401k Plan data: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN plan

HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 401k Plan overview

Plan Name	HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN
Plan identification number	005

HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

HILLVIEW MENTAL HEALTH CENTER INC has sponsored the creation of one or more 401k plans.

Company Name: HILLVIEW MENTAL HEALTH CENTER INC

Employer identification number (EIN): 953928411

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Additional information about HILLVIEW MENTAL HEALTH CENTER INC

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C1307914

More information about HILLVIEW MENTAL HEALTH CENTER INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
005 2022-01-01 EVA MCCRAVEN 2023-08-28
005 2021-01-01 EVA MCCRAVEN 2022-08-31
005 2020-01-01 EVA MCCRAVEN 2021-08-19
005 2019-01-01 EVA MCCRAVEN 2020-09-22
005 2018-01-01
005 2017-01-01
005 2016-01-01
005 2015-01-01
005 2014-01-01 EVA MCCRAVEN 2015-05-29
005 2013-01-01 EVA MCCRAVEN 2014-07-17
005 2012-01-01 EVA MCCRAVEN 2013-05-31
005 2011-01-01 EVA MCCRAVEN 2012-06-08
005 2010-01-01 EVA MCCRAVEN 2011-07-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
005	2022-01-01	EVA MCCRAVEN	2023-08-28
005	2021-01-01	EVA MCCRAVEN	2022-08-31
005	2020-01-01	EVA MCCRAVEN	2021-08-19
005	2019-01-01	EVA MCCRAVEN	2020-09-22
005	2018-01-01
005	2017-01-01
005	2016-01-01
005	2015-01-01
005	2014-01-01	EVA MCCRAVEN	2015-05-29
005	2013-01-01	EVA MCCRAVEN	2014-07-17
005	2012-01-01	EVA MCCRAVEN	2013-05-31
005	2011-01-01	EVA MCCRAVEN	2012-06-08
005	2010-01-01	EVA MCCRAVEN	2011-07-13

Plan Statistics for HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN

401k plan membership statisitcs for HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN

Measure Date Value
2022: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 72
Number of retired or separated participants receiving benefits 2022-01-01 45
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 117
Number of participants with account balances 2022-01-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 72
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 2021-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 110
Number of participants with account balances 2021-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 79
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 24
Total of all active and inactive participants 2020-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 103
Number of participants with account balances 2020-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 83
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 31
Total of all active and inactive participants 2019-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 114
Number of participants with account balances 2019-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 83
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 51
Total of all active and inactive participants 2018-01-01 134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 134
Number of participants with account balances 2018-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 94
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 42
Total of all active and inactive participants 2017-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 136
Number of participants with account balances 2017-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	72
Number of retired or separated participants receiving benefits	2022-01-01	45
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	117
Number of participants with account balances	2022-01-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	72
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	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	110
Number of participants with account balances	2021-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	79
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	24
Total of all active and inactive participants	2020-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	103
Number of participants with account balances	2020-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	83
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	31
Total of all active and inactive participants	2019-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	114
Number of participants with account balances	2019-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	83
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	51
Total of all active and inactive participants	2018-01-01	134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	134
Number of participants with account balances	2018-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	94
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	42
Total of all active and inactive participants	2017-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	136
Number of participants with account balances	2017-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN

Measure	Date	Value
2022 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION 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	$-461,381
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,400,365
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,370,269
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$355,460
Value of total assets at end of year	2022-12-31	$4,036,185
Value of total assets at beginning of year	2022-12-31	$5,897,931
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$30,096
Total interest from all sources	2022-12-31	$5,476
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
Administrative expenses professional fees incurred	2022-12-31	$971
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	$200,835
Participant contributions at end of year	2022-12-31	$91,907
Participant contributions at beginning of year	2022-12-31	$87,862
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$798
Other income not declared elsewhere	2022-12-31	$7,604
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$4,820
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	$-1,861,746
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,036,185
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,897,931
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 pooled separate accounts at end of year	2022-12-31	$3,944,278
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$5,805,249
Interest on participant loans	2022-12-31	$5,476
Net investment gain/loss from pooled separate accounts	2022-12-31	$-829,921
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	$153,827
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,370,269
Contract administrator fees	2022-12-31	$29,125
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	PENSION ASSURANCE LLP
Accountancy firm EIN	2022-12-31	300840934
2021 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION 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	$978,532
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$386,516
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$363,631
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$429,602
Value of total assets at end of year	2021-12-31	$5,897,931
Value of total assets at beginning of year	2021-12-31	$5,305,915
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$22,885
Total interest from all sources	2021-12-31	$4,546
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$2,729
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	$248,420
Participant contributions at end of year	2021-12-31	$87,862
Participant contributions at beginning of year	2021-12-31	$68,281
Other income not declared elsewhere	2021-12-31	$8,368
Total non interest bearing cash at end of year	2021-12-31	$4,820
Total non interest bearing cash at beginning of year	2021-12-31	$14,380
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	$592,016
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,897,931
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$5,305,915
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 pooled separate accounts at end of year	2021-12-31	$5,805,249
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$5,223,254
Interest on participant loans	2021-12-31	$4,546
Net investment gain/loss from pooled separate accounts	2021-12-31	$536,016
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	$181,182
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$363,631
Contract administrator fees	2021-12-31	$20,156
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PENSION ASSURANCE LLP
Accountancy firm EIN	2021-12-31	300840934
2020 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,104,383
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$161,651
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$159,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$395,041
Value of total assets at end of year	2020-12-31	$5,305,915
Value of total assets at beginning of year	2020-12-31	$4,363,183
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,348
Total interest from all sources	2020-12-31	$4,829
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$888
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$223,470
Participant contributions at end of year	2020-12-31	$68,281
Participant contributions at beginning of year	2020-12-31	$83,974
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$498
Other income not declared elsewhere	2020-12-31	$35,386
Total non interest bearing cash at end of year	2020-12-31	$14,380
Total non interest bearing cash at beginning of year	2020-12-31	$4,820
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	$942,732
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,305,915
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,363,183
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$5,223,254
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,274,389
Interest on participant loans	2020-12-31	$4,829
Net investment gain/loss from pooled separate accounts	2020-12-31	$669,127
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	$171,073
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$159,303
Contract administrator fees	2020-12-31	$1,460
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PENSION ASSURANCE LLP
Accountancy firm EIN	2020-12-31	300840934
2019 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at 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	$1,036,322
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$221,973
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$216,599
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$381,540
Value of total assets at end of year	2019-12-31	$4,363,183
Value of total assets at beginning of year	2019-12-31	$3,548,834
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,374
Total interest from all sources	2019-12-31	$4,126
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$1,504
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
Contributions received from participants	2019-12-31	$199,025
Participant contributions at end of year	2019-12-31	$83,974
Participant contributions at beginning of year	2019-12-31	$52,724
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$26,305
Other income not declared elsewhere	2019-12-31	$3,976
Total non interest bearing cash at end of year	2019-12-31	$4,820
Total non interest bearing cash at beginning of year	2019-12-31	$4,178
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	$814,349
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,363,183
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,548,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,274,389
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,491,932
Interest on participant loans	2019-12-31	$4,126
Net investment gain/loss from pooled separate accounts	2019-12-31	$646,680
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	$156,210
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$216,599
Contract administrator fees	2019-12-31	$3,870
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
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	PENSION ASSURANCE LLP
Accountancy firm EIN	2019-12-31	300840934
2018 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$173,594
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$147,657
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$145,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$395,764
Value of total assets at end of year	2018-12-31	$3,548,834
Value of total assets at beginning of year	2018-12-31	$3,522,897
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,909
Total interest from all sources	2018-12-31	$3,874
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$654
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
Contributions received from participants	2018-12-31	$210,493
Participant contributions at end of year	2018-12-31	$52,724
Participant contributions at beginning of year	2018-12-31	$69,736
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$13,103
Other income not declared elsewhere	2018-12-31	$1,512
Total non interest bearing cash at end of year	2018-12-31	$4,178
Total non interest bearing cash at beginning of year	2018-12-31	$4,178
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	$25,937
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,548,834
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,522,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$3,491,932
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,448,983
Interest on participant loans	2018-12-31	$3,874
Net investment gain/loss from pooled separate accounts	2018-12-31	$-227,556
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	$172,168
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$145,748
Contract administrator fees	2018-12-31	$1,255
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	PENSION ASSURANCE LLP
Accountancy firm EIN	2018-12-31	300840934
2017 : HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$801,515
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$146,086
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$142,340
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$395,970
Value of total assets at end of year	2017-12-31	$3,522,897
Value of total assets at beginning of year	2017-12-31	$2,867,468
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,746
Total interest from all sources	2017-12-31	$3,678
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$988
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
Contributions received from participants	2017-12-31	$227,922
Participant contributions at end of year	2017-12-31	$69,736
Participant contributions at beginning of year	2017-12-31	$70,475
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$3,907
Total non interest bearing cash at end of year	2017-12-31	$4,178
Total non interest bearing cash at beginning of year	2017-12-31	$2,184
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	$655,429
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,522,897
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,867,468
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$3,448,983
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,794,809
Interest on participant loans	2017-12-31	$3,678
Net investment gain/loss from pooled separate accounts	2017-12-31	$401,867
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	$164,141
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$142,340
Contract administrator fees	2017-12-31	$2,758
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	PENSION ASSURANCE LLP
Accountancy firm EIN	2017-12-31	300840934

Form 5500 Responses for HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN

2022: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 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 funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 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 funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: HILLVIEW MENTAL HEALTH CENTER, INC. 401(K) DEFINED CONTRIBUTION PLAN 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 funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	102
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 $12,984
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	12984
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE
Insurance broker organization code?	5

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	99
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 $4,192
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	4192
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE
Insurance broker organization code?	5

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	101
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $-1,374
Total amount of fees paid to insurance company	USD $3,700
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	3700
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE
Insurance broker organization code?	5

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	99
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $15,622
Total amount of fees paid to insurance company	USD $5,857
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,622
Insurance broker organization code?	3
Amount paid for insurance broker fees	5857
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	120
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $14,333
Total amount of fees paid to insurance company	USD $3,248
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,333
Insurance broker organization code?	3
Amount paid for insurance broker fees	3248
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE

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

Policy contract number

96391

Policy instance

Insurance contract or identification number	96391
Number of Individuals Covered	118
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $12,318
Total amount of fees paid to insurance company	USD $4,332
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,494
Insurance broker organization code?	3
Amount paid for insurance broker fees	4332
Additional information about fees paid to insurance broker	TPA COMPENSATION, TPA FEE
Insurance broker name	ACTUARIAL BENEFITS CORP

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See full terms and conditions

Company Name:	HILLVIEW MENTAL HEALTH CENTER INC
Employer identification number (EIN):	953928411
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C1307914