401k Plan data: OAKWOOD CARE CENTER 401K RETIREMENT PLAN plan

OAKWOOD CARE CENTER 401K RETIREMENT PLAN 401k Plan overview

Plan Name	OAKWOOD CARE CENTER 401K RETIREMENT PLAN
Plan identification number	001

OAKWOOD CARE CENTER 401K RETIREMENT 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.
Plan covering Self-Employed individuals.
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

HS CARE, LLC D/B/A OAKWOOD CARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: HS CARE, LLC D/B/A OAKWOOD CARE CENTER

Employer identification number (EIN): 542070877

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OAKWOOD CARE CENTER 401K RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01 FRANCIS VALLE 2019-10-15
001 2018-01-01
001 2018-01-01
001 2017-01-01 FRANCIS VALLE
001 2017-01-01 FRANCIS VALLE
001 2016-01-01 DONNA PALIUGI
001 2015-01-01 KATHY SCHOMBS
001 2014-01-01 KATHY SCHOMBS
001 2013-01-01 KATHY SCHOMBS
001 2012-01-01 DAVID LANDA
001 2011-01-01 DAVID LANDA
001 2010-01-01 DAVID LANDA
001 2009-01-01 DAVID LANDA

Plan Statistics for OAKWOOD CARE CENTER 401K RETIREMENT PLAN

401k plan membership statisitcs for OAKWOOD CARE CENTER 401K RETIREMENT PLAN

Measure Date Value
2018: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 352
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 327
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 339
Number of other retired or separated participants entitled to future benefits 2017-01-01 15
Total of all active and inactive participants 2017-01-01 354
Total participants 2017-01-01 354
Number of participants with account balances 2017-01-01 23
2016: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 290
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 11
Total of all active and inactive participants 2016-01-01 303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 303
Number of participants with account balances 2016-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 302
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 11
Total of all active and inactive participants 2015-01-01 315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 315
Number of participants with account balances 2015-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 355
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 320
Number of other retired or separated participants entitled to future benefits 2014-01-01 12
Total of all active and inactive participants 2014-01-01 332
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 332
Number of participants with account balances 2014-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 328
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 13
Total of all active and inactive participants 2013-01-01 342
Total participants 2013-01-01 342
Number of participants with account balances 2013-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 342
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 306
Number of other retired or separated participants entitled to future benefits 2012-01-01 14
Total of all active and inactive participants 2012-01-01 320
Total participants 2012-01-01 320
Number of participants with account balances 2012-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 362
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 329
Number of other retired or separated participants entitled to future benefits 2011-01-01 13
Total of all active and inactive participants 2011-01-01 342
Total participants 2011-01-01 342
Number of participants with account balances 2011-01-01 33
2010: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 350
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 338
Number of other retired or separated participants entitled to future benefits 2010-01-01 12
Total of all active and inactive participants 2010-01-01 350
Total participants 2010-01-01 350
Number of participants with account balances 2010-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 249
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 10
Total of all active and inactive participants 2009-01-01 259
Total participants 2009-01-01 259
Number of participants with account balances 2009-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2018: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	352
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	327
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	339
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	354
Total participants	2017-01-01	354
Number of participants with account balances	2017-01-01	23
2016: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	290
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	11
Total of all active and inactive participants	2016-01-01	303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	303
Number of participants with account balances	2016-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	302
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	11
Total of all active and inactive participants	2015-01-01	315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	315
Number of participants with account balances	2015-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	355
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	320
Number of other retired or separated participants entitled to future benefits	2014-01-01	12
Total of all active and inactive participants	2014-01-01	332
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	332
Number of participants with account balances	2014-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	328
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	13
Total of all active and inactive participants	2013-01-01	342
Total participants	2013-01-01	342
Number of participants with account balances	2013-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	342
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	306
Number of other retired or separated participants entitled to future benefits	2012-01-01	14
Total of all active and inactive participants	2012-01-01	320
Total participants	2012-01-01	320
Number of participants with account balances	2012-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	362
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	329
Number of other retired or separated participants entitled to future benefits	2011-01-01	13
Total of all active and inactive participants	2011-01-01	342
Total participants	2011-01-01	342
Number of participants with account balances	2011-01-01	33
2010: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	350
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	338
Number of other retired or separated participants entitled to future benefits	2010-01-01	12
Total of all active and inactive participants	2010-01-01	350
Total participants	2010-01-01	350
Number of participants with account balances	2010-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	249
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	10
Total of all active and inactive participants	2009-01-01	259
Total participants	2009-01-01	259
Number of participants with account balances	2009-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on OAKWOOD CARE CENTER 401K RETIREMENT PLAN

Measure	Date	Value
2018 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2018 401k financial data
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	$2,414
Total income from all sources (including contributions)	2018-12-31	$14,606
Total of all expenses incurred	2018-12-31	$553,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$550,983
Expenses. Certain deemed distributions of participant loans	2018-12-31	$2,678
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$8,575
Value of total assets at end of year	2018-12-31	$0
Value of total assets at beginning of year	2018-12-31	$541,469
Total interest from all sources	2018-12-31	$6,031
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$8,575
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$2,932
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$2,414
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	$-539,055
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$539,055
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	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$538,537
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$6,031
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$550,983
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	Yes
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	KHOZEM MASTER CPA PA
Accountancy firm EIN	2018-12-31	275025505
2017 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$2,414
Total income from all sources (including contributions)	2017-12-31	$127,581
Total of all expenses incurred	2017-12-31	$171,274
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$171,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$56,292
Value of total assets at end of year	2017-12-31	$541,469
Value of total assets at beginning of year	2017-12-31	$585,162
Total interest from all sources	2017-12-31	$1,175
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	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$4
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$56,292
Participant contributions at end of year	2017-12-31	$2,932
Participant contributions at beginning of year	2017-12-31	$29,069
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$9,011
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$2,414
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	$-43,693
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$541,469
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$585,162
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 pooled separate accounts at end of year	2017-12-31	$538,537
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$556,093
Interest on participant loans	2017-12-31	$1,175
Net investment gain/loss from pooled separate accounts	2017-12-31	$70,114
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$171,274
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
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	KHOZEM MASTER CPA PA
Accountancy firm EIN	2017-12-31	275025505
2016 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$179,708
Total of all expenses incurred	2016-12-31	$70,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$62,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$144,300
Value of total assets at end of year	2016-12-31	$585,162
Value of total assets at beginning of year	2016-12-31	$476,035
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$8,339
Total interest from all sources	2016-12-31	$421
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	$43,932
Participant contributions at end of year	2016-12-31	$29,069
Participant contributions at beginning of year	2016-12-31	$6,445
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$100,368
Administrative expenses (other) incurred	2016-12-31	$600
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	$109,127
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$585,162
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$476,035
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	$7,739
Value of interest in pooled separate accounts at end of year	2016-12-31	$556,093
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$469,590
Interest on participant loans	2016-12-31	$421
Net investment gain/loss from pooled separate accounts	2016-12-31	$34,987
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$62,242
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	KHOZEM MASTER CPA PC
Accountancy firm EIN	2016-12-31	275025505
2015 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$26,848
Total of all expenses incurred	2015-12-31	$9,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,422
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$31,020
Value of total assets at end of year	2015-12-31	$476,035
Value of total assets at beginning of year	2015-12-31	$458,348
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$7,739
Total interest from all sources	2015-12-31	$273
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	$500,000
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	$31,020
Participant contributions at end of year	2015-12-31	$6,445
Participant contributions at beginning of year	2015-12-31	$9,311
Participant contributions at beginning of year	2015-12-31	$533
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$17,687
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$476,035
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$458,348
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
Investment advisory and management fees	2015-12-31	$7,389
Value of interest in pooled separate accounts at end of year	2015-12-31	$469,590
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$448,504
Interest on participant loans	2015-12-31	$273
Net investment gain/loss from pooled separate accounts	2015-12-31	$-4,445
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,422
Contract administrator fees	2015-12-31	$350
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	STEPHEN ONEILL
Accountancy firm EIN	2015-12-31	770708820
2014 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$50,263
Total of all expenses incurred	2014-12-31	$44,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$36,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$28,951
Value of total assets at end of year	2014-12-31	$458,348
Value of total assets at beginning of year	2014-12-31	$452,311
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$7,765
Total interest from all sources	2014-12-31	$508
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	$50,000
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	$28,951
Participant contributions at end of year	2014-12-31	$9,311
Participant contributions at beginning of year	2014-12-31	$14,378
Participant contributions at end of year	2014-12-31	$533
Participant contributions at beginning of year	2014-12-31	$3,298
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$6,037
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$458,348
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$452,311
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
Investment advisory and management fees	2014-12-31	$7,315
Value of interest in pooled separate accounts at end of year	2014-12-31	$448,504
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$434,635
Interest on participant loans	2014-12-31	$508
Net investment gain/loss from pooled separate accounts	2014-12-31	$20,804
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$36,461
Contract administrator fees	2014-12-31	$450
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	STEPHEN ONEILL
Accountancy firm EIN	2014-12-31	770708820
2013 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$92,965
Total of all expenses incurred	2013-12-31	$70,791
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$70,791
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$51,709
Value of total assets at end of year	2013-12-31	$452,311
Value of total assets at beginning of year	2013-12-31	$430,137
Total interest from all sources	2013-12-31	$837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$50,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$51,709
Participant contributions at end of year	2013-12-31	$14,378
Participant contributions at beginning of year	2013-12-31	$23,045
Participant contributions at end of year	2013-12-31	$3,298
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$22,174
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$452,311
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$430,137
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$434,635
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$407,092
Interest on participant loans	2013-12-31	$837
Net investment gain/loss from pooled separate accounts	2013-12-31	$40,419
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$70,791
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	STEPHEN ONEIL
Accountancy firm EIN	2013-12-31	770708820
2012 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$113,133
Total of all expenses incurred	2012-12-31	$70,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$63,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$68,825
Value of total assets at end of year	2012-12-31	$430,137
Value of total assets at beginning of year	2012-12-31	$387,238
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,653
Total interest from all sources	2012-12-31	$1,097
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	No
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$68,825
Participant contributions at end of year	2012-12-31	$23,045
Participant contributions at beginning of year	2012-12-31	$19,122
Administrative expenses (other) incurred	2012-12-31	$525
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$42,899
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$430,137
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$387,238
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$407,092
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$368,116
Interest on participant loans	2012-12-31	$1,097
Net investment gain/loss from pooled separate accounts	2012-12-31	$43,211
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$63,581
Contract administrator fees	2012-12-31	$6,128
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	STEPHEN ONEIL
Accountancy firm EIN	2012-12-31	770708820
2011 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$48,436
Total of all expenses incurred	2011-12-31	$13,582
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$7,504
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$52,177
Value of total assets at end of year	2011-12-31	$387,238
Value of total assets at beginning of year	2011-12-31	$352,384
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,078
Total interest from all sources	2011-12-31	$348
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$52,177
Participant contributions at end of year	2011-12-31	$19,122
Participant contributions at beginning of year	2011-12-31	$1,475
Participant contributions at beginning of year	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$34,854
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$387,238
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$352,384
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$368,116
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$350,909
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$348
Net investment gain/loss from pooled separate accounts	2011-12-31	$-4,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$7,504
Contract administrator fees	2011-12-31	$5,953
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	STEPHEN ONEIL
Accountancy firm EIN	2011-12-31	770708820
2010 : OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$91,295
Total of all expenses incurred	2010-12-31	$15,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$9,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$55,452
Value of total assets at end of year	2010-12-31	$352,384
Value of total assets at beginning of year	2010-12-31	$276,283
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$5,285
Total interest from all sources	2010-12-31	$35
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$54,015
Participant contributions at end of year	2010-12-31	$1,475
Participant contributions at beginning of year	2010-12-31	$1,846
Participant contributions at end of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,437
Administrative expenses (other) incurred	2010-12-31	$225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$76,101
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$352,384
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$276,283
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$5,060
Value of interest in pooled separate accounts at end of year	2010-12-31	$350,909
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$274,437
Interest on participant loans	2010-12-31	$35
Net investment gain/loss from pooled separate accounts	2010-12-31	$35,808
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$9,909
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	STEPHEN ONEIL
Accountancy firm EIN	2010-12-31	770708820

Form 5500 Responses for OAKWOOD CARE CENTER 401K RETIREMENT PLAN

2018: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	This submission is the final filing	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 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	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 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 funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: OAKWOOD CARE CENTER 401K RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Total amount of commissions paid to insurance broker	USD $1,657
Total amount of fees paid to insurance company	USD $859
Commission paid to Insurance Broker	USD $1,657
Amount paid for insurance broker fees	859
Insurance broker organization code?	4

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	23
Total amount of commissions paid to insurance broker	USD $493
Total amount of fees paid to insurance company	USD $3,451
Commission paid to Insurance Broker	USD $493
Amount paid for insurance broker fees	3451
Insurance broker organization code?	4
Insurance broker name	INTAC

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	26
Total amount of commissions paid to insurance broker	USD $2,667
Total amount of fees paid to insurance company	USD $587
Commission paid to Insurance Broker	USD $2,667
Amount paid for insurance broker fees	587
Insurance broker organization code?	4
Insurance broker name	INTAC

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Total amount of commissions paid to insurance broker	USD $2,658
Total amount of fees paid to insurance company	USD $450
Commission paid to Insurance Broker	USD $2,658
Amount paid for insurance broker fees	450
Insurance broker organization code?	3
Insurance broker name	INTAC

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	27
Total amount of commissions paid to insurance broker	USD $3,341
Commission paid to Insurance Broker	USD $3,341
Insurance broker name	INTAC

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	33
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,577
Total amount of fees paid to insurance company	USD $525
Commission paid to Insurance Broker	USD $2,577
Amount paid for insurance broker fees	525
Insurance broker organization code?	5
Insurance broker name	INTAC ACTUARIAL SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	33
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,349
Total amount of fees paid to insurance company	USD $305
Are there contracts with allocated funds for group deferred annuity?	Yes

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

84531

Policy instance

Insurance contract or identification number	84531
Number of Individuals Covered	34
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,199
Total amount of fees paid to insurance company	USD $441
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2,199
Amount paid for insurance broker fees	441
Insurance broker organization code?	5
Insurance broker name	INTAC ACTUARIAL SERVICES, INC.

Potentially related plans

OAKWOOD CARE CENTER 401(K) PLAN [EIN = 461508862]

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The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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See full terms and conditions

Company Name:	HS CARE, LLC D/B/A OAKWOOD CARE CENTER
Employer identification number (EIN):	542070877
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2018-01-01	FRANCIS VALLE	2019-10-15
001	2018-01-01
001	2018-01-01
001	2017-01-01	FRANCIS VALLE
001	2017-01-01	FRANCIS VALLE
001	2016-01-01	DONNA PALIUGI
001	2015-01-01	KATHY SCHOMBS
001	2014-01-01	KATHY SCHOMBS
001	2013-01-01	KATHY SCHOMBS
001	2012-01-01	DAVID LANDA
001	2011-01-01	DAVID LANDA
001	2010-01-01	DAVID LANDA
001	2009-01-01	DAVID LANDA