TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 401k Plan overview

Plan Name	TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION
Plan identification number	001

TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l). ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1. Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations. Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations. Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account. Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

NORTHERN MAINE MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:	NORTHERN MAINE MEDICAL CENTER
Employer identification number (EIN):	010234189
NAIC Classification:	622000
NAIC Description:	Hospitals

Additional information about NORTHERN MAINE MEDICAL CENTER

Jurisdiction of Incorporation:	Maine Bureau of Corporations, Elections & Commissions
Incorporation Date:
Company Identification Number:	19400036ND

More information about NORTHERN MAINE MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	ROBIN DAMBOISE
001	2016-01-01	ROBIN DAMBOISE
001	2015-01-01	ROBIN DAMBOISE
001	2014-01-01	ROBIN DAMBOISE
001	2013-01-01	ROBIN DAMBOISE
001	2012-01-01	ROBIN DAMABOISE FOR NMMC
001	2011-01-01	ROBIN DAMBOISE
001	2010-01-01	ROBIN DAMBOISE
001	2009-01-01	ROBIN DAMBOISE
001	2009-01-01	ROBIN DAMBOISE
001	2009-01-01	ROBIN DAMBOISE
001	2009-01-01	ROBIN DAMBOISE
001	2009-01-01	ROBIN DAMBOISE
001	2008-01-01	PETER SIROIS

Plan Statistics for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION

401k plan membership statisitcs for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION

Measure	Date	Value
2022: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2022 401k membership
Total participants, beginning-of-year	2022-01-01	792
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	494
Number of retired or separated participants receiving benefits	2022-01-01	8
Number of other retired or separated participants entitled to future benefits	2022-01-01	248
Total of all active and inactive participants	2022-01-01	750
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	751
Number of participants with account balances	2022-01-01	568
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	23
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2021 401k membership
Total participants, beginning-of-year	2021-01-01	664
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	539
Number of retired or separated participants receiving benefits	2021-01-01	9
Number of other retired or separated participants entitled to future benefits	2021-01-01	243
Total of all active and inactive participants	2021-01-01	791
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	792
Number of participants with account balances	2021-01-01	586
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	21
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2020 401k membership
Total participants, beginning-of-year	2020-01-01	718
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	556
Number of retired or separated participants receiving benefits	2020-01-01	8
Number of other retired or separated participants entitled to future benefits	2020-01-01	100
Total of all active and inactive participants	2020-01-01	664
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	664
Number of participants with account balances	2020-01-01	445
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	15
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2019 401k membership
Total participants, beginning-of-year	2019-01-01	734
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	573
Number of retired or separated participants receiving benefits	2019-01-01	4
Number of other retired or separated participants entitled to future benefits	2019-01-01	140
Total of all active and inactive participants	2019-01-01	717
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	718
Number of participants with account balances	2019-01-01	583
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	12
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2018 401k membership
Total participants, beginning-of-year	2018-01-01	701
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	540
Number of retired or separated participants receiving benefits	2018-01-01	3
Number of other retired or separated participants entitled to future benefits	2018-01-01	190
Total of all active and inactive participants	2018-01-01	733
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	734
Number of participants with account balances	2018-01-01	519
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	8
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2017 401k membership
Total participants, beginning-of-year	2017-01-01	651
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	504
Number of retired or separated participants receiving benefits	2017-01-01	3
Number of other retired or separated participants entitled to future benefits	2017-01-01	193
Total of all active and inactive participants	2017-01-01	700
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	701
Number of participants with account balances	2017-01-01	519
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2016 401k membership
Total participants, beginning-of-year	2016-01-01	697
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	497
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	150
Total of all active and inactive participants	2016-01-01	650
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	651
Number of participants with account balances	2016-01-01	525
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2015 401k membership
Total participants, beginning-of-year	2015-01-01	688
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	496
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	197
Total of all active and inactive participants	2015-01-01	695
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	696
Number of participants with account balances	2015-01-01	535
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2014 401k membership
Total participants, beginning-of-year	2014-01-01	732
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	485
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	201
Total of all active and inactive participants	2014-01-01	688
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	688
Number of participants with account balances	2014-01-01	546
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2013 401k membership
Total participants, beginning-of-year	2013-01-01	788
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	508
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	224
Total of all active and inactive participants	2013-01-01	732
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	732
Number of participants with account balances	2013-01-01	567
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2012 401k membership
Total participants, beginning-of-year	2012-01-01	763
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	562
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	226
Total of all active and inactive participants	2012-01-01	788
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	788
Number of participants with account balances	2012-01-01	597
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2011 401k membership
Total participants, beginning-of-year	2011-01-01	778
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	560
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	203
Total of all active and inactive participants	2011-01-01	763
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	763
Number of participants with account balances	2011-01-01	572
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2010 401k membership
Total participants, beginning-of-year	2010-01-01	623
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	603
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	175
Total of all active and inactive participants	2010-01-01	778
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	778
Number of participants with account balances	2010-01-01	539
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2009 401k membership
Total participants, beginning-of-year	2009-01-01	666
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	536
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	87
Total of all active and inactive participants	2009-01-01	623
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	623
Number of participants with account balances	2009-01-01	578
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1
2008: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2008 401k membership
Total of all active and inactive participants	2008-01-01	0
Total participants	2008-01-01	0

Financial Data on TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION

Measure	Date	Value
2022 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$-4,155,452
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,827,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,809,426
Expenses. Certain deemed distributions of participant loans	2022-12-31	$-492
Value of total corrective distributions	2022-12-31	$662
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,354,443
Value of total assets at end of year	2022-12-31	$35,186,206
Value of total assets at beginning of year	2022-12-31	$42,168,967
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$17,713
Total interest from all sources	2022-12-31	$372,694
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$1,135,973
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	$1,135,973
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	$1,699,303
Participant contributions at end of year	2022-12-31	$198,846
Participant contributions at beginning of year	2022-12-31	$218,430
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$138,906
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	$-6,982,761
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$35,186,206
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$42,168,967
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$22,848,358
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$29,929,784
Value of interest in pooled separate accounts at end of year	2022-12-31	$11,901
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$11,411
Interest on participant loans	2022-12-31	$8,856
Interest earned on other investments	2022-12-31	$363,838
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$12,127,101
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$12,009,342
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-8,016,423
Net investment gain/loss from pooled separate accounts	2022-12-31	$-2,139
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	$516,234
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,809,426
Contract administrator fees	2022-12-31	$17,713
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	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2022-12-31	010523282
2021 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$6,529,983
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,077,615
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,060,089
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,586,372
Value of total assets at end of year	2021-12-31	$42,168,967
Value of total assets at beginning of year	2021-12-31	$37,716,599
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$17,526
Total interest from all sources	2021-12-31	$357,113
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$2,401,386
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$2,401,386
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	$1,787,800
Participant contributions at end of year	2021-12-31	$218,430
Participant contributions at beginning of year	2021-12-31	$214,160
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$217,228
Other income not declared elsewhere	2021-12-31	$8,149
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	$4,452,368
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$42,168,967
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$37,716,599
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$29,929,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$25,356,930
Value of interest in pooled separate accounts at end of year	2021-12-31	$11,411
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$7,375
Interest on participant loans	2021-12-31	$10,188
Interest earned on other investments	2021-12-31	$346,925
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$12,009,342
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$12,138,134
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,176,060
Net investment gain/loss from pooled separate accounts	2021-12-31	$903
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	$581,344
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,060,089
Contract administrator fees	2021-12-31	$17,526
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	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2021-12-31	010523282
2020 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$8,703,192
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,125,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,121,396
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$3,328,804
Value of total assets at end of year	2020-12-31	$37,716,599
Value of total assets at beginning of year	2020-12-31	$31,139,274
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$4,471
Total interest from all sources	2020-12-31	$368,283
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,010,048
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$1,010,048
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	$1,683,430
Participant contributions at end of year	2020-12-31	$214,160
Participant contributions at beginning of year	2020-12-31	$251,453
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$1,099,614
Other income not declared elsewhere	2020-12-31	$628
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	$6,577,325
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$37,716,599
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$31,139,274
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$25,356,930
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$20,394,774
Value of interest in pooled separate accounts at end of year	2020-12-31	$7,375
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$6,827
Interest on participant loans	2020-12-31	$10,983
Interest earned on other investments	2020-12-31	$357,300
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$12,138,134
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$10,486,220
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$3,994,937
Net investment gain/loss from pooled separate accounts	2020-12-31	$492
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	$545,760
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$2,121,396
Contract administrator fees	2020-12-31	$4,471
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	Unqualified
Accountancy firm name	2020-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2020-12-31	010523282
2019 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$6,551,533
Total income from all sources (including contributions)	2019-12-31	$6,551,533
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,432,519
Total of all expenses incurred	2019-12-31	$1,432,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,428,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,428,435
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,734
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,734
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,228,563
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,228,563
Value of total assets at end of year	2019-12-31	$31,139,274
Value of total assets at end of year	2019-12-31	$31,139,274
Value of total assets at beginning of year	2019-12-31	$26,020,260
Value of total assets at beginning of year	2019-12-31	$26,020,260
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,350
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,350
Total interest from all sources	2019-12-31	$340,392
Total interest from all sources	2019-12-31	$340,392
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$853,570
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$853,570
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$853,570
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$853,570
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,581,222
Contributions received from participants	2019-12-31	$1,581,222
Participant contributions at end of year	2019-12-31	$251,453
Participant contributions at end of year	2019-12-31	$251,453
Participant contributions at beginning of year	2019-12-31	$217,191
Participant contributions at beginning of year	2019-12-31	$217,191
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$129,444
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$129,444
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$5,119,014
Value of net income/loss	2019-12-31	$5,119,014
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$31,139,274
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$31,139,274
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$26,020,260
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$26,020,260
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$20,394,774
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$20,394,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$16,299,355
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$16,299,355
Value of interest in pooled separate accounts at end of year	2019-12-31	$6,827
Value of interest in pooled separate accounts at end of year	2019-12-31	$6,827
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,197
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,197
Interest on participant loans	2019-12-31	$12,103
Interest on participant loans	2019-12-31	$12,103
Interest earned on other investments	2019-12-31	$328,289
Interest earned on other investments	2019-12-31	$328,289
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$10,486,220
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$10,486,220
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$9,499,517
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$9,499,517
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,128,273
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,128,273
Net investment gain/loss from pooled separate accounts	2019-12-31	$735
Net investment gain/loss from pooled separate accounts	2019-12-31	$735
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$517,897
Contributions received in cash from employer	2019-12-31	$517,897
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,428,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,428,435
Contract administrator fees	2019-12-31	$2,350
Contract administrator fees	2019-12-31	$2,350
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm name	2019-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2019-12-31	010523282
Accountancy firm EIN	2019-12-31	010523282
2018 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$1,361,844
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$817,369
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$817,032
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$2,092,367
Value of total assets at end of year	2018-12-31	$26,020,260
Value of total assets at beginning of year	2018-12-31	$25,475,785
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$337
Total interest from all sources	2018-12-31	$317,967
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,001,102
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$1,001,102
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	$1,492,248
Participant contributions at end of year	2018-12-31	$217,191
Participant contributions at beginning of year	2018-12-31	$217,935
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$95,944
Other income not declared elsewhere	2018-12-31	$6,480
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	$544,475
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$26,020,260
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$25,475,785
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$16,299,355
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$16,174,366
Value of interest in pooled separate accounts at end of year	2018-12-31	$4,197
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,080
Interest on participant loans	2018-12-31	$6,746
Interest earned on other investments	2018-12-31	$311,221
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$9,499,517
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$9,080,404
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,055,828
Net investment gain/loss from pooled separate accounts	2018-12-31	$-244
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	$504,175
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$817,032
Contract administrator fees	2018-12-31	$337
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	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2018-12-31	010523282
2017 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$4,519,416
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$579,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$572,016
Expenses. Certain deemed distributions of participant loans	2017-12-31	$7,091
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,893,052
Value of total assets at end of year	2017-12-31	$25,475,785
Value of total assets at beginning of year	2017-12-31	$21,535,776
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$300
Total interest from all sources	2017-12-31	$304,649
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$668,931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$668,931
Administrative expenses professional fees incurred	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,294,381
Participant contributions at end of year	2017-12-31	$217,935
Participant contributions at beginning of year	2017-12-31	$213,346
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$178,995
Other income not declared elsewhere	2017-12-31	$3,915
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$3,940,009
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$25,475,785
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$21,535,776
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$16,174,366
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$12,859,313
Value of interest in pooled separate accounts at end of year	2017-12-31	$3,080
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,517
Interest on participant loans	2017-12-31	$6,164
Interest earned on other investments	2017-12-31	$298,485
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$9,080,404
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$8,461,600
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,648,572
Net investment gain/loss from pooled separate accounts	2017-12-31	$297
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	Yes
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	$419,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$572,016
Contract administrator fees	2017-12-31	$300
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	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2017-12-31	010523282
2016 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$2,701,944
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$547,358
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$534,178
Expenses. Certain deemed distributions of participant loans	2016-12-31	$2,670
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,545,111
Value of total assets at end of year	2016-12-31	$21,535,776
Value of total assets at beginning of year	2016-12-31	$19,381,190
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$10,510
Total interest from all sources	2016-12-31	$296,108
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$462,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$462,837
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,166,061
Participant contributions at end of year	2016-12-31	$213,346
Participant contributions at beginning of year	2016-12-31	$193,321
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$100
Other income not declared elsewhere	2016-12-31	$9,139
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$2,154,586
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$21,535,776
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$19,381,190
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$10,234
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$12,859,313
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$11,210,707
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,517
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$213
Interest on participant loans	2016-12-31	$4,884
Interest earned on other investments	2016-12-31	$291,224
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$8,461,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$7,976,949
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$388,702
Net investment gain/loss from pooled separate accounts	2016-12-31	$47
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$378,950
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$534,178
Contract administrator fees	2016-12-31	$276
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2016-12-31	010523282
2015 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$2,168,448
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$815,753
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$805,595
Value of total corrective distributions	2015-12-31	$47
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,782,716
Value of total assets at end of year	2015-12-31	$19,381,190
Value of total assets at beginning of year	2015-12-31	$18,028,495
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$10,111
Total interest from all sources	2015-12-31	$304,072
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$547,986
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$547,986
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,077,577
Participant contributions at end of year	2015-12-31	$193,321
Participant contributions at beginning of year	2015-12-31	$166,326
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$354,935
Other income not declared elsewhere	2015-12-31	$5,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$1,352,695
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$19,381,190
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$18,028,495
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$9,698
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$11,210,707
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$9,968,864
Value of interest in pooled separate accounts at end of year	2015-12-31	$213
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$4,098
Interest earned on other investments	2015-12-31	$299,974
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$7,976,949
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$7,893,305
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-471,354
Net investment gain/loss from pooled separate accounts	2015-12-31	$-2
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$350,204
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$805,595
Contract administrator fees	2015-12-31	$413
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2015-12-31	010523282
2014 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$2,715,529
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,020,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,015,536
Expenses. Certain deemed distributions of participant loans	2014-12-31	$4,622
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,721,304
Value of total assets at end of year	2014-12-31	$18,028,495
Value of total assets at beginning of year	2014-12-31	$16,333,650
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$526
Total interest from all sources	2014-12-31	$289,243
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$604,564
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$604,564
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,031,303
Participant contributions at end of year	2014-12-31	$166,326
Participant contributions at beginning of year	2014-12-31	$250,429
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$323,357
Other income not declared elsewhere	2014-12-31	$4,623
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,694,845
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$18,028,495
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$16,333,650
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$9,968,864
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$9,008,733
Interest on participant loans	2014-12-31	$6,293
Interest earned on other investments	2014-12-31	$282,950
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$7,893,305
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$7,074,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$95,795
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$366,644
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,015,536
Contract administrator fees	2014-12-31	$526
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2014-12-31	010523282
2013 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$3,525,298
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$711,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$664,976
Expenses. Certain deemed distributions of participant loans	2013-12-31	$25,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,455,316
Value of total assets at end of year	2013-12-31	$16,333,650
Value of total assets at beginning of year	2013-12-31	$13,519,870
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$20,781
Total interest from all sources	2013-12-31	$272,091
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$355,115
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$355,115
Administrative expenses professional fees incurred	2013-12-31	$19,850
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
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	$983,882
Participant contributions at end of year	2013-12-31	$250,429
Participant contributions at beginning of year	2013-12-31	$288,338
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$108,489
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$1
Other income not declared elsewhere	2013-12-31	$3,716
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	$2,813,780
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$16,333,650
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$13,519,870
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	$9,008,733
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$6,678,906
Interest on participant loans	2013-12-31	$7,727
Interest earned on other investments	2013-12-31	$264,363
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$7,074,488
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$6,552,625
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,439,060
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	$362,945
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$664,976
Contract administrator fees	2013-12-31	$931
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	BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN	2013-12-31	010523282
2012 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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	$6,255
Total income from all sources (including contributions)	2012-12-31	$2,202,398
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$692,904
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$664,412
Expenses. Certain deemed distributions of participant loans	2012-12-31	$27,848
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,123,827
Value of total assets at end of year	2012-12-31	$13,519,870
Value of total assets at beginning of year	2012-12-31	$12,016,631
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$644
Total interest from all sources	2012-12-31	$252,272
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$63,699
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$63,699
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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	$786,215
Participant contributions at end of year	2012-12-31	$288,338
Participant contributions at beginning of year	2012-12-31	$291,991
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$144,967
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$1
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$6,255
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$6,255
Other income not declared elsewhere	2012-12-31	$3,269
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	$1,509,494
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$13,519,870
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$12,010,376
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	$6,678,906
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$5,521,993
Interest on participant loans	2012-12-31	$8,819
Interest earned on other investments	2012-12-31	$243,450
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$12,653
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$12,653
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$6,552,625
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$6,183,739
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$759,331
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	Yes
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	$192,645
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$664,412
Contract administrator fees	2012-12-31	$644
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	BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN	2012-12-31	010523282
2011 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$6,255
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$5,261
Total income from all sources (including contributions)	2011-12-31	$834,136
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$984,172
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$972,737
Expenses. Certain deemed distributions of participant loans	2011-12-31	$10,966
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$781,038
Value of total assets at end of year	2011-12-31	$12,016,631
Value of total assets at beginning of year	2011-12-31	$12,165,673
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$469
Total interest from all sources	2011-12-31	$250,238
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$92,831
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$92,831
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$688,551
Participant contributions at end of year	2011-12-31	$291,991
Participant contributions at beginning of year	2011-12-31	$261,631
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$5,773
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$6,255
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$5,261
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$6,255
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$5,261
Other income not declared elsewhere	2011-12-31	$3,303
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-150,036
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$12,010,376
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$12,160,412
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$5,521,993
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,793,812
Interest on participant loans	2011-12-31	$8,979
Interest earned on other investments	2011-12-31	$241,257
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$12,653
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$9,298
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$9,298
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$6,183,739
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$6,095,671
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-293,274
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$86,714
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$972,737
Contract administrator fees	2011-12-31	$469
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2011-12-31	010523282
2010 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$5,261
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$5,472
Total income from all sources (including contributions)	2010-12-31	$1,756,802
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$724,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$724,369
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$744,574
Value of total assets at end of year	2010-12-31	$12,165,673
Value of total assets at beginning of year	2010-12-31	$11,133,701
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$250
Total interest from all sources	2010-12-31	$247,612
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$94,974
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$94,974
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$726,619
Participant contributions at end of year	2010-12-31	$261,631
Participant contributions at beginning of year	2010-12-31	$274,270
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$17,955
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$5,261
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$5,472
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$5,261
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$5,472
Other income not declared elsewhere	2010-12-31	$3,034
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,032,183
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$12,160,412
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$11,128,229
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$5,793,812
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,013,262
Interest on participant loans	2010-12-31	$8,326
Interest earned on other investments	2010-12-31	$239,284
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$9,298
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$6,236
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$6,236
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$6,095,671
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$5,834,461
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$666,608
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$724,369
Contract administrator fees	2010-12-31	$250
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	BAKER NEWMAN NOYES LLC
Accountancy firm EIN	2010-12-31	010494526
2009 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION

2022: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF NORTHERN MAINE MEDICAL CENTER TO INCLUDE FOREST HILL AND VALLEY MEDICAL ASSOCIATION 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130+001
Policy instance	4
Insurance contract or identification number 195130+001 Number of Individuals Covered 26 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 21 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $2,259 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $2,259 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 220 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $8,412 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $8,412 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 335 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 367 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 232 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $7,021 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $7,021 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 24 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $1,939 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,939 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130+001
Policy instance	4
Insurance contract or identification number 195130+001 Number of Individuals Covered 26 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 379 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 240 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $7,977 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $7,977 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 25 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,008 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $2,008 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130+001
Policy instance	4
Insurance contract or identification number 195130+001 Number of Individuals Covered 29 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 386 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 25 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $1,662 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,662 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 249 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $8,370 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $8,370 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130+001
Policy instance	4
Insurance contract or identification number 195130+001 Number of Individuals Covered 29 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 353 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 258 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $7,661 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $7,661 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 26 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,681 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,681 Insurance broker organization code? 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 29 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 31 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 26 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,750 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,750 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 265 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $8,565 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $8,565 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 337 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 315 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 285 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $12,954 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $12,954 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 28 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,424 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,424 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 33 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 386 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 298 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $12,594 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $12,594 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 31 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,621 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,621 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 34 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 36 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 403 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 316 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $8,144 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $8,144 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 34 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,414 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,414 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS COR
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	2
Insurance contract or identification number 890393-006 Number of Individuals Covered 330 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $7,441 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $7,441 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	3
Insurance contract or identification number 195121-001 Number of Individuals Covered 34 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,310 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $1,310 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	1
Insurance contract or identification number 892955-007 Number of Individuals Covered 445 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 $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	4
Insurance contract or identification number 195130-001 Number of Individuals Covered 37 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $911 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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 $911 Insurance broker organization code? 4 Insurance broker name LINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	4
Insurance contract or identification number 892955-007 Number of Individuals Covered 374 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	3
Insurance contract or identification number 890393-006 Number of Individuals Covered 346 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $3,043 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	2
Insurance contract or identification number 195130-001 Number of Individuals Covered 37 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	1
Insurance contract or identification number 195121-001 Number of Individuals Covered 36 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $1,751 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	892955-007
Policy instance	4
Insurance contract or identification number 892955-007 Number of Individuals Covered 357 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 $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195130-001
Policy instance	2
Insurance contract or identification number 195130-001 Number of Individuals Covered 39 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 $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	890393-006
Policy instance	3
Insurance contract or identification number 890393-006 Number of Individuals Covered 361 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 $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	195121-001
Policy instance	1
Insurance contract or identification number 195121-001 Number of Individuals Covered 39 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $332 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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