387
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$26,158
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$32,609
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$87,796
Net investment gain/loss from pooled separate accounts	2019-12-31	$545
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	$12,981
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$48,872
Contract administrator fees	2019-12-31	$7,426
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2019-12-31	420941961
2018 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$98,570
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$50,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$44,185
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$128,782
Value of total assets at end of year	2018-12-31	$508,580
Value of total assets at beginning of year	2018-12-31	$460,533
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$6,338
Total interest from all sources	2018-12-31	$405
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$18,404
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	$18,404
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$70,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$61,214
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$52,729
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$48,047
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$508,580
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$460,533
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$475,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$432,815
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest earned on other investments	2018-12-31	$405
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$32,609
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$27,718
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-49,021
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	$14,839
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$44,185
Contract administrator fees	2018-12-31	$6,338
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2018-12-31	420941961
2017 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$155,288
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$38,580
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$35,670
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$101,316
Value of total assets at end of year	2017-12-31	$460,533
Value of total assets at beginning of year	2017-12-31	$343,825
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,910
Total interest from all sources	2017-12-31	$475
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$12,814
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	$12,814
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	$46,934
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
Contributions received from participants	2017-12-31	$58,026
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$29,072
Administrative expenses (other) incurred	2017-12-31	$24
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$116,708
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$460,533
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$343,825
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$432,815
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$286,397
Value of interest in pooled separate accounts at end of year	2017-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest earned on other investments	2017-12-31	$475
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$27,718
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$57,428
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$37,862
Net investment gain/loss from pooled separate accounts	2017-12-31	$2,821
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	$14,218
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$35,670
Contract administrator fees	2017-12-31	$2,886
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
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	KING, REINSCH, PROSSER, & CO.,LLP
Accountancy firm EIN	2017-12-31	420941961
2016 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$57,911
Total of all expenses incurred	2016-12-31	$183,427
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$183,135
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$35,520
Value of total assets at end of year	2016-12-31	$343,825
Value of total assets at beginning of year	2016-12-31	$469,341
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$292
Total interest from all sources	2016-12-31	$588
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$46,934
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$35,520
Administrative expenses (other) incurred	2016-12-31	$292
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-125,516
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$343,825
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$469,341
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$286,397
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$401,172
Interest earned on other investments	2016-12-31	$588
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$57,428
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$68,169
Net investment gain/loss from pooled separate accounts	2016-12-31	$21,803
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$183,135
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
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2016-12-31	420941961
2015 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$41,639
Total of all expenses incurred	2015-12-31	$58,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$58,411
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$43,991
Value of total assets at end of year	2015-12-31	$469,341
Value of total assets at beginning of year	2015-12-31	$486,437
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$324
Total interest from all sources	2015-12-31	$791
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$48,644
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$43,991
Administrative expenses (other) incurred	2015-12-31	$324
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-17,096
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$469,341
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$486,437
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$401,172
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$415,244
Interest earned on other investments	2015-12-31	$791
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$68,169
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$71,193
Net investment gain/loss from pooled separate accounts	2015-12-31	$-3,143
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$58,411
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
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2015-12-31	420941961
2014 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$129,466
Total of all expenses incurred	2014-12-31	$23,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$23,408
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$105,920
Value of total assets at end of year	2014-12-31	$486,437
Value of total assets at beginning of year	2014-12-31	$380,734
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$355
Total interest from all sources	2014-12-31	$768
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$38,073
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$45,738
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$60,182
Administrative expenses (other) incurred	2014-12-31	$355
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$105,703
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$486,437
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$380,734
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$415,244
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$317,346
Interest earned on other investments	2014-12-31	$768
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$71,193
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$63,388
Net investment gain/loss from pooled separate accounts	2014-12-31	$22,778
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$23,408
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	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2014-12-31	420941961
2013 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$117,659
Total of all expenses incurred	2013-12-31	$7,350
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$6,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$64,016
Value of total assets at end of year	2013-12-31	$380,734
Value of total assets at beginning of year	2013-12-31	$270,425
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$376
Total interest from all sources	2013-12-31	$757
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$27,043
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$64,016
Administrative expenses (other) incurred	2013-12-31	$376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$110,309
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$380,734
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$270,425
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$317,346
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$217,894
Interest earned on other investments	2013-12-31	$757
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$63,388
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$52,531
Net investment gain/loss from pooled separate accounts	2013-12-31	$52,886
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	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$6,974
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2013-12-31	420941961
2012 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$99,502
Total of all expenses incurred	2012-12-31	$3,399
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$3,070
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$79,393
Value of total assets at end of year	2012-12-31	$270,425
Value of total assets at beginning of year	2012-12-31	$174,322
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$329
Total interest from all sources	2012-12-31	$818
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$74,350
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$5,043
Administrative expenses (other) incurred	2012-12-31	$329
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$96,103
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$270,425
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$174,322
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$217,894
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$135,409
Interest earned on other investments	2012-12-31	$818
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$52,531
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$38,913
Net investment gain/loss from pooled separate accounts	2012-12-31	$19,291
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$3,070
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2012-12-31	420941961
2011 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$63,206
Total of all expenses incurred	2011-12-31	$2,679
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,400
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$65,425
Value of total assets at end of year	2011-12-31	$174,322
Value of total assets at beginning of year	2011-12-31	$113,795
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$279
Total interest from all sources	2011-12-31	$877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	Yes
Amount of non-exempt transactions with any party-in-interest	2011-12-31	$2,275
Contributions received from participants	2011-12-31	$65,425
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$2,275
Administrative expenses (other) incurred	2011-12-31	$279
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$60,527
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$174,322
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$113,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$135,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$70,890
Interest earned on other investments	2011-12-31	$877
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$38,913
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$40,630
Net investment gain/loss from pooled separate accounts	2011-12-31	$-3,096
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2011-12-31	420941961
2010 : TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$59,092
Total of all expenses incurred	2010-12-31	$6,631
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$6,365
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$50,240
Value of total assets at end of year	2010-12-31	$113,795
Value of total assets at beginning of year	2010-12-31	$61,334
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$266
Total interest from all sources	2010-12-31	$1,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	Yes
Amount of non-exempt transactions with any party-in-interest	2010-12-31	$2,275
Contributions received from participants	2010-12-31	$50,240
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$2,275
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	$52,461
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$113,795
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$61,334
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
Investment advisory and management fees	2010-12-31	$266
Value of interest in pooled separate accounts at end of year	2010-12-31	$70,890
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$25,188
Interest earned on other investments	2010-12-31	$1,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$40,630
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$36,146
Net investment gain/loss from pooled separate accounts	2010-12-31	$7,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$6,365
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	KING, REINSCH, PROSSER, & CO., L.L.
Accountancy firm EIN	2010-12-31	420941961

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF SUNRISE MANOR

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

Insurance Providers Used on plan

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

Policy contract number

9-07851

Policy instance

Insurance contract or identification number	9-07851
Number of Individuals Covered	3
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

458027-01

Policy instance

Insurance contract or identification number	458027-01
Number of Individuals Covered	50
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	3
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

458027-01

Policy instance

Insurance contract or identification number	458027-01
Number of Individuals Covered	56
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

458027-01

Policy instance

Insurance contract or identification number	458027-01
Number of Individuals Covered	67
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	3
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

458027-01

Policy instance

Insurance contract or identification number	458027-01
Number of Individuals Covered	60
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	3
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 $148
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	148
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?	3
Insurance broker name	MINNEAPOLIS REGIONAL OFFICE

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

458027-01

Policy instance

Insurance contract or identification number	458027-01
Number of Individuals Covered	56
Insurance policy start date	2017-01-10
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	35
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $139
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	139
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?	3
Insurance broker name	MINNEAPOLIS REGIONAL OFFICE

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	35
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $74
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	74
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	MINNEAPOLIS REGIONAL OFFICE

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	32
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $139
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	139
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	MINNEAPOLIS REGIONAL OFFICE

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	30
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $200
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	72
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	ADAM JOHNSON

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
Number of Individuals Covered	25
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 $171
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

050487-G

Policy instance

Insurance contract or identification number	050487-G
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 $67
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	20
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	ADAM JOHNSON

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Company Name:	SUNRISE MANOR
Employer identification number (EIN):	420805391
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1956-07-13
Company Identification Number:	078180
Legal Registered Office Address:	5501 GORDON DR SIOUX CITY United States of America (USA) 51106