401k Plan data: EDGEWOOD SUMMIT, INC. 401K PLAN plan

EDGEWOOD SUMMIT, INC. 401K PLAN 401k Plan overview

Plan Name	EDGEWOOD SUMMIT, INC. 401K PLAN
Plan identification number	001

EDGEWOOD SUMMIT, INC. 401K 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.

401k Sponsoring company profile

EDGEWOOD SUMMIT, INC. has sponsored the creation of one or more 401k plans.

Company Name: EDGEWOOD SUMMIT, INC.

Employer identification number (EIN): 550701159

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDGEWOOD SUMMIT, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-07-01 DIANE T GOUHIN 2023-03-30
001 2020-07-01 DIANE T GOUHIN 2022-04-12
001 2019-07-01 DIANE T GOUHIN 2021-04-15
001 2018-07-01 DIANE T GOUHIN 2020-07-14
001 2017-07-01 DIANE T GOUHIN 2019-04-15
001 2016-07-01
001 2015-07-01
001 2013-07-01 DIANE T GOUHIN 2015-03-18
001 2012-07-01 DIANE T GOUHIN 2014-04-15
001 2011-07-01 DIANE T GOUHIN 2014-03-26
001 2010-07-01 DIANE T GOUHIN
001 2009-07-01 DIANE T GOUHIN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-07-01	DIANE T GOUHIN	2023-03-30
001	2020-07-01	DIANE T GOUHIN	2022-04-12
001	2019-07-01	DIANE T GOUHIN	2021-04-15
001	2018-07-01	DIANE T GOUHIN	2020-07-14
001	2017-07-01	DIANE T GOUHIN	2019-04-15
001	2016-07-01
001	2015-07-01
001	2013-07-01	DIANE T GOUHIN	2015-03-18
001	2012-07-01	DIANE T GOUHIN	2014-04-15
001	2011-07-01	DIANE T GOUHIN	2014-03-26
001	2010-07-01	DIANE T GOUHIN
001	2009-07-01	DIANE T GOUHIN

Plan Statistics for EDGEWOOD SUMMIT, INC. 401K PLAN

401k plan membership statisitcs for EDGEWOOD SUMMIT, INC. 401K PLAN

Measure Date Value
2021: EDGEWOOD SUMMIT, INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 129
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 103
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 103
Number of participants with account balances 2021-07-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: EDGEWOOD SUMMIT, INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 144
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 129
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 129
Number of participants with account balances 2020-07-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: EDGEWOOD SUMMIT, INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 182
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 134
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 10
Total of all active and inactive participants 2019-07-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 144
Number of participants with account balances 2019-07-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: EDGEWOOD SUMMIT, INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 147
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 175
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 7
Total of all active and inactive participants 2018-07-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 182
Number of participants with account balances 2018-07-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: EDGEWOOD SUMMIT, INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 185
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 139
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 8
Total of all active and inactive participants 2017-07-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 147
Number of participants with account balances 2017-07-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2010: EDGEWOOD SUMMIT, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 28
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 27
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 0
Total of all active and inactive participants 2010-07-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 27
Number of participants with account balances 2010-07-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: EDGEWOOD SUMMIT, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 28
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 28
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 28
Number of participants with account balances 2009-07-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2021: EDGEWOOD SUMMIT, INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	129
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	103
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	103
Number of participants with account balances	2021-07-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: EDGEWOOD SUMMIT, INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	144
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	129
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	129
Number of participants with account balances	2020-07-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: EDGEWOOD SUMMIT, INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	182
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	134
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	10
Total of all active and inactive participants	2019-07-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	144
Number of participants with account balances	2019-07-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: EDGEWOOD SUMMIT, INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	147
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	175
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	7
Total of all active and inactive participants	2018-07-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	182
Number of participants with account balances	2018-07-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: EDGEWOOD SUMMIT, INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	185
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	139
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	8
Total of all active and inactive participants	2017-07-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	147
Number of participants with account balances	2017-07-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2010: EDGEWOOD SUMMIT, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	28
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	27
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	0
Total of all active and inactive participants	2010-07-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	27
Number of participants with account balances	2010-07-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: EDGEWOOD SUMMIT, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	28
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	28
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	28
Number of participants with account balances	2009-07-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on EDGEWOOD SUMMIT, INC. 401K PLAN

Measure	Date	Value
2022 : EDGEWOOD SUMMIT, INC. 401K PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-06-30	$-222,498
Total unrealized appreciation/depreciation of assets	2022-06-30	$-222,498
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-53,126
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$106,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$92,029
Value of total corrective distributions	2022-06-30	$594
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$167,122
Value of total assets at end of year	2022-06-30	$1,225,260
Value of total assets at beginning of year	2022-06-30	$1,384,628
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$13,619
Total interest from all sources	2022-06-30	$2,250
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Administrative expenses professional fees incurred	2022-06-30	$2,230
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$103,685
Participant contributions at end of year	2022-06-30	$44,010
Participant contributions at beginning of year	2022-06-30	$37,296
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-06-30	$0
Total non interest bearing cash at end of year	2022-06-30	$53
Total non interest bearing cash at beginning of year	2022-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-159,368
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$1,225,260
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$1,384,628
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Investment advisory and management fees	2022-06-30	$6,873
Value of interest in pooled separate accounts at end of year	2022-06-30	$1,181,197
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$1,347,332
Interest on participant loans	2022-06-30	$2,250
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$63,437
Employer contributions (assets) at end of year	2022-06-30	$0
Employer contributions (assets) at beginning of year	2022-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$92,029
Contract administrator fees	2022-06-30	$4,516
Did the plan have assets held for investment	2022-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	BAKER TILLY US, LLP
Accountancy firm EIN	2022-06-30	390859910
2021 : EDGEWOOD SUMMIT, INC. 401K PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-06-30	$305,767
Total unrealized appreciation/depreciation of assets	2021-06-30	$305,767
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$443,838
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$93,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$81,411
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$135,729
Value of total assets at end of year	2021-06-30	$1,384,628
Value of total assets at beginning of year	2021-06-30	$1,034,297
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$12,096
Total interest from all sources	2021-06-30	$2,342
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$81,443
Participant contributions at end of year	2021-06-30	$37,296
Participant contributions at beginning of year	2021-06-30	$43,829
Participant contributions at end of year	2021-06-30	$0
Participant contributions at beginning of year	2021-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-06-30	$0
Total non interest bearing cash at end of year	2021-06-30	$0
Total non interest bearing cash at beginning of year	2021-06-30	$18,921
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$350,331
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$1,384,628
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$1,034,297
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Investment advisory and management fees	2021-06-30	$12,096
Value of interest in pooled separate accounts at end of year	2021-06-30	$1,347,332
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$971,547
Interest on participant loans	2021-06-30	$2,342
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$54,286
Employer contributions (assets) at end of year	2021-06-30	$0
Employer contributions (assets) at beginning of year	2021-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$81,411
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Disclaimer
Accountancy firm name	2021-06-30	BAKER TILLY US, LLP
Accountancy firm EIN	2021-06-30	390859910
2020 : EDGEWOOD SUMMIT, INC. 401K PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-06-30	$23,697
Total unrealized appreciation/depreciation of assets	2020-06-30	$23,697
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$3,978
Total income from all sources (including contributions)	2020-06-30	$149,958
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$12,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$2,588
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$123,380
Value of total assets at end of year	2020-06-30	$1,034,297
Value of total assets at beginning of year	2020-06-30	$900,784
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$9,879
Total interest from all sources	2020-06-30	$2,881
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Administrative expenses professional fees incurred	2020-06-30	$9,879
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$73,338
Participant contributions at end of year	2020-06-30	$43,829
Participant contributions at beginning of year	2020-06-30	$35,368
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$3,978
Total non interest bearing cash at end of year	2020-06-30	$18,921
Total non interest bearing cash at beginning of year	2020-06-30	$2,816
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$137,491
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$1,034,297
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$896,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in pooled separate accounts at end of year	2020-06-30	$971,547
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$862,564
Interest on participant loans	2020-06-30	$2,881
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$50,042
Employer contributions (assets) at end of year	2020-06-30	$0
Employer contributions (assets) at beginning of year	2020-06-30	$36
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$2,588
Did the plan have assets held for investment	2020-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2020-06-30	550486667
2019 : EDGEWOOD SUMMIT, INC. 401K PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-06-30	$40,136
Total unrealized appreciation/depreciation of assets	2019-06-30	$40,136
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$3,978
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$3,977
Total income from all sources (including contributions)	2019-06-30	$179,688
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$101,691
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$92,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$137,758
Value of total assets at end of year	2019-06-30	$900,784
Value of total assets at beginning of year	2019-06-30	$822,786
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$9,345
Total interest from all sources	2019-06-30	$1,794
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$68,195
Participant contributions at end of year	2019-06-30	$35,368
Participant contributions at beginning of year	2019-06-30	$25,218
Participant contributions at end of year	2019-06-30	$0
Participant contributions at beginning of year	2019-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$25,164
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-06-30	$3
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-06-30	$3,978
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-06-30	$3,977
Total non interest bearing cash at end of year	2019-06-30	$2,816
Total non interest bearing cash at beginning of year	2019-06-30	$2,816
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$77,997
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$896,806
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$818,809
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Investment advisory and management fees	2019-06-30	$9,345
Value of interest in pooled separate accounts at end of year	2019-06-30	$862,564
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$794,752
Interest on participant loans	2019-06-30	$1,794
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$44,399
Employer contributions (assets) at end of year	2019-06-30	$36
Employer contributions (assets) at beginning of year	2019-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$92,343
Did the plan have assets held for investment	2019-06-30	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	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2019-06-30	550486667
2018 : EDGEWOOD SUMMIT, INC. 401K PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-06-30	$54,249
Total unrealized appreciation/depreciation of assets	2018-06-30	$54,249
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$3,977
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$153,658
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$29,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$20,858
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$98,191
Value of total assets at end of year	2018-06-30	$822,786
Value of total assets at beginning of year	2018-06-30	$694,559
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$8,550
Total interest from all sources	2018-06-30	$1,218
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$48,699
Participant contributions at end of year	2018-06-30	$25,218
Participant contributions at beginning of year	2018-06-30	$26,124
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$29,240
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$3,977
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$0
Total non interest bearing cash at end of year	2018-06-30	$2,816
Total non interest bearing cash at beginning of year	2018-06-30	$2,816
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$124,250
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$818,809
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$694,559
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Investment advisory and management fees	2018-06-30	$3,756
Value of interest in pooled separate accounts at end of year	2018-06-30	$794,752
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$665,619
Interest on participant loans	2018-06-30	$1,218
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$20,252
Employer contributions (assets) at end of year	2018-06-30	$0
Employer contributions (assets) at beginning of year	2018-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$20,858
Contract administrator fees	2018-06-30	$4,794
Did the plan have assets held for investment	2018-06-30	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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2018-06-30	550486667
2011 : EDGEWOOD SUMMIT, INC. 401K PLAN 2011 401k financial data
Total income from all sources	2011-06-30	$105,862
Expenses. Total of all expenses incurred	2011-06-30	$8,210
Benefits paid (including direct rollovers)	2011-06-30	$8,210
Total plan assets at end of year	2011-06-30	$415,904
Total plan assets at beginning of year	2011-06-30	$318,252
Value of fidelity bond covering the plan	2011-06-30	$80,000
Total contributions received or receivable from participants	2011-06-30	$25,980
Other income received	2011-06-30	$67,857
Net income (gross income less expenses)	2011-06-30	$97,652
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$415,904
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$318,252
Assets. Value of participant loans	2011-06-30	$31,396
Total contributions received or receivable from employer(s)	2011-06-30	$12,025
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
2010 : EDGEWOOD SUMMIT, INC. 401K PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for EDGEWOOD SUMMIT, INC. 401K PLAN

2021: EDGEWOOD SUMMIT, INC. 401K PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: EDGEWOOD SUMMIT, INC. 401K PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: EDGEWOOD SUMMIT, INC. 401K PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: EDGEWOOD SUMMIT, INC. 401K PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: EDGEWOOD SUMMIT, INC. 401K PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2010: EDGEWOOD SUMMIT, INC. 401K PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: EDGEWOOD SUMMIT, INC. 401K PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	66
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,230
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Amount paid for insurance broker fees	2230
Additional information about fees paid to insurance broker	TPA SERVICES
Insurance broker organization code?	5

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	49
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,467
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	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Amount paid for insurance broker fees	1467
Additional information about fees paid to insurance broker	TPA SERVICES
Insurance broker organization code?	5

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	46
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $932
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Amount paid for insurance broker fees	932
Additional information about fees paid to insurance broker	TPA SERVICES
Insurance broker organization code?	5

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	42
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,069
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Amount paid for insurance broker fees	1069
Additional information about fees paid to insurance broker	TPA SERVICES
Insurance broker organization code?	5

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	36
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $959
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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

Policy contract number

29893

Policy instance

Insurance contract or identification number	29893
Number of Individuals Covered	27
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $2,805
Total amount of fees paid to insurance company	USD $84
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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Company Name:	EDGEWOOD SUMMIT, INC.
Employer identification number (EIN):	550701159
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities