401k Plan data: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. plan

401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 401k Plan overview

Plan Name	401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.
Plan identification number	002

401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

THE WILLIAM BREMAN JEWISH HOME, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE WILLIAM BREMAN JEWISH HOME, INC.

Employer identification number (EIN): 580610059

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2020-01-01
002 2019-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 NEELAM RAHATEKAR NEELAM RAHATEKAR 2018-10-15
002 2016-01-01 NEELAM RAHATEKAR NEELAM RAHATEKAR 2018-01-29

Plan Statistics for 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.

401k plan membership statisitcs for 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.

Measure Date Value
2022: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 427
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 432
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 219
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 131
Total of all active and inactive participants 2021-01-01 350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 5
Total participants 2021-01-01 355
Number of participants with account balances 2021-01-01 343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 407
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 354
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 74
Total of all active and inactive participants 2020-01-01 428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 4
Total participants 2020-01-01 432
Number of participants with account balances 2020-01-01 421
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 18
2019: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 456
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 325
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 77
Total of all active and inactive participants 2019-01-01 402
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 5
Total participants 2019-01-01 407
Number of participants with account balances 2019-01-01 376
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 23
2018: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 370
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 412
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 42
Total of all active and inactive participants 2018-01-01 454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 2
Total participants 2018-01-01 456
Number of participants with account balances 2018-01-01 450
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 15
2017: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 355
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 14
Total of all active and inactive participants 2017-01-01 369
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 370
Number of participants with account balances 2017-01-01 363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 8
2016: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 229
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 230
Number of participants with account balances 2016-01-01 176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 10

Measure	Date	Value
2022: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	427
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	432
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	219
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	131
Total of all active and inactive participants	2021-01-01	350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	5
Total participants	2021-01-01	355
Number of participants with account balances	2021-01-01	343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	407
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	354
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	74
Total of all active and inactive participants	2020-01-01	428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	4
Total participants	2020-01-01	432
Number of participants with account balances	2020-01-01	421
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	18
2019: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	456
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	325
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	77
Total of all active and inactive participants	2019-01-01	402
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	5
Total participants	2019-01-01	407
Number of participants with account balances	2019-01-01	376
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	23
2018: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	370
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	412
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	42
Total of all active and inactive participants	2018-01-01	454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	2
Total participants	2018-01-01	456
Number of participants with account balances	2018-01-01	450
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	15
2017: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	355
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	14
Total of all active and inactive participants	2017-01-01	369
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	370
Number of participants with account balances	2017-01-01	363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	8
2016: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	229
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	230
Number of participants with account balances	2016-01-01	176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	10

Financial Data on 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.

Measure	Date	Value
2022 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-132,328
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,295,915
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,274,625
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$35,059
Value of total assets at end of year	2022-12-31	$0
Value of total assets at beginning of year	2022-12-31	$2,428,243
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$21,290
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$20,543
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,428,243
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,428,243
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,300,670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$127,573
Net investment gain/loss from pooled separate accounts	2022-12-31	$-167,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$35,059
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,274,625
Contract administrator fees	2022-12-31	$747
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MAULDIN & JENKINS, LLC
Accountancy firm EIN	2022-12-31	580692043
2021 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$345,114
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$312,142
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$308,382
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$-37,629
Value of total assets at end of year	2021-12-31	$2,463,275
Value of total assets at beginning of year	2021-12-31	$2,430,303
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$3,760
Total interest from all sources	2021-12-31	$1,419
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$2,356
Other income not declared elsewhere	2021-12-31	$60,521
Administrative expenses (other) incurred	2021-12-31	$3,760
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$32,972
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,463,275
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,430,303
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,300,670
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,273,789
Interest on participant loans	2021-12-31	$0
Interest earned on other investments	2021-12-31	$1,419
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$162,605
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$156,514
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$320,803
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$-39,985
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$308,382
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MAULDIN & JENKINS, LLC
Accountancy firm EIN	2021-12-31	580692043
2020 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,112,764
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$182,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$178,380
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$837,655
Value of total assets at end of year	2020-12-31	$2,430,303
Value of total assets at beginning of year	2020-12-31	$1,499,765
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$3,846
Total interest from all sources	2020-12-31	$1,500
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$552,972
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$3,846
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$930,538
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,430,303
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,499,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,273,789
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,313,678
Interest on participant loans	2020-12-31	$0
Interest earned on other investments	2020-12-31	$1,500
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$156,514
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$186,087
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$273,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$284,683
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$178,380
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MAULDIN & JENKINS, LLC
Accountancy firm EIN	2020-12-31	580692043
2019 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$742,541
Total income from all sources (including contributions)	2019-12-31	$742,541
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$143,791
Total of all expenses incurred	2019-12-31	$143,791
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$139,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$139,014
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$542,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$542,506
Value of total assets at end of year	2019-12-31	$1,499,765
Value of total assets at end of year	2019-12-31	$1,499,765
Value of total assets at beginning of year	2019-12-31	$901,015
Value of total assets at beginning of year	2019-12-31	$901,015
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,777
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,777
Total interest from all sources	2019-12-31	$1,914
Total interest from all sources	2019-12-31	$1,914
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$0
Contributions received from participants	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$223,815
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$223,815
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$4,777
Administrative expenses (other) incurred	2019-12-31	$4,777
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$598,750
Value of net income/loss	2019-12-31	$598,750
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,499,765
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,499,765
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$901,015
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$901,015
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,313,678
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,313,678
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$813,687
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$813,687
Interest on participant loans	2019-12-31	$0
Interest on participant loans	2019-12-31	$0
Interest earned on other investments	2019-12-31	$1,914
Interest earned on other investments	2019-12-31	$1,914
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$186,087
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$186,087
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$87,328
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$87,328
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$198,121
Net investment gain/loss from pooled separate accounts	2019-12-31	$198,121
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$318,691
Contributions received in cash from employer	2019-12-31	$318,691
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$139,014
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$139,014
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MAULDIN & JENKINS CPA, LLC
Accountancy firm name	2019-12-31	MAULDIN & JENKINS CPA, LLC
Accountancy firm EIN	2019-12-31	580692043
Accountancy firm EIN	2019-12-31	580692043
2018 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$314,701
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$55,384
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$51,122
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$370,115
Value of total assets at end of year	2018-12-31	$901,015
Value of total assets at beginning of year	2018-12-31	$641,698
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$4,262
Total interest from all sources	2018-12-31	$733
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$4,262
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	$259,317
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$901,015
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$641,698
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$813,687
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$582,667
Interest on participant loans	2018-12-31	$0
Interest earned on other investments	2018-12-31	$733
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$87,328
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$59,031
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-56,147
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$370,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$51,122
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MAULDIN & JENKINS CPA LLC
Accountancy firm EIN	2018-12-31	580692043
2017 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$390,255
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$9,756
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$7,290
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$323,704
Value of total assets at end of year	2017-12-31	$641,698
Value of total assets at beginning of year	2017-12-31	$261,199
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,466
Total interest from all sources	2017-12-31	$418
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$2,466
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	$380,499
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$641,698
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$261,199
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$582,667
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$235,799
Interest on participant loans	2017-12-31	$0
Interest earned on other investments	2017-12-31	$418
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$59,031
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$25,400
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$66,133
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$323,704
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$7,290
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	MAULDIN & JENKINS CPA LLC
Accountancy firm EIN	2017-12-31	580692043
2016 : 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$267,825
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$6,626
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$5,577
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$247,825
Value of total assets at end of year	2016-12-31	$261,199
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,049
Total interest from all sources	2016-12-31	$183
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
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	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$1,049
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	$261,199
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$261,199
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$235,799
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Interest on participant loans	2016-12-31	$0
Interest earned on other investments	2016-12-31	$183
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$25,400
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$19,817
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$247,825
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$5,577
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	MAULDIN & JENKINS CPA LLC
Accountancy firm EIN	2016-12-31	580692043

Form 5500 Responses for 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC.

2022: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: 401(A) THRIFT PLAN OF THE WILLIAM BREMAN JEWISH HOME, INC. 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

051932

Policy instance

Insurance contract or identification number	051932
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

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

Policy contract number

051932G

Policy instance

Insurance contract or identification number	051932G
Number of Individuals Covered	355
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,649
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1649
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051932G

Policy instance

Insurance contract or identification number	051932G
Number of Individuals Covered	432
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,649
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1649
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051932G

Policy instance

Insurance contract or identification number	051932G
Number of Individuals Covered	407
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,783
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2783
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051932G

Policy instance

Insurance contract or identification number	051932G
Number of Individuals Covered	456
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,895
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1895
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

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

Policy contract number

051932G

Policy instance

Insurance contract or identification number	051932G
Number of Individuals Covered	370
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $574
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	574
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	ATLANTA REGIONAL OFFICE

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Company Name:	THE WILLIAM BREMAN JEWISH HOME, INC.
Employer identification number (EIN):	580610059
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities