401k Plan data: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC plan

401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 401k Plan overview

Plan Name	401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC
Plan identification number	002

401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

DEACONESS VNA PLUS LLC has sponsored the creation of one or more 401k plans.

Company Name: DEACONESS VNA PLUS LLC

Employer identification number (EIN): 465223267

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Additional information about DEACONESS VNA PLUS LLC

Jurisdiction of Incorporation: Indiana Secretary of State

Incorporation Date:

Company Identification Number: 014032600261

More information about DEACONESS VNA PLUS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-01-01
002 2018-01-01
002 2017-01-01 KATHERINE CLODFELTER KATHERINE CLODFELTER 2018-10-12
002 2017-01-01 KATHERINE CLODFELTER KATHERINE CLODFELTER 2018-10-11
002 2016-01-01 KATHERINE CLODFELTER KATHERINE CLODFELTER 2017-10-06
002 2015-01-01 CRYSTAL HEATON CRYSTAL HEATON 2016-10-05
002 2014-01-01 GLORIA HORTON GLORIA HORTON 2015-10-07

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2019-01-01
002	2018-01-01
002	2017-01-01	KATHERINE CLODFELTER	KATHERINE CLODFELTER	2018-10-12
002	2017-01-01	KATHERINE CLODFELTER	KATHERINE CLODFELTER	2018-10-11
002	2016-01-01	KATHERINE CLODFELTER	KATHERINE CLODFELTER	2017-10-06
002	2015-01-01	CRYSTAL HEATON	CRYSTAL HEATON	2016-10-05
002	2014-01-01	GLORIA HORTON	GLORIA HORTON	2015-10-07

Plan Statistics for 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC

401k plan membership statisitcs for 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC

Measure Date Value
2019: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2019 401k membership
Total participants, beginning-of-year 2019-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 72
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 118
Total of all active and inactive participants 2019-01-01 190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 2
Total participants 2019-01-01 192
Number of participants with account balances 2019-01-01 189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 16
2018: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2018 401k membership
Total participants, beginning-of-year 2018-01-01 175
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 91
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 103
Total of all active and inactive participants 2018-01-01 194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 194
Number of participants with account balances 2018-01-01 190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 7
2017: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2017 401k membership
Total participants, beginning-of-year 2017-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 66
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 108
Total of all active and inactive participants 2017-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 175
Number of participants with account balances 2017-01-01 174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2016 401k membership
Total participants, beginning-of-year 2016-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 107
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 98
Total of all active and inactive participants 2016-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 206
Number of participants with account balances 2016-01-01 203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 17
2015: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2015 401k membership
Total participants, beginning-of-year 2015-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 120
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 95
Total of all active and inactive participants 2015-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 216
Number of participants with account balances 2015-01-01 216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 15
2014: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2014 401k membership
Total participants, beginning-of-year 2014-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 125
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 82
Total of all active and inactive participants 2014-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 208
Number of participants with account balances 2014-01-01 208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2019: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2019 401k membership
Total participants, beginning-of-year	2019-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	72
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	118
Total of all active and inactive participants	2019-01-01	190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	2
Total participants	2019-01-01	192
Number of participants with account balances	2019-01-01	189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	16
2018: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2018 401k membership
Total participants, beginning-of-year	2018-01-01	175
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	91
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	103
Total of all active and inactive participants	2018-01-01	194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	194
Number of participants with account balances	2018-01-01	190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	7
2017: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2017 401k membership
Total participants, beginning-of-year	2017-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	66
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	108
Total of all active and inactive participants	2017-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	175
Number of participants with account balances	2017-01-01	174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2016 401k membership
Total participants, beginning-of-year	2016-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	107
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	98
Total of all active and inactive participants	2016-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	206
Number of participants with account balances	2016-01-01	203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	17
2015: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2015 401k membership
Total participants, beginning-of-year	2015-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	120
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	95
Total of all active and inactive participants	2015-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	216
Number of participants with account balances	2015-01-01	216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	15
2014: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2014 401k membership
Total participants, beginning-of-year	2014-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	125
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	82
Total of all active and inactive participants	2014-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	208
Number of participants with account balances	2014-01-01	208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC

Measure	Date	Value
2019 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
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 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 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	$1,027,238
Total income from all sources (including contributions)	2019-12-31	$1,027,238
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$628,767
Total of all expenses incurred	2019-12-31	$628,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$627,247
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$627,247
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$242,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$242,928
Value of total assets at end of year	2019-12-31	$4,698,531
Value of total assets at end of year	2019-12-31	$4,698,531
Value of total assets at beginning of year	2019-12-31	$4,300,060
Value of total assets at beginning of year	2019-12-31	$4,300,060
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,520
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,520
Total interest from all sources	2019-12-31	$12,393
Total interest from all sources	2019-12-31	$12,393
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
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
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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	$168,473
Contributions received from participants	2019-12-31	$168,473
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$52,224
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$52,224
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$1,520
Administrative expenses (other) incurred	2019-12-31	$1,520
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
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	$398,471
Value of net income/loss	2019-12-31	$398,471
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,698,531
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,698,531
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,300,060
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,300,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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
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	$4,000,029
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,000,029
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,537,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,537,787
Interest on participant loans	2019-12-31	$0
Interest on participant loans	2019-12-31	$0
Interest earned on other investments	2019-12-31	$12,393
Interest earned on other investments	2019-12-31	$12,393
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$698,502
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$698,502
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$762,273
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$762,273
Expenses. Payments to insurance carriers foe the provision of benefits	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	$771,917
Net investment gain/loss from pooled separate accounts	2019-12-31	$771,917
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$22,231
Contributions received in cash from employer	2019-12-31	$22,231
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$627,247
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$627,247
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
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
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WEINZAPFEL & CO., LLC
Accountancy firm name	2019-12-31	WEINZAPFEL & CO., LLC
Accountancy firm EIN	2019-12-31	352152081
Accountancy firm EIN	2019-12-31	352152081
2018 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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	$269,688
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$504,276
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$502,777
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$561,338
Value of total assets at end of year	2018-12-31	$4,300,060
Value of total assets at beginning of year	2018-12-31	$4,534,648
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,499
Total interest from all sources	2018-12-31	$7,309
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$166,120
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$394,676
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$1,499
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	$-234,588
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,300,060
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,534,648
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	$3,537,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,800,084
Interest on participant loans	2018-12-31	$0
Interest earned on other investments	2018-12-31	$7,309
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$762,273
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$734,564
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-298,959
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	$542
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$502,777
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	WEINZAPFEL & CO., LLC
Accountancy firm EIN	2018-12-31	352152081
2017 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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	$781,176
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,259,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,258,024
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	$186,699
Value of total assets at end of year	2017-12-31	$4,534,648
Value of total assets at beginning of year	2017-12-31	$5,013,203
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,707
Total interest from all sources	2017-12-31	$8,681
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$162,794
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$2,542
Other income not declared elsewhere	2017-12-31	$12
Administrative expenses (other) incurred	2017-12-31	$1,707
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	$-478,555
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,534,648
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$5,013,203
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	$3,800,084
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$4,009,353
Interest on participant loans	2017-12-31	$0
Interest earned on other investments	2017-12-31	$8,681
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$734,564
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,003,850
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	$585,784
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	$21,363
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,258,024
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	WEINZAPFEL & CO LLC
Accountancy firm EIN	2017-12-31	352152081
2016 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$617,125
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$761,740
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$759,721
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	$245,674
Value of total assets at end of year	2016-12-31	$5,013,203
Value of total assets at beginning of year	2016-12-31	$5,157,818
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,019
Total interest from all sources	2016-12-31	$12,659
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
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$212,874
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$10
Administrative expenses (other) incurred	2016-12-31	$2,019
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	$-144,615
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$5,013,203
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$5,157,818
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	$4,009,353
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,818,652
Interest on participant loans	2016-12-31	$0
Interest earned on other investments	2016-12-31	$12,659
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,003,850
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,339,166
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$358,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$32,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$759,721
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	WEINZAPFEL & CO. LLC.
Accountancy firm EIN	2016-12-31	352152081
2015 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$470,524
Total of all expenses incurred	2015-12-31	$965,142
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$964,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$481,448
Value of total assets at end of year	2015-12-31	$5,167,961
Value of total assets at beginning of year	2015-12-31	$5,662,579
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,025
Total interest from all sources	2015-12-31	$15,706
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	$300,000
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	$252,762
Participant contributions at end of year	2015-12-31	$8,813
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$194,897
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	$-494,618
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,167,961
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,662,579
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 pooled separate accounts at end of year	2015-12-31	$3,818,652
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$3,798,279
Interest earned on other investments	2015-12-31	$15,706
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,339,166
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,864,300
Net investment gain/loss from pooled separate accounts	2015-12-31	$-26,630
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	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$33,789
Employer contributions (assets) at end of year	2015-12-31	$1,330
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$964,117
Contract administrator fees	2015-12-31	$1,025
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	WEINZAPFEL & CO., LLC
Accountancy firm EIN	2015-12-31	352152081
2014 : 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$573,560
Total of all expenses incurred	2014-12-31	$889,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$887,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$274,392
Value of total assets at end of year	2014-12-31	$5,662,579
Value of total assets at beginning of year	2014-12-31	$5,978,505
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,516
Total interest from all sources	2014-12-31	$18,914
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	$1,000,000
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	$215,547
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$26,535
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	$-315,926
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,662,579
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,978,505
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 pooled separate accounts at end of year	2014-12-31	$3,798,279
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$3,998,059
Interest earned on other investments	2014-12-31	$18,914
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,864,300
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,980,446
Net investment gain/loss from pooled separate accounts	2014-12-31	$280,254
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
Contributions received in cash from employer	2014-12-31	$32,310
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$887,970
Contract administrator fees	2014-12-31	$1,516
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	WEINZAPFEL & CO., LLC
Accountancy firm EIN	2014-12-31	352152081

Form 5500 Responses for 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC

2019: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
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: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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: 401(K) PROFIT-SHARING PLAN OF DEACONESS VNA PLUS, LLC 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

Insurance Providers Used on plan

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

Policy contract number

051908J

Policy instance

Insurance contract or identification number	051908J
Number of Individuals Covered	192
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $834
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	834
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051908J

Policy instance

Insurance contract or identification number	051908J
Number of Individuals Covered	194
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $296
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	296
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051908J

Policy instance

Insurance contract or identification number	051908J
Number of Individuals Covered	175
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 $467
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	467
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	INDIANAPOLIS REGIONAL OFFICE

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

Policy contract number

051908J

Policy instance

Insurance contract or identification number	051908J
Number of Individuals Covered	216
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $196
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	196
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	INDIANAPOLIS REGIONAL OFFICE

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

Policy contract number

051908J

Policy instance

Insurance contract or identification number	051908J
Number of Individuals Covered	208
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $255
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	255
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	INDIANAPOLIS REGIONAL OFFICE

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See full terms and conditions

Company Name:	DEACONESS VNA PLUS LLC
Employer identification number (EIN):	465223267
NAIC Classification:	621610
NAIC Description:	Home Health Care Services

Jurisdiction of Incorporation:	Indiana Secretary of State
Incorporation Date:
Company Identification Number:	014032600261