401k Plan data: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN plan

BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 401k Plan overview

Plan Name	BRIA HEALTHCARE MANAGEMENT 401(K) PLAN
Plan identification number	001

BRIA HEALTHCARE MANAGEMENT 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

BRIA HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: BRIA HEALTH SERVICES, LLC

Employer identification number (EIN): 460645536

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRIA HEALTHCARE MANAGEMENT 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 AVRUM WEINFELD
001 2016-01-01 AVRUM WEINFELD

Plan Statistics for BRIA HEALTHCARE MANAGEMENT 401(K) PLAN

401k plan membership statisitcs for BRIA HEALTHCARE MANAGEMENT 401(K) PLAN

Measure Date Value
2022: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 841
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 760
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 24
Total of all active and inactive participants 2022-01-01 784
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 784
Number of participants with account balances 2022-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 854
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 721
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 23
Total of all active and inactive participants 2021-01-01 744
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 744
Number of participants with account balances 2021-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 955
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 715
Number of other retired or separated participants entitled to future benefits 2020-01-01 25
Total of all active and inactive participants 2020-01-01 740
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 740
Number of participants with account balances 2020-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 9
2019: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 816
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 822
Number of other retired or separated participants entitled to future benefits 2019-01-01 21
Total of all active and inactive participants 2019-01-01 843
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 843
Number of participants with account balances 2019-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 834
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 670
Number of other retired or separated participants entitled to future benefits 2018-01-01 19
Total of all active and inactive participants 2018-01-01 689
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 689
Number of participants with account balances 2018-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 891
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 622
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 15
Total of all active and inactive participants 2017-01-01 637
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 637
Number of participants with account balances 2017-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 14
2016: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 752
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 886
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 5
Total of all active and inactive participants 2016-01-01 891
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 891
Number of participants with account balances 2016-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 5

Measure	Date	Value
2022: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	841
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	760
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	24
Total of all active and inactive participants	2022-01-01	784
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	784
Number of participants with account balances	2022-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	854
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	721
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	23
Total of all active and inactive participants	2021-01-01	744
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	744
Number of participants with account balances	2021-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	955
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	715
Number of other retired or separated participants entitled to future benefits	2020-01-01	25
Total of all active and inactive participants	2020-01-01	740
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	740
Number of participants with account balances	2020-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	9
2019: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	816
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	822
Number of other retired or separated participants entitled to future benefits	2019-01-01	21
Total of all active and inactive participants	2019-01-01	843
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	843
Number of participants with account balances	2019-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	834
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	670
Number of other retired or separated participants entitled to future benefits	2018-01-01	19
Total of all active and inactive participants	2018-01-01	689
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	689
Number of participants with account balances	2018-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	891
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	622
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	15
Total of all active and inactive participants	2017-01-01	637
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	637
Number of participants with account balances	2017-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	14
2016: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	752
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	886
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	5
Total of all active and inactive participants	2016-01-01	891
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	891
Number of participants with account balances	2016-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	5

Financial Data on BRIA HEALTHCARE MANAGEMENT 401(K) PLAN

Measure	Date	Value
2022 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$34,134
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$32,302
Total income from all sources (including contributions)	2022-12-31	$141,034
Total of all expenses incurred	2022-12-31	$44,321
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$34,000
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$258,859
Value of total assets at end of year	2022-12-31	$758,434
Value of total assets at beginning of year	2022-12-31	$659,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$10,321
Total interest from all sources	2022-12-31	$596
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
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	$0
Administrative expenses professional fees incurred	2022-12-31	$375
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$100,000
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	$114,841
Participant contributions at end of year	2022-12-31	$14,899
Participant contributions at beginning of year	2022-12-31	$4,040
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$127,693
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$34,134
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$32,302
Administrative expenses (other) incurred	2022-12-31	$3,268
Total non interest bearing cash at end of year	2022-12-31	$1,687
Total non interest bearing cash at beginning of year	2022-12-31	$3,186
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	$96,713
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$724,300
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$627,587
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
Investment advisory and management fees	2022-12-31	$120
Value of interest in pooled separate accounts at end of year	2022-12-31	$741,848
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$652,663
Interest on participant loans	2022-12-31	$596
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-118,421
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	$16,325
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$34,000
Contract administrator fees	2022-12-31	$6,558
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	GGM ASSOCIATES INC.
Accountancy firm EIN	2022-12-31	844230150
2021 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$32,302
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$19,774
Total income from all sources (including contributions)	2021-12-31	$240,575
Total of all expenses incurred	2021-12-31	$207,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$200,216
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$149,955
Value of total assets at end of year	2021-12-31	$659,889
Value of total assets at beginning of year	2021-12-31	$614,553
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$7,551
Total interest from all sources	2021-12-31	$93
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
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	$0
Administrative expenses professional fees incurred	2021-12-31	$400
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$100,000
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	$131,029
Participant contributions at end of year	2021-12-31	$4,040
Participant contributions at beginning of year	2021-12-31	$0
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$459
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$5,251
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$32,302
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$19,774
Total non interest bearing cash at end of year	2021-12-31	$3,186
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	$32,808
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$627,587
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$594,779
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
Investment advisory and management fees	2021-12-31	$132
Value of interest in pooled separate accounts at end of year	2021-12-31	$652,663
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$614,038
Interest on participant loans	2021-12-31	$93
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$90,527
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
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	$13,675
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$56
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$200,216
Contract administrator fees	2021-12-31	$7,019
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	GGM ASSOCIATES INC.
Accountancy firm EIN	2021-12-31	844230150
2020 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$19,774
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$7,615
Total income from all sources (including contributions)	2020-12-31	$211,476
Total of all expenses incurred	2020-12-31	$56,765
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$13,115
Expenses. Certain deemed distributions of participant loans	2020-12-31	$13,819
Value of total corrective distributions	2020-12-31	$19,774
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$124,821
Value of total assets at end of year	2020-12-31	$614,553
Value of total assets at beginning of year	2020-12-31	$447,683
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$10,057
Total interest from all sources	2020-12-31	$195
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
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	$0
Administrative expenses professional fees incurred	2020-12-31	$4,926
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$100,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$107,599
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$13,624
Participant contributions at end of year	2020-12-31	$459
Participant contributions at beginning of year	2020-12-31	$587
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$6,185
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$19,774
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$7,615
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	$154,711
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$594,779
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$440,068
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	$95
Value of interest in pooled separate accounts at end of year	2020-12-31	$614,038
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$429,765
Interest on participant loans	2020-12-31	$195
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$3,683
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$3,683
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$86,460
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	$11,037
Employer contributions (assets) at end of year	2020-12-31	$56
Employer contributions (assets) at beginning of year	2020-12-31	$24
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$13,115
Contract administrator fees	2020-12-31	$5,036
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	GGM ASSOCIATES INC.
Accountancy firm EIN	2020-12-31	844230150
2019 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$7,615
Total income from all sources (including contributions)	2019-12-31	$193,244
Total of all expenses incurred	2019-12-31	$178,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$168,112
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$838
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$95,922
Value of total assets at end of year	2019-12-31	$447,683
Value of total assets at beginning of year	2019-12-31	$425,116
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,342
Total interest from all sources	2019-12-31	$673
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
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	$0
Administrative expenses professional fees incurred	2019-12-31	$4,181
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$400,000
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	$86,701
Participant contributions at end of year	2019-12-31	$13,624
Participant contributions at beginning of year	2019-12-31	$16,627
Participant contributions at end of year	2019-12-31	$587
Participant contributions at beginning of year	2019-12-31	$530
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$193
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$7,615
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	$14,952
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$440,068
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$425,116
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
Investment advisory and management fees	2019-12-31	$92
Value of interest in pooled separate accounts at end of year	2019-12-31	$429,765
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$403,062
Interest on participant loans	2019-12-31	$673
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$3,683
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$4,873
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$4,873
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$96,649
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	$9,028
Employer contributions (assets) at end of year	2019-12-31	$24
Employer contributions (assets) at beginning of year	2019-12-31	$24
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$168,112
Contract administrator fees	2019-12-31	$5,069
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	OSTROW REISEN BERK & ABRAMS, LTD.
Accountancy firm EIN	2019-12-31	362938874
2018 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$63,326
Total of all expenses incurred	2018-12-31	$104,094
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$95,671
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$3,102
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$88,185
Value of total assets at end of year	2018-12-31	$425,116
Value of total assets at beginning of year	2018-12-31	$465,884
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$5,321
Total interest from all sources	2018-12-31	$881
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$100,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$78,579
Participant contributions at end of year	2018-12-31	$16,627
Participant contributions at beginning of year	2018-12-31	$21,368
Participant contributions at end of year	2018-12-31	$530
Participant contributions at beginning of year	2018-12-31	$1,868
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$962
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$5,321
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	$-40,768
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$425,116
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$465,884
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 pooled separate accounts at end of year	2018-12-31	$403,062
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$425,718
Interest on participant loans	2018-12-31	$881
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$4,873
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$1,689
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$1,689
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-25,740
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	$8,644
Employer contributions (assets) at end of year	2018-12-31	$24
Employer contributions (assets) at beginning of year	2018-12-31	$15,241
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$95,671
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	OSTROW REISEN BERK & ABRAMS, LTD.
Accountancy firm EIN	2018-12-31	362938874
2017 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$420,212
Total of all expenses incurred	2017-12-31	$46,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$42,422
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$379,062
Value of total assets at end of year	2017-12-31	$465,884
Value of total assets at beginning of year	2017-12-31	$92,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$4,443
Total interest from all sources	2017-12-31	$908
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$327
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$130,369
Participant contributions at end of year	2017-12-31	$21,368
Participant contributions at beginning of year	2017-12-31	$0
Participant contributions at end of year	2017-12-31	$1,868
Participant contributions at beginning of year	2017-12-31	$5,003
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$232,052
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
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	$373,347
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$465,884
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$92,537
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
Investment advisory and management fees	2017-12-31	$55
Value of interest in pooled separate accounts at end of year	2017-12-31	$425,718
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$81,822
Interest on participant loans	2017-12-31	$908
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$1,689
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$40,242
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	$16,641
Employer contributions (assets) at end of year	2017-12-31	$15,241
Employer contributions (assets) at beginning of year	2017-12-31	$5,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$42,422
Contract administrator fees	2017-12-31	$4,061
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	OSTROW REISIN BERK & ABRAMS, LTD
Accountancy firm EIN	2017-12-31	362974963
2016 : BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$92,845
Total of all expenses incurred	2016-12-31	$308
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$0
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$90,972
Value of total assets at end of year	2016-12-31	$92,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$308
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
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	$42,976
Participant contributions at end of year	2016-12-31	$0
Participant contributions at end of year	2016-12-31	$5,003
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$41,962
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$92,537
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$92,537
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
Investment advisory and management fees	2016-12-31	$4
Value of interest in pooled separate accounts at end of year	2016-12-31	$81,822
Interest on participant loans	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,873
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	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$6,034
Employer contributions (assets) at end of year	2016-12-31	$5,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$0
Contract administrator fees	2016-12-31	$304
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	DAVID FISCH & CO., CPA'S P.C.
Accountancy firm EIN	2016-12-31	133624679

Form 5500 Responses for BRIA HEALTHCARE MANAGEMENT 401(K) PLAN

2022: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: BRIA HEALTHCARE MANAGEMENT 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	64
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,288
Total amount of fees paid to insurance company	USD $3,644
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	3644
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $2,982

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	56
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $3,639
Total amount of fees paid to insurance company	USD $400
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,307
Insurance broker organization code?	4
Amount paid for insurance broker fees	400

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	53
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,555
Total amount of fees paid to insurance company	USD $4,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $235
Amount paid for insurance broker fees	4967
Insurance broker organization code?	5

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	49
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,554
Total amount of fees paid to insurance company	USD $4,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4180
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $2,315

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	51
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,327
Total amount of fees paid to insurance company	USD $450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,106
Insurance broker organization code?	4
Amount paid for insurance broker fees	450

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

Policy contract number

124645

Policy instance

Insurance contract or identification number	124645
Number of Individuals Covered	49
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,906
Total amount of fees paid to insurance company	USD $350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,204
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	4
Amount paid for insurance broker fees	350
Insurance broker name	INTAC ACTUARIAL SERVICES

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Company Name:	BRIA HEALTH SERVICES, LLC
Employer identification number (EIN):	460645536
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities