401k Plan data: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL plan

TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 401k Plan overview

Plan Name	TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL
Plan identification number	002

TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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.

401k Sponsoring company profile

UPPER CONNECTICUT VALLEY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: UPPER CONNECTICUT VALLEY HOSPITAL

Employer identification number (EIN): 020276210

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 MATTHEW STREETER 2023-06-20
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 CELESTE PITTS
002 2016-01-01 CELESTE PITTS
002 2015-01-01 HEIDI SAARI
002 2014-01-01 HEIDI SAARI
002 2013-01-01 HEIDI SAARI
002 2012-01-01 HEIDI SAARI 2013-10-14 HEIDI SAARI 2013-10-14
002 2011-01-01 HEIDI SAARI
002 2009-01-01 HEIDI SAARI

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	MATTHEW STREETER	2023-06-20
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	CELESTE PITTS
002	2016-01-01	CELESTE PITTS
002	2015-01-01	HEIDI SAARI
002	2014-01-01	HEIDI SAARI
002	2013-01-01	HEIDI SAARI
002	2012-01-01	HEIDI SAARI	2013-10-14	HEIDI SAARI	2013-10-14
002	2011-01-01	HEIDI SAARI
002	2009-01-01	HEIDI SAARI

Plan Statistics for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL

401k plan membership statisitcs for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL

Measure Date Value
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2021 401k membership
Total participants, beginning-of-year 2021-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 13
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 29
Total of all active and inactive participants 2021-01-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 42
Number of participants with account balances 2021-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2020 401k membership
Total participants, beginning-of-year 2020-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 128
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 51
Total of all active and inactive participants 2020-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 179
Number of participants with account balances 2020-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2019 401k membership
Total participants, beginning-of-year 2019-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 128
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 51
Total of all active and inactive participants 2019-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 179
Number of participants with account balances 2019-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2018 401k membership
Total participants, beginning-of-year 2018-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 123
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 42
Total of all active and inactive participants 2018-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 165
Number of participants with account balances 2018-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2017 401k membership
Total participants, beginning-of-year 2017-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 125
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 46
Total of all active and inactive participants 2017-01-01 171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 171
Number of participants with account balances 2017-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2016 401k membership
Total participants, beginning-of-year 2016-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 128
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 45
Total of all active and inactive participants 2016-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 173
Number of participants with account balances 2016-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2015 401k membership
Total participants, beginning-of-year 2015-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 124
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 41
Total of all active and inactive participants 2015-01-01 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 165
Number of participants with account balances 2015-01-01 113
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 UPPER CONNECTICUT VALLEY HOSPITAL 2014 401k membership
Total participants, beginning-of-year 2014-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 133
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 44
Total of all active and inactive participants 2014-01-01 177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 177
Number of participants with account balances 2014-01-01 110
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 UPPER CONNECTICUT VALLEY HOSPITAL 2013 401k membership
Total participants, beginning-of-year 2013-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 138
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 45
Total of all active and inactive participants 2013-01-01 183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 183
Number of participants with account balances 2013-01-01 110
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 UPPER CONNECTICUT VALLEY HOSPITAL 2012 401k membership
Total participants, beginning-of-year 2012-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 133
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 48
Total of all active and inactive participants 2012-01-01 181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 181
Number of participants with account balances 2012-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2011 401k membership
Total participants, beginning-of-year 2011-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 147
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 49
Total of all active and inactive participants 2011-01-01 196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 197
Number of participants with account balances 2011-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 153
Number of retired or separated participants receiving benefits 2009-01-01 43
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 197
Number of participants with account balances 2009-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2021 401k membership
Total participants, beginning-of-year	2021-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	13
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	29
Total of all active and inactive participants	2021-01-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	42
Number of participants with account balances	2021-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2020 401k membership
Total participants, beginning-of-year	2020-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	128
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	51
Total of all active and inactive participants	2020-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	179
Number of participants with account balances	2020-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2019 401k membership
Total participants, beginning-of-year	2019-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	128
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	51
Total of all active and inactive participants	2019-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	179
Number of participants with account balances	2019-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2018 401k membership
Total participants, beginning-of-year	2018-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	123
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	42
Total of all active and inactive participants	2018-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	165
Number of participants with account balances	2018-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2017 401k membership
Total participants, beginning-of-year	2017-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	125
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	46
Total of all active and inactive participants	2017-01-01	171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	171
Number of participants with account balances	2017-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2016 401k membership
Total participants, beginning-of-year	2016-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	128
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	45
Total of all active and inactive participants	2016-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	173
Number of participants with account balances	2016-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2015 401k membership
Total participants, beginning-of-year	2015-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	124
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	41
Total of all active and inactive participants	2015-01-01	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	165
Number of participants with account balances	2015-01-01	113
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 UPPER CONNECTICUT VALLEY HOSPITAL 2014 401k membership
Total participants, beginning-of-year	2014-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	133
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	44
Total of all active and inactive participants	2014-01-01	177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	177
Number of participants with account balances	2014-01-01	110
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 UPPER CONNECTICUT VALLEY HOSPITAL 2013 401k membership
Total participants, beginning-of-year	2013-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	138
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	45
Total of all active and inactive participants	2013-01-01	183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	183
Number of participants with account balances	2013-01-01	110
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 UPPER CONNECTICUT VALLEY HOSPITAL 2012 401k membership
Total participants, beginning-of-year	2012-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	133
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	48
Total of all active and inactive participants	2012-01-01	181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	181
Number of participants with account balances	2012-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2011 401k membership
Total participants, beginning-of-year	2011-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	147
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	49
Total of all active and inactive participants	2011-01-01	196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	197
Number of participants with account balances	2011-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	153
Number of retired or separated participants receiving benefits	2009-01-01	43
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	197
Number of participants with account balances	2009-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL

Measure	Date	Value
2021 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$365,790
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$3,402,941
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,402,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$0
Value of total assets at end of year	2021-12-31	$1,085,695
Value of total assets at beginning of year	2021-12-31	$4,122,846
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$0
Total interest from all sources	2021-12-31	$60,592
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
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
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$2,170
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	$-3,037,151
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,085,695
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,122,846
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	$587,517
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,940,430
Interest on participant loans	2021-12-31	$45
Interest earned on other investments	2021-12-31	$60,547
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$498,178
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$2,180,246
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$305,198
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,402,941
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	BERRYDUNN
Accountancy firm EIN	2021-12-31	010523282
2020 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$432,255
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$186,739
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$186,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$0
Value of total assets at end of year	2020-12-31	$4,122,846
Value of total assets at beginning of year	2020-12-31	$3,877,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$0
Total interest from all sources	2020-12-31	$94,624
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
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
Participant contributions at end of year	2020-12-31	$2,170
Participant contributions at beginning of year	2020-12-31	$5,434
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	$245,516
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,122,846
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,877,330
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	$1,940,430
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,628,174
Interest on participant loans	2020-12-31	$191
Interest earned on other investments	2020-12-31	$94,433
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$2,180,246
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$2,243,722
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$337,631
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$186,739
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	BERRYDUNN
Accountancy firm EIN	2020-12-31	010523282
2019 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$465,328
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$226,246
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$226,078
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$0
Value of total assets at end of year	2019-12-31	$3,877,330
Value of total assets at beginning of year	2019-12-31	$3,638,248
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$168
Total interest from all sources	2019-12-31	$98,034
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Participant contributions at end of year	2019-12-31	$5,434
Participant contributions at beginning of year	2019-12-31	$42,855
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	$239,082
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,877,330
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,638,248
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,628,174
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,389,974
Interest on participant loans	2019-12-31	$1,360
Interest earned on other investments	2019-12-31	$96,674
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$2,243,722
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,205,419
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$367,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$226,078
Contract administrator fees	2019-12-31	$168
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BERRYDUNN
Accountancy firm EIN	2019-12-31	010523282
2018 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$5,219
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,275,043
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,274,743
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$0
Value of total assets at end of year	2018-12-31	$3,638,248
Value of total assets at beginning of year	2018-12-31	$4,908,072
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$300
Total interest from all sources	2018-12-31	$103,436
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
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
Participant contributions at end of year	2018-12-31	$42,855
Participant contributions at beginning of year	2018-12-31	$81,272
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	$-1,269,824
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,638,248
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,908,072
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	$1,389,974
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,263,075
Interest on participant loans	2018-12-31	$2,555
Interest earned on other investments	2018-12-31	$100,881
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$2,205,419
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$2,563,725
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-98,217
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	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,274,743
Contract administrator fees	2018-12-31	$300
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	Yes
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	TAWNEY, PLLC.
Accountancy firm EIN	2018-12-31	464585449
2017 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$855,398
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$377,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$377,500
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$355,143
Value of total assets at end of year	2017-12-31	$4,908,072
Value of total assets at beginning of year	2017-12-31	$4,430,192
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$18
Total interest from all sources	2017-12-31	$112,731
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
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	$230,725
Participant contributions at end of year	2017-12-31	$81,272
Participant contributions at beginning of year	2017-12-31	$98,376
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$73,226
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$477,880
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,908,072
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,430,192
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	$2,263,075
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,024,998
Interest on participant loans	2017-12-31	$3,858
Interest earned on other investments	2017-12-31	$108,873
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$2,563,725
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,306,818
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$387,524
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	$51,192
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$377,500
Contract administrator fees	2017-12-31	$18
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
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	TAWNEY, PLLC.
Accountancy firm EIN	2017-12-31	464585449
2016 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$901,578
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$207,934
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$207,934
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$660,602
Value of total assets at end of year	2016-12-31	$4,430,192
Value of total assets at beginning of year	2016-12-31	$3,736,548
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$95,175
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
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	$230,832
Participant contributions at end of year	2016-12-31	$98,376
Participant contributions at beginning of year	2016-12-31	$133,650
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$368,861
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$693,644
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,430,192
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,736,548
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,024,998
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,010,254
Interest on participant loans	2016-12-31	$4,269
Interest earned on other investments	2016-12-31	$90,906
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,306,818
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,592,644
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$145,801
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	$60,909
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$207,934
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	TAWNEY, PLLC.
Accountancy firm EIN	2016-12-31	464585449
2015 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$393,739
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$805,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$805,012
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$332,442
Value of total assets at end of year	2015-12-31	$3,736,548
Value of total assets at beginning of year	2015-12-31	$4,148,497
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$676
Total interest from all sources	2015-12-31	$78,444
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
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	$210,242
Participant contributions at end of year	2015-12-31	$133,650
Participant contributions at beginning of year	2015-12-31	$76,329
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$63,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-411,949
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,736,548
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,148,497
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$2,010,254
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,357,627
Interest on participant loans	2015-12-31	$3,657
Interest earned on other investments	2015-12-31	$74,787
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,592,644
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,714,541
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-17,147
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	$58,681
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$805,012
Contract administrator fees	2015-12-31	$676
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2015-12-31	020476956
2014 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$524,791
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$282,903
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$267,303
Expenses. Certain deemed distributions of participant loans	2014-12-31	$13,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$260,851
Value of total assets at end of year	2014-12-31	$4,148,497
Value of total assets at beginning of year	2014-12-31	$3,906,609
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,907
Total interest from all sources	2014-12-31	$78,018
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
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	$204,006
Participant contributions at end of year	2014-12-31	$76,329
Participant contributions at beginning of year	2014-12-31	$75,434
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$490
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	$241,888
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,148,497
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,906,609
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	$2,357,627
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,160,705
Interest on participant loans	2014-12-31	$2,045
Interest earned on other investments	2014-12-31	$75,973
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,714,541
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,670,470
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$185,922
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	$56,355
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$267,303
Contract administrator fees	2014-12-31	$1,907
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2014-12-31	020476956
2013 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$806,867
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$529,071
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$529,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$269,216
Value of total assets at end of year	2013-12-31	$3,906,609
Value of total assets at beginning of year	2013-12-31	$3,628,813
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$76,954
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
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	$212,790
Participant contributions at end of year	2013-12-31	$75,434
Participant contributions at beginning of year	2013-12-31	$61,878
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,379
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	$277,796
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,906,609
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,628,813
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	$2,160,705
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,813,967
Interest on participant loans	2013-12-31	$2,919
Interest earned on other investments	2013-12-31	$74,035
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,670,470
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,752,968
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$460,697
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	$55,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$529,071
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2013-12-31	020476956
2012 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$559,738
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$270,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$270,107
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$240,491
Value of total assets at end of year	2012-12-31	$3,628,813
Value of total assets at beginning of year	2012-12-31	$3,339,182
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$71,461
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
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	$190,895
Participant contributions at end of year	2012-12-31	$61,878
Participant contributions at beginning of year	2012-12-31	$100,155
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,305
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	$289,631
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,628,813
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,339,182
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	$1,813,967
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,773,919
Interest on participant loans	2012-12-31	$2,360
Interest earned on other investments	2012-12-31	$69,101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,752,968
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,457,304
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$247,786
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$48,291
Employer contributions (assets) at beginning of year	2012-12-31	$7,804
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$270,107
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2012-12-31	020476956
2011 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$324,588
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$390,451
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$386,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$386,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$349,456
Value of total assets at end of year	2011-12-31	$2,998,172
Value of total assets at beginning of year	2011-12-31	$2,994,333
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$150
Total interest from all sources	2011-12-31	$62,116
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
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	$207,208
Participant contributions at end of year	2011-12-31	$100,155
Participant contributions at beginning of year	2011-12-31	$99,291
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$82,989
Administrative expenses (other) incurred	2011-12-31	$150
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	$3,839
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,998,172
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,994,333
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	$1,488,125
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,721,039
Interest on participant loans	2011-12-31	$4,533
Interest earned on other investments	2011-12-31	$57,583
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,402,088
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,174,003
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-21,121
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	No
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	$59,259
Employer contributions (assets) at end of year	2011-12-31	$7,804
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$386,462
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2011-12-31	020476956
2010 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$660,534
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$139,783
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$139,720
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$341,211
Value of total assets at end of year	2010-12-31	$2,994,333
Value of total assets at beginning of year	2010-12-31	$2,473,582
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$63
Total interest from all sources	2010-12-31	$52,597
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
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	$276,009
Participant contributions at end of year	2010-12-31	$99,291
Participant contributions at beginning of year	2010-12-31	$54,794
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$12,409
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	$520,751
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,994,333
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,473,582
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	$1,721,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,342,223
Interest on participant loans	2010-12-31	$2,371
Interest earned on other investments	2010-12-31	$50,226
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,174,003
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,076,565
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$266,726
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$52,793
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$139,720
Contract administrator fees	2010-12-31	$63
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	TYLER, SIMMS & ST SAUVEUR
Accountancy firm EIN	2010-12-31	020476956
2009 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL

2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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 UPPER CONNECTICUT VALLEY HOSPITAL 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
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF UPPER CONNECTICUT VALLEY HOSPITAL 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

859

Policy instance

Insurance contract or identification number	859
Number of Individuals Covered	40
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

SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )

Policy contract number

950A

Policy instance

Insurance contract or identification number	950A
Number of Individuals Covered	2
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

859

Policy instance

Insurance contract or identification number	859
Number of Individuals Covered	79
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

SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )

Policy contract number

950A

Policy instance

Insurance contract or identification number	950A
Number of Individuals Covered	3
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

859

Policy instance

Insurance contract or identification number	859
Number of Individuals Covered	83
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

SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )

Policy contract number

950A

Policy instance

Insurance contract or identification number	950A
Number of Individuals Covered	3
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

859

Policy instance

Insurance contract or identification number	859
Number of Individuals Covered	116
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

SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )

Policy contract number

950A

Policy instance

Insurance contract or identification number	950A
Number of Individuals Covered	3
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

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Company Name:	UPPER CONNECTICUT VALLEY HOSPITAL
Employer identification number (EIN):	020276210
NAIC Classification:	622000
NAIC Description:	Hospitals