401k Plan data: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS plan

403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 401k Plan overview

Plan Name	403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS
Plan identification number	003

403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 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.
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

OLYMPIC COMMUNITY ACTION PROGRAMS has sponsored the creation of one or more 401k plans.

Company Name: OLYMPIC COMMUNITY ACTION PROGRAMS

Employer identification number (EIN): 910814319

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about OLYMPIC COMMUNITY ACTION PROGRAMS

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1966-05-10

Company Identification Number: 600443619

Legal Registered Office Address: 823 COMMERCE LOOP

PORT TOWNSEND
United States of America (USA)
983682904

More information about OLYMPIC COMMUNITY ACTION PROGRAMS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2022-01-01
003 2021-01-01
003 2021-01-01
003 2020-01-01
003 2019-01-01 IMELDA WALTERS 2020-07-15
003 2018-01-01 IMELDA WALTERS 2019-07-16
003 2017-01-01 CORENA STERN CORENA STERN 2018-06-20
003 2016-01-01 CORENA STERN CORENA STERN 2017-07-22
003 2015-01-01 CORENA STERN
003 2014-01-01 CORENA STERN
003 2013-01-01 JANE ERBE CORENA STERN 2014-10-06
003 2012-01-01 MICHAEL LIEUALLEN
003 2011-01-01 BETSI FARRELL 2012-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2022-01-01
003	2021-01-01
003	2021-01-01
003	2020-01-01
003	2019-01-01	IMELDA WALTERS	2020-07-15
003	2018-01-01	IMELDA WALTERS	2019-07-16
003	2017-01-01	CORENA STERN		CORENA STERN	2018-06-20
003	2016-01-01	CORENA STERN		CORENA STERN	2017-07-22
003	2015-01-01	CORENA STERN
003	2014-01-01	CORENA STERN
003	2013-01-01	JANE ERBE		CORENA STERN	2014-10-06
003	2012-01-01	MICHAEL LIEUALLEN
003	2011-01-01	BETSI FARRELL	2012-10-15

Plan Statistics for 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS

401k plan membership statisitcs for 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS

Measure Date Value
2022: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2022 401k membership
Total participants, beginning-of-year 2022-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 113
Number of retired or separated participants receiving benefits 2022-01-01 3
Number of other retired or separated participants entitled to future benefits 2022-01-01 49
Total of all active and inactive participants 2022-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 165
Number of participants with account balances 2022-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2021 401k membership
Total participants, beginning-of-year 2021-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 67
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 38
Total of all active and inactive participants 2021-01-01 105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 107
Number of participants with account balances 2021-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2020 401k membership
Total participants, beginning-of-year 2020-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 72
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 32
Total of all active and inactive participants 2020-01-01 104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 106
Number of participants with account balances 2020-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2017: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2017 401k membership
Total participants, beginning-of-year 2017-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 68
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 20
Total of all active and inactive participants 2017-01-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 88
Number of participants with account balances 2017-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2016 401k membership
Total participants, beginning-of-year 2016-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 65
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 45
Total of all active and inactive participants 2016-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 110
Number of participants with account balances 2016-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 6
2015: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2015 401k membership
Total participants, beginning-of-year 2015-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 64
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 46
Total of all active and inactive participants 2015-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 111
Number of participants with account balances 2015-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 4
2014: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2014 401k membership
Total participants, beginning-of-year 2014-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 66
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 34
Total of all active and inactive participants 2014-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 100
Number of participants with account balances 2014-01-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2013 401k membership
Total participants, beginning-of-year 2013-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 68
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 30
Total of all active and inactive participants 2013-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 98
Number of participants with account balances 2013-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2012 401k membership
Total participants, beginning-of-year 2012-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 74
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 36
Total of all active and inactive participants 2012-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 110
Number of participants with account balances 2012-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2022: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2022 401k membership
Total participants, beginning-of-year	2022-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	113
Number of retired or separated participants receiving benefits	2022-01-01	3
Number of other retired or separated participants entitled to future benefits	2022-01-01	49
Total of all active and inactive participants	2022-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	165
Number of participants with account balances	2022-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2021 401k membership
Total participants, beginning-of-year	2021-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	67
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	38
Total of all active and inactive participants	2021-01-01	105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	107
Number of participants with account balances	2021-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2020 401k membership
Total participants, beginning-of-year	2020-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	72
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	32
Total of all active and inactive participants	2020-01-01	104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	106
Number of participants with account balances	2020-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2017: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2017 401k membership
Total participants, beginning-of-year	2017-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	68
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	20
Total of all active and inactive participants	2017-01-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	88
Number of participants with account balances	2017-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2016 401k membership
Total participants, beginning-of-year	2016-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	65
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	45
Total of all active and inactive participants	2016-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	110
Number of participants with account balances	2016-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	6
2015: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2015 401k membership
Total participants, beginning-of-year	2015-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	64
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	46
Total of all active and inactive participants	2015-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	111
Number of participants with account balances	2015-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	4
2014: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2014 401k membership
Total participants, beginning-of-year	2014-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	66
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	34
Total of all active and inactive participants	2014-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	100
Number of participants with account balances	2014-01-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2013 401k membership
Total participants, beginning-of-year	2013-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	68
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	30
Total of all active and inactive participants	2013-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	98
Number of participants with account balances	2013-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2012 401k membership
Total participants, beginning-of-year	2012-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	74
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	36
Total of all active and inactive participants	2012-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	110
Number of participants with account balances	2012-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS

Measure	Date	Value
2022 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	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	$-66,728
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$44,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$43,813
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$186,039
Value of total assets at end of year	2022-12-31	$1,617,880
Value of total assets at beginning of year	2022-12-31	$1,729,215
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$794
Total interest from all sources	2022-12-31	$857
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	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$175,000
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	$89,990
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$6,070
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$794
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
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-111,335
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,617,880
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,729,215
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
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,373,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$1,523,604
Interest on participant loans	2022-12-31	$0
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$857
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$244,570
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$205,611
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-253,624
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
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	$89,979
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$43,813
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
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
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	AIKEN & SANDERS, INC.
Accountancy firm EIN	2022-12-31	910870697
2021 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$383,843
Expenses. Total of all expenses incurred	2021-12-31	$65,494
Benefits paid (including direct rollovers)	2021-12-31	$64,404
Total plan assets at end of year	2021-12-31	$1,729,215
Total plan assets at beginning of year	2021-12-31	$1,410,866
Value of fidelity bond covering the plan	2021-12-31	$175,000
Total contributions received or receivable from participants	2021-12-31	$93,280
Expenses. Other expenses not covered elsewhere	2021-12-31	$1,090
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$210,040
Net income (gross income less expenses)	2021-12-31	$318,349
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,729,215
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,410,866
Total contributions received or receivable from employer(s)	2021-12-31	$80,523
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$380,917
Expenses. Total of all expenses incurred	2020-12-31	$90,752
Benefits paid (including direct rollovers)	2020-12-31	$89,729
Total plan assets at end of year	2020-12-31	$1,410,866
Total plan assets at beginning of year	2020-12-31	$1,120,701
Value of fidelity bond covering the plan	2020-12-31	$150,000
Total contributions received or receivable from participants	2020-12-31	$103,524
Expenses. Other expenses not covered elsewhere	2020-12-31	$1,023
Contributions received from other sources (not participants or employers)	2020-12-31	$49,927
Other income received	2020-12-31	$153,811
Net income (gross income less expenses)	2020-12-31	$290,165
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,410,866
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,120,701
Total contributions received or receivable from employer(s)	2020-12-31	$73,655
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2017 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2017 401k financial data
Total income from all sources	2017-12-31	$240,027
Expenses. Total of all expenses incurred	2017-12-31	$166,016
Benefits paid (including direct rollovers)	2017-12-31	$165,017
Total plan assets at end of year	2017-12-31	$962,486
Total plan assets at beginning of year	2017-12-31	$888,475
Value of fidelity bond covering the plan	2017-12-31	$100,000
Total contributions received or receivable from participants	2017-12-31	$66,480
Contributions received from other sources (not participants or employers)	2017-12-31	$9,786
Other income received	2017-12-31	$104,420
Net income (gross income less expenses)	2017-12-31	$74,011
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$962,486
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$888,475
Total contributions received or receivable from employer(s)	2017-12-31	$59,341
Value of certain deemed distributions of participant loans	2017-12-31	$999
2016 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$180,893
Expenses. Total of all expenses incurred	2016-12-31	$105,524
Benefits paid (including direct rollovers)	2016-12-31	$104,151
Total plan assets at end of year	2016-12-31	$888,475
Total plan assets at beginning of year	2016-12-31	$813,106
Value of fidelity bond covering the plan	2016-12-31	$100,000
Total contributions received or receivable from participants	2016-12-31	$69,175
Expenses. Other expenses not covered elsewhere	2016-12-31	$1,373
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$56,113
Net income (gross income less expenses)	2016-12-31	$75,369
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$888,475
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$813,106
Assets. Value of participant loans	2016-12-31	$0
Total contributions received or receivable from employer(s)	2016-12-31	$55,605
Value of certain deemed distributions of participant loans	2016-12-31	$0
2015 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$110,156
Expenses. Total of all expenses incurred	2015-12-31	$106,622
Benefits paid (including direct rollovers)	2015-12-31	$105,924
Total plan assets at end of year	2015-12-31	$813,106
Total plan assets at beginning of year	2015-12-31	$809,572
Value of fidelity bond covering the plan	2015-12-31	$100,000
Total contributions received or receivable from participants	2015-12-31	$60,176
Expenses. Other expenses not covered elsewhere	2015-12-31	$698
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-7,675
Net income (gross income less expenses)	2015-12-31	$3,534
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$813,106
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$809,572
Total contributions received or receivable from employer(s)	2015-12-31	$57,655
Value of certain deemed distributions of participant loans	2015-12-31	$0
2014 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$156,874
Expenses. Total of all expenses incurred	2014-12-31	$83,820
Benefits paid (including direct rollovers)	2014-12-31	$83,820
Total plan assets at end of year	2014-12-31	$809,572
Total plan assets at beginning of year	2014-12-31	$736,518
Value of fidelity bond covering the plan	2014-12-31	$100,000
Total contributions received or receivable from participants	2014-12-31	$54,929
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$4,913
Other income received	2014-12-31	$38,757
Net income (gross income less expenses)	2014-12-31	$73,054
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$809,572
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$736,518
Total contributions received or receivable from employer(s)	2014-12-31	$58,275
Value of certain deemed distributions of participant loans	2014-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$259,391
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$146,246
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$146,246
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$159,472
Value of total assets at end of year	2013-12-31	$736,518
Value of total assets at beginning of year	2013-12-31	$623,373
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$1,177
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$100,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$49,172
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$49,384
Other income not declared elsewhere	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$113,145
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$736,518
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$623,373
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$591,738
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$531,186
Interest on participant loans	2013-12-31	$0
Interest earned on other investments	2013-12-31	$1,177
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$144,780
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$92,187
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from pooled separate accounts	2013-12-31	$98,742
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$60,916
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$146,246
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	AIKEN & SANDERS INC PS
Accountancy firm EIN	2013-12-31	910870697
2012 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$193,179
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$43,257
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$43,257
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$146,892
Value of total assets at end of year	2012-12-31	$623,373
Value of total assets at beginning of year	2012-12-31	$473,451
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$1,544
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$100,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$64,861
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$13,342
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$149,922
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$623,373
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$473,451
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$531,186
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$384,600
Interest on participant loans	2012-12-31	$0
Interest earned on other investments	2012-12-31	$1,544
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$92,187
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$88,851
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$44,743
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$68,689
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$43,257
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	AIKEN AND SANDERS, INC. PS
Accountancy firm EIN	2012-12-31	910870697
2010 : 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2010 401k financial data
Total income from all sources	2010-12-31	$273,316
Expenses. Total of all expenses incurred	2010-12-31	$7,222
Benefits paid (including direct rollovers)	2010-12-31	$7,222
Total plan assets at end of year	2010-12-31	$267,920
Total plan assets at beginning of year	2010-12-31	$1,826
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$107,699
Contributions received from other sources (not participants or employers)	2010-12-31	$58,509
Other income received	2010-12-31	$18,262
Net income (gross income less expenses)	2010-12-31	$266,094
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$267,920
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,826
Total contributions received or receivable from employer(s)	2010-12-31	$88,846
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS

2022: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 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	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 benefit arrangement – Insurance	Yes
2021: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 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 benefit arrangement – Insurance	Yes
2020: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
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
2017: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 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: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2014: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2013: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: 403(B) THRIFT PLAN OF OLYMPIC COMMUNITY ACTION PROGRAMS 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	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

058046

Policy instance

Insurance contract or identification number	058046
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 $481
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
Amount paid for insurance broker fees	481
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	107
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 $253
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	253
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

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	106
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 $253
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	253
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

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	88
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 $489
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	489
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	SEATTLE REGIONAL OFFICE

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	111
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $178
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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	178
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	SEATTLE REGIONAL OFFICE

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	100
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $685
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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	685
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	SEATTLE REGIONAL OFFICE

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	98
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $115
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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	115
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	SEATTLE REGIONAL OFFICE

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	110
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $257
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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	72
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	ADAM REUGH

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

Policy contract number

058046F

Policy instance

Insurance contract or identification number	058046F
Number of Individuals Covered	113
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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	1
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	ANNETTE C. HENRY

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Company Name:	OLYMPIC COMMUNITY ACTION PROGRAMS
Employer identification number (EIN):	910814319
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1966-05-10
Company Identification Number:	600443619
Legal Registered Office Address:	823 COMMERCE LOOP PORT TOWNSEND United States of America (USA) 983682904