401k Plan data: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. plan

RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 401k Plan overview

Plan Name	RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.
Plan identification number	001

RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021). Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation). Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ANDROSCOGGIN VALLEY HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: ANDROSCOGGIN VALLEY HOSPITAL, INC.

Employer identification number (EIN): 020280367

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 JOHN MORRIS JOHN MORRIS 2015-09-24
001 2013-01-01 JOHN MORRIS JOHN MORRIS 2014-10-07
001 2012-01-01 JOHN MORRIS JOHN MORRIS 2013-10-04
001 2011-01-01 JOHN MORRIS JOHN MORRIS 2012-10-02
001 2009-01-01 JOHN MORRIS JOHN MORRIS 2010-10-15
001 2009-01-01 JOHN MORRIS JOHN MORRIS 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	JOHN MORRIS	JOHN MORRIS	2015-09-24
001	2013-01-01	JOHN MORRIS	JOHN MORRIS	2014-10-07
001	2012-01-01	JOHN MORRIS	JOHN MORRIS	2013-10-04
001	2011-01-01	JOHN MORRIS	JOHN MORRIS	2012-10-02
001	2009-01-01	JOHN MORRIS	JOHN MORRIS	2010-10-15
001	2009-01-01	JOHN MORRIS	JOHN MORRIS	2010-10-15

Plan Statistics for RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.

401k plan membership statisitcs for RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.

Measure Date Value
2017: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Total participants 2017-01-01 0
2016: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 435
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Total participants 2016-01-01 0
2015: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 467
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 174
Number of retired or separated participants receiving benefits 2015-01-01 101
Number of other retired or separated participants entitled to future benefits 2015-01-01 160
Total of all active and inactive participants 2015-01-01 435
Total participants 2015-01-01 435
2014: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 475
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 188
Number of retired or separated participants receiving benefits 2014-01-01 93
Number of other retired or separated participants entitled to future benefits 2014-01-01 179
Total of all active and inactive participants 2014-01-01 460
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 8
Total participants 2014-01-01 468
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 483
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 200
Number of retired or separated participants receiving benefits 2013-01-01 84
Number of other retired or separated participants entitled to future benefits 2013-01-01 183
Total of all active and inactive participants 2013-01-01 467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 8
Total participants 2013-01-01 475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 488
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 229
Number of retired or separated participants receiving benefits 2012-01-01 72
Number of other retired or separated participants entitled to future benefits 2012-01-01 174
Total of all active and inactive participants 2012-01-01 475
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 8
Total participants 2012-01-01 483
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 495
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 242
Number of retired or separated participants receiving benefits 2011-01-01 60
Number of other retired or separated participants entitled to future benefits 2011-01-01 180
Total of all active and inactive participants 2011-01-01 482
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 6
Total participants 2011-01-01 488
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 509
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 263
Number of retired or separated participants receiving benefits 2009-01-01 46
Number of other retired or separated participants entitled to future benefits 2009-01-01 181
Total of all active and inactive participants 2009-01-01 490
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 4
Total participants 2009-01-01 494
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Total participants	2017-01-01	0
2016: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	435
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Total participants	2016-01-01	0
2015: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	467
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	174
Number of retired or separated participants receiving benefits	2015-01-01	101
Number of other retired or separated participants entitled to future benefits	2015-01-01	160
Total of all active and inactive participants	2015-01-01	435
Total participants	2015-01-01	435
2014: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	475
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	188
Number of retired or separated participants receiving benefits	2014-01-01	93
Number of other retired or separated participants entitled to future benefits	2014-01-01	179
Total of all active and inactive participants	2014-01-01	460
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	8
Total participants	2014-01-01	468
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	483
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	200
Number of retired or separated participants receiving benefits	2013-01-01	84
Number of other retired or separated participants entitled to future benefits	2013-01-01	183
Total of all active and inactive participants	2013-01-01	467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	8
Total participants	2013-01-01	475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	488
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	229
Number of retired or separated participants receiving benefits	2012-01-01	72
Number of other retired or separated participants entitled to future benefits	2012-01-01	174
Total of all active and inactive participants	2012-01-01	475
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	8
Total participants	2012-01-01	483
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	495
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	242
Number of retired or separated participants receiving benefits	2011-01-01	60
Number of other retired or separated participants entitled to future benefits	2011-01-01	180
Total of all active and inactive participants	2011-01-01	482
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	6
Total participants	2011-01-01	488
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	509
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	263
Number of retired or separated participants receiving benefits	2009-01-01	46
Number of other retired or separated participants entitled to future benefits	2009-01-01	181
Total of all active and inactive participants	2009-01-01	490
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	4
Total participants	2009-01-01	494
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.

Measure	Date	Value
2017 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2017 401k financial data
Total of all expenses incurred	2017-01-31	$69,573
Value of total assets at end of year	2017-01-31	$0
Value of total assets at beginning of year	2017-01-31	$69,573
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-01-31	$69,573
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-01-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-01-31	$0
Was this plan covered by a fidelity bond	2017-01-31	Yes
Value of fidelity bond cover	2017-01-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2017-01-31	No
Administrative expenses (other) incurred	2017-01-31	$69,573
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-01-31	No
Value of net income/loss	2017-01-31	$-69,573
Value of net assets at end of year (total assets less liabilities)	2017-01-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-01-31	$69,573
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-01-31	No
Were any leases to which the plan was party in default or uncollectible	2017-01-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-01-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-01-31	$69,573
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-01-31	$69,573
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-01-31	No
Was there a failure to transmit to the plan any participant contributions	2017-01-31	No
Has the plan failed to provide any benefit when due under the plan	2017-01-31	No
Did the plan have assets held for investment	2017-01-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-01-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-01-31	No
Opinion of an independent qualified public accountant for this plan	2017-01-31	Unqualified
Accountancy firm name	2017-01-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2017-01-31	010523282
2016 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$13,667,586
Total of all expenses incurred	2016-12-31	$26,537,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$26,410,165
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$13,233,371
Value of total assets at end of year	2016-12-31	$69,573
Value of total assets at beginning of year	2016-12-31	$12,939,780
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$127,628
Total interest from all sources	2016-12-31	$20,315
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$2,016
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$2,016
Administrative expenses professional fees incurred	2016-12-31	$81,806
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$48,289
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$67,520
Other income not declared elsewhere	2016-12-31	$426,179
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	$-12,870,207
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$69,573
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$12,939,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$45,822
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$409,897
Income. Interest from US Government securities	2016-12-31	$15,525
Income. Interest from corporate debt instruments	2016-12-31	$3,928
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$69,573
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$429,374
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$429,374
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$862
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$6,992,307
Asset value of US Government securities at beginning of year	2016-12-31	$4,481,570
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$-14,295
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	$13,233,371
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$26,410,165
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$510,823
Did the plan have assets held for investment	2016-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	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
2015 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$294,201
Total of all expenses incurred	2015-12-31	$2,146,139
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,807,849
Value of total assets at end of year	2015-12-31	$12,939,780
Value of total assets at beginning of year	2015-12-31	$14,791,718
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$338,290
Total interest from all sources	2015-12-31	$35,531
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$45,927
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$45,927
Administrative expenses professional fees incurred	2015-12-31	$22,788
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$48,289
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$941,444
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$67,520
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$30,906
Administrative expenses (other) incurred	2015-12-31	$220,805
Total non interest bearing cash at beginning of year	2015-12-31	$1,309
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	$-1,851,938
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$12,939,780
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$14,791,718
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$94,697
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$409,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$5,609,998
Income. Interest from US Government securities	2015-12-31	$-24,053
Income. Interest from corporate debt instruments	2015-12-31	$59,372
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$429,374
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$567,866
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$567,866
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$212
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$6,992,307
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$607,226
Asset value of US Government securities at end of year	2015-12-31	$4,481,570
Asset value of US Government securities at beginning of year	2015-12-31	$3,846,793
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$212,743
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,807,849
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$510,823
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$3,186,176
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	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	BERRY DUNN MCNEIL & PARKER, LLC
Accountancy firm EIN	2015-12-31	010523282
2014 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,220,153
Total of all expenses incurred	2014-12-31	$871,683
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$810,447
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$900,000
Value of total assets at end of year	2014-12-31	$14,791,718
Value of total assets at beginning of year	2014-12-31	$14,443,248
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$61,236
Total interest from all sources	2014-12-31	$208,132
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$139,968
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$139,968
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$3,000,000
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
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$941,444
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$887,898
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$30,906
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$50,945
Total non interest bearing cash at end of year	2014-12-31	$1,309
Total non interest bearing cash at beginning of year	2014-12-31	$1,834
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	$348,470
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$14,791,718
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$14,443,248
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
Investment advisory and management fees	2014-12-31	$49,400
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$5,609,998
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,418,325
Interest earned on other investments	2014-12-31	$41,918
Income. Interest from US Government securities	2014-12-31	$33,454
Income. Interest from corporate debt instruments	2014-12-31	$132,143
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$567,866
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$874,105
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$874,105
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$617
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$607,226
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$672,223
Asset value of US Government securities at end of year	2014-12-31	$3,846,793
Asset value of US Government securities at beginning of year	2014-12-31	$1,566,991
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-27,947
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
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	$900,000
Employer contributions (assets) at beginning of year	2014-12-31	$300,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$810,447
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$3,186,176
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$4,670,927
Contract administrator fees	2014-12-31	$11,836
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	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	TYLER, SIMMS & ST. SAUVEUR, CPAS PC
Accountancy firm EIN	2014-12-31	020476956
2013 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,666,016
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$737,081
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$679,194
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,178,168
Value of total assets at end of year	2013-12-31	$14,443,248
Value of total assets at beginning of year	2013-12-31	$13,514,313
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$57,887
Total interest from all sources	2013-12-31	$210,713
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$171,077
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$171,077
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$3,000,000
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
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$887,898
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$395,343
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$50,945
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$44,957
Other income not declared elsewhere	2013-12-31	$82,844
Total non interest bearing cash at end of year	2013-12-31	$1,834
Total non interest bearing cash at beginning of year	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$928,935
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$14,443,248
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$13,514,313
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
Investment advisory and management fees	2013-12-31	$45,134
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,418,325
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$6,069,202
Interest earned on other investments	2013-12-31	$45,978
Income. Interest from US Government securities	2013-12-31	$35,611
Income. Interest from corporate debt instruments	2013-12-31	$129,031
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$874,105
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$944,942
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$944,942
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$93
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$672,223
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$762,431
Asset value of US Government securities at end of year	2013-12-31	$1,566,991
Asset value of US Government securities at beginning of year	2013-12-31	$2,165,688
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$23,214
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
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	$1,178,168
Employer contributions (assets) at end of year	2013-12-31	$300,000
Employer contributions (assets) at beginning of year	2013-12-31	$21,452
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$679,194
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$4,670,927
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$3,110,298
Contract administrator fees	2013-12-31	$12,753
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	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	TYLER, SIMMS & ST. SAUVEUR, CPAS PC
Accountancy firm EIN	2013-12-31	020476956
2012 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,603,588
Total of all expenses incurred	2012-12-31	$652,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$595,822
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$782,306
Value of total assets at end of year	2012-12-31	$13,514,313
Value of total assets at beginning of year	2012-12-31	$12,563,036
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$56,489
Total interest from all sources	2012-12-31	$267,829
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$136,156
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$136,156
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$3,000,000
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
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$395,343
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$429,484
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$44,957
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$27,066
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	$951,277
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$13,514,313
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$12,563,036
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
Investment advisory and management fees	2012-12-31	$42,356
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$6,069,202
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$6,404,648
Interest earned on other investments	2012-12-31	$98,820
Income. Interest from US Government securities	2012-12-31	$56,080
Income. Interest from corporate debt instruments	2012-12-31	$112,599
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$944,942
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$2,694,001
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$2,694,001
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$330
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$762,431
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$870,848
Asset value of US Government securities at end of year	2012-12-31	$2,165,688
Asset value of US Government securities at beginning of year	2012-12-31	$1,137,395
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$417,297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$782,306
Employer contributions (assets) at end of year	2012-12-31	$21,452
Employer contributions (assets) at beginning of year	2012-12-31	$300,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$595,822
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$3,110,298
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$699,594
Contract administrator fees	2012-12-31	$14,133
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	TYLER, SIMMS & ST. SAUVEUR, CPAS PC
Accountancy firm EIN	2012-12-31	020476956
2011 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2011 401k financial data
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	$1,010,294
Total of all expenses incurred	2011-12-31	$586,438
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$530,964
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,150,000
Value of total assets at end of year	2011-12-31	$12,563,036
Value of total assets at beginning of year	2011-12-31	$12,139,180
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$55,474
Total interest from all sources	2011-12-31	$190,409
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$213,147
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$213,147
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$2,000,000
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
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$429,484
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$79,449
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$27,066
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$31,433
Other income not declared elsewhere	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$423,856
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$12,563,036
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$12,139,180
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
Investment advisory and management fees	2011-12-31	$39,668
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$6,404,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,766,705
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,167,890
Interest earned on other investments	2011-12-31	$89,322
Income. Interest from US Government securities	2011-12-31	$55,319
Income. Interest from corporate debt instruments	2011-12-31	$45,768
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$2,694,001
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$1,978,505
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$1,978,505
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$870,848
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$988,867
Asset value of US Government securities at end of year	2011-12-31	$1,137,395
Asset value of US Government securities at beginning of year	2011-12-31	$1,369,515
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-571,660
Net investment gain/loss from pooled separate accounts	2011-12-31	$28,398
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	$1,150,000
Employer contributions (assets) at end of year	2011-12-31	$300,000
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$530,964
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$699,594
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$756,816
Contract administrator fees	2011-12-31	$15,806
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	TYLER, SIMMS & ST. SAUVEUR, CPAS PC
Accountancy firm EIN	2011-12-31	020476956
2010 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$364,565
Total unrealized appreciation/depreciation of assets	2010-12-31	$364,565
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	$1,955,953
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$453,646
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$414,150
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$800,000
Value of total assets at end of year	2010-12-31	$12,139,180
Value of total assets at beginning of year	2010-12-31	$10,636,873
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$39,496
Total interest from all sources	2010-12-31	$225,325
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$86,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$86,664
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$2,000,000
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
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$79,449
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$108,964
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$31,433
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$47,765
Other income not declared elsewhere	2010-12-31	$269
Administrative expenses (other) incurred	2010-12-31	$365
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,502,307
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$12,139,180
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$10,636,873
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
Investment advisory and management fees	2010-12-31	$39,131
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$5,766,705
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,167,890
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,390,000
Interest earned on other investments	2010-12-31	$71,092
Income. Interest from US Government securities	2010-12-31	$88,564
Income. Interest from corporate debt instruments	2010-12-31	$65,669
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$1,978,505
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$574,957
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$574,957
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$988,867
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,248,261
Asset value of US Government securities at end of year	2010-12-31	$1,369,515
Asset value of US Government securities at beginning of year	2010-12-31	$2,122,999
Net investment gain/loss from pooled separate accounts	2010-12-31	$479,130
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	$800,000
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$125,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$414,150
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$756,816
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$1,018,927
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	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	TYLER, SIMMS & ST. SAUVEUR, CPAS PC
Accountancy firm EIN	2010-12-31	020476956
2009 : RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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 RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC.

2017: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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: RETIREMENT PLAN FOR EMPLOYEES OF ANDROSCOGGIN VALLEY HOSPITAL, INC. 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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

G-27716.01.0001

Policy instance

Insurance contract or identification number	G-27716.01.0001
Number of Individuals Covered	435
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	475
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	475
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	483
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	488
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE CO. OF AMERICA (National Association of Insurance Commissioners NAIC id number: 25453 )

Policy contract number

006238-201-001

Policy instance

Insurance contract or identification number	006238-201-001
Number of Individuals Covered	495
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $12,829
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

004254

Policy instance

Insurance contract or identification number	004254
Number of Individuals Covered	495
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ANDROSCOGGIN VALLEY HOSPITAL, INC.
Employer identification number (EIN):	020280367
NAIC Classification:	622000
NAIC Description:	Hospitals