401k Plan data: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN plan

LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 401k Plan overview

Plan Name	LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN
Plan identification number	001

LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

LIFE CARE PASTORAL SERVICES has sponsored the creation of one or more 401k plans.

Company Name: LIFE CARE PASTORAL SERVICES

Employer identification number (EIN): 593480191

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 BRUCE JONES BRUCE JONES 2018-07-24
001 2015-01-01 DBRUCE JONES DBRUCE JONES 2016-07-07
001 2014-01-01 BRUCE JONES BRUCE JONES 2015-10-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	BRUCE JONES	BRUCE JONES	2018-07-24
001	2015-01-01	DBRUCE JONES	DBRUCE JONES	2016-07-07
001	2014-01-01	BRUCE JONES	BRUCE JONES	2015-10-19

Plan Statistics for LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN

401k plan membership statisitcs for LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN

Measure Date Value
2022: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 343
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 26
Total of all active and inactive participants 2022-01-01 369
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 2
Total participants 2022-01-01 371
Number of participants with account balances 2022-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 3
2021: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 286
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 27
Total of all active and inactive participants 2021-01-01 313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 314
Number of participants with account balances 2021-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 4
2020: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 361
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 274
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 25
Total of all active and inactive participants 2020-01-01 299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 300
Number of participants with account balances 2020-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 7
2019: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 384
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 346
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 26
Total of all active and inactive participants 2019-01-01 372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 373
Number of participants with account balances 2019-01-01 152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 564
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 499
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 29
Total of all active and inactive participants 2018-01-01 528
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 529
Number of participants with account balances 2018-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 553
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 456
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 32
Total of all active and inactive participants 2017-01-01 488
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 489
Number of participants with account balances 2017-01-01 164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 11
2015: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 595
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 550
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 32
Total of all active and inactive participants 2015-01-01 582
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 583
Number of participants with account balances 2015-01-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 6
2014: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 596
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 484
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 21
Total of all active and inactive participants 2014-01-01 505
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 506
Number of participants with account balances 2014-01-01 185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 9

Measure	Date	Value
2022: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	343
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	26
Total of all active and inactive participants	2022-01-01	369
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	2
Total participants	2022-01-01	371
Number of participants with account balances	2022-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	3
2021: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	286
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	27
Total of all active and inactive participants	2021-01-01	313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	314
Number of participants with account balances	2021-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	4
2020: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	361
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	274
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	25
Total of all active and inactive participants	2020-01-01	299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	300
Number of participants with account balances	2020-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	7
2019: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	384
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	346
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	26
Total of all active and inactive participants	2019-01-01	372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	373
Number of participants with account balances	2019-01-01	152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	564
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	499
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	29
Total of all active and inactive participants	2018-01-01	528
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	529
Number of participants with account balances	2018-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	553
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	456
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	32
Total of all active and inactive participants	2017-01-01	488
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	489
Number of participants with account balances	2017-01-01	164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	11
2015: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	595
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	550
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	32
Total of all active and inactive participants	2015-01-01	582
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	583
Number of participants with account balances	2015-01-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	6
2014: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	596
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	484
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	21
Total of all active and inactive participants	2014-01-01	505
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	506
Number of participants with account balances	2014-01-01	185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	9

Financial Data on LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN

Measure	Date	Value
2022 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 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	$-793,587
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$968,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$948,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$621,260
Value of total assets at end of year	2022-12-31	$6,112,441
Value of total assets at beginning of year	2022-12-31	$7,874,852
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$20,318
Total interest from all sources	2022-12-31	$9,130
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$76,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$76,736
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
Contributions received from participants	2022-12-31	$410,776
Participant contributions at end of year	2022-12-31	$100,989
Participant contributions at beginning of year	2022-12-31	$134,376
Participant contributions at end of year	2022-12-31	$14,982
Participant contributions at beginning of year	2022-12-31	$10,992
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$11,892
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	$-1,762,411
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$6,112,441
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$7,874,852
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	$5,614,958
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$7,323,038
Interest on participant loans	2022-12-31	$4,551
Interest earned on other investments	2022-12-31	$4,579
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$375,838
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$400,554
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,500,713
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	$198,592
Employer contributions (assets) at end of year	2022-12-31	$5,674
Employer contributions (assets) at beginning of year	2022-12-31	$5,892
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$948,506
Contract administrator fees	2022-12-31	$20,318
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MSL, PA
Accountancy firm EIN	2022-12-31	593070669
2021 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 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	$1,421,566
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$403,974
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$380,866
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$493,273
Value of total assets at end of year	2021-12-31	$7,874,852
Value of total assets at beginning of year	2021-12-31	$6,857,260
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$23,108
Total interest from all sources	2021-12-31	$11,511
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$113,240
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$113,240
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	$325,075
Participant contributions at end of year	2021-12-31	$134,376
Participant contributions at beginning of year	2021-12-31	$158,879
Participant contributions at end of year	2021-12-31	$10,992
Participant contributions at beginning of year	2021-12-31	$11,073
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$4,610
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	$1,017,592
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$7,874,852
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,857,260
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	$7,323,038
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$6,245,065
Interest on participant loans	2021-12-31	$6,410
Interest earned on other investments	2021-12-31	$5,101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$400,554
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$436,324
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$803,542
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	$163,588
Employer contributions (assets) at end of year	2021-12-31	$5,892
Employer contributions (assets) at beginning of year	2021-12-31	$5,919
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$380,866
Contract administrator fees	2021-12-31	$23,108
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	MSL,PA
Accountancy firm EIN	2021-12-31	593070669
2020 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	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	$1,447,227
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$853,652
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$828,810
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Value of total corrective distributions	2020-12-31	$1,411
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$509,231
Value of total assets at end of year	2020-12-31	$6,857,260
Value of total assets at beginning of year	2020-12-31	$6,263,685
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$23,431
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$16,546
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$67,761
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$67,761
Administrative expenses professional fees incurred	2020-12-31	$0
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
Amount of non-exempt transactions with any party-in-interest	2020-12-31	$0
Contributions received from participants	2020-12-31	$337,288
Participant contributions at end of year	2020-12-31	$158,879
Participant contributions at beginning of year	2020-12-31	$143,651
Participant contributions at end of year	2020-12-31	$11,073
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$593,575
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,857,260
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,263,685
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2020-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$6,245,065
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$5,623,768
Interest on participant loans	2020-12-31	$7,957
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$8,589
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$436,324
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$496,266
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$853,689
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
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	$171,943
Employer contributions (assets) at end of year	2020-12-31	$5,919
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$828,810
Contract administrator fees	2020-12-31	$23,431
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
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
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MSL, P.A.
Accountancy firm EIN	2020-12-31	593070669
2019 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	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 income from all sources (including contributions)	2019-12-31	$1,574,471
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$481,529
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$456,720
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$347
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$486,783
Value of total assets at end of year	2019-12-31	$6,263,685
Value of total assets at beginning of year	2019-12-31	$5,170,743
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$24,462
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$18,461
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$77,986
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$77,986
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
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
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
Amount of non-exempt transactions with any party-in-interest	2019-12-31	$0
Contributions received from participants	2019-12-31	$317,380
Participant contributions at end of year	2019-12-31	$143,651
Participant contributions at beginning of year	2019-12-31	$193,621
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$232
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,092,942
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,263,685
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,170,743
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2019-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,623,768
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,490,547
Interest on participant loans	2019-12-31	$9,737
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$8,724
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$496,266
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$486,575
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$991,241
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$169,403
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$456,488
Contract administrator fees	2019-12-31	$24,462
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MSL, PA
Accountancy firm EIN	2019-12-31	593070669
2018 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	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	$170,935
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$874,314
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$847,038
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$2,178
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$456,693
Value of total assets at end of year	2018-12-31	$5,170,743
Value of total assets at beginning of year	2018-12-31	$5,874,122
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$25,098
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$17,224
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$76,782
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$76,782
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
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
Amount of non-exempt transactions with any party-in-interest	2018-12-31	$0
Contributions received from participants	2018-12-31	$301,159
Participant contributions at end of year	2018-12-31	$193,621
Participant contributions at beginning of year	2018-12-31	$150,797
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-703,379
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$5,170,743
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,874,122
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2018-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$4,490,547
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$5,157,816
Interest on participant loans	2018-12-31	$8,591
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$8,633
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$486,575
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$565,509
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-379,764
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
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	$155,534
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$847,038
Contract administrator fees	2018-12-31	$25,098
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	MOORE STEPHENS LOVELACE, PA
Accountancy firm EIN	2018-12-31	593070669
2017 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	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	$1,420,298
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,286,293
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,261,776
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$560,779
Value of total assets at end of year	2017-12-31	$5,874,122
Value of total assets at beginning of year	2017-12-31	$5,740,117
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$24,517
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$19,784
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$82,183
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$82,183
Administrative expenses professional fees incurred	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Amount of non-exempt transactions with any party-in-interest	2017-12-31	$0
Contributions received from participants	2017-12-31	$344,999
Participant contributions at end of year	2017-12-31	$150,797
Participant contributions at beginning of year	2017-12-31	$166,084
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$26,812
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$134,005
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,874,122
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$5,740,117
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2017-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$5,157,816
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$4,735,161
Interest on participant loans	2017-12-31	$7,462
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$12,322
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$565,509
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$838,872
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$757,552
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
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	$188,968
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,261,776
Contract administrator fees	2017-12-31	$24,517
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
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
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
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	MOORE STEPHENS LOVELACE, P.A.
Accountancy firm EIN	2017-12-31	593070669
2015 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$608,870
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,395,791
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,369,501
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$293
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$577,634
Value of total assets at end of year	2015-12-31	$5,192,110
Value of total assets at beginning of year	2015-12-31	$5,979,031
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$25,997
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$21,418
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$36,324
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$36,324
Administrative expenses professional fees incurred	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Amount of non-exempt transactions with any party-in-interest	2015-12-31	$0
Contributions received from participants	2015-12-31	$362,009
Participant contributions at end of year	2015-12-31	$171,785
Participant contributions at beginning of year	2015-12-31	$106,501
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$2,500
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$26
Administrative expenses (other) incurred	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-786,921
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,192,110
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,979,031
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2015-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$4,281,790
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$5,131,007
Interest on participant loans	2015-12-31	$5,960
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$15,458
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$738,535
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$741,523
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-26,532
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$213,125
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,369,501
Contract administrator fees	2015-12-31	$25,997
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MOORE STEPHENS LOVELACE, PA
Accountancy firm EIN	2015-12-31	593070669
2014 : LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$918,727
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,190,557
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,162,915
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$543,963
Value of total assets at end of year	2014-12-31	$5,979,031
Value of total assets at beginning of year	2014-12-31	$6,250,861
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$27,642
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$23,050
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$61,767
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$61,767
Administrative expenses professional fees incurred	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Amount of non-exempt transactions with any party-in-interest	2014-12-31	$0
Contributions received from participants	2014-12-31	$319,306
Participant contributions at end of year	2014-12-31	$106,501
Participant contributions at beginning of year	2014-12-31	$152,704
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$32,392
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-271,830
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,979,031
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,250,861
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2014-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$5,131,007
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,322,499
Interest on participant loans	2014-12-31	$5,829
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$17,221
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$741,523
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$775,658
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$289,947
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$192,265
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,162,915
Contract administrator fees	2014-12-31	$27,642
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MSL MOORE STEPHEN LOVELACE, PA
Accountancy firm EIN	2014-12-31	593070669

Form 5500 Responses for LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN

2022: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
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 funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
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 funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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 funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
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 funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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 funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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 funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2015: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LIFE CARE PASTORAL SERVICES TAX SHELTERED ANNUITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	371
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,009
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,009
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	314
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,073
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,073
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	300
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,541
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,541
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	373
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,219
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $610
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	489
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,734
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,734
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	NYLIFE SECURITIES LLC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	583
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,605
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,605
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	NYLIFE SECURITIES LLC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441463

Policy instance

Insurance contract or identification number	441463
Number of Individuals Covered	506
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,591
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,591
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	NYLIFE SECURITIES LLC

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Company Name:	LIFE CARE PASTORAL SERVICES
Employer identification number (EIN):	593480191
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities