401k Plan data: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN plan

DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 401k Plan overview

Plan Name	DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN
Plan identification number	001

DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
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

NEW ENGLAND HOSPITAL DBA DIMOCK COMMUNITY HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name: NEW ENGLAND HOSPITAL DBA DIMOCK COMMUNITY HEALTH CENTER

Employer identification number (EIN): 042103609

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 PETER GERONDEAU JULIE GROOM 2017-10-13
001 2015-01-01 PETER GERONDEAU
001 2014-01-01 JERONICA GOODWIN
001 2013-01-01 JERONICA GOODWIN
001 2012-01-01 GAIL WAGNER
001 2011-01-01 GAIL WAGNER
001 2009-01-01 GAIL WAGNER
001 2009-01-01 GAIL WAGNER
001 2009-01-01 GAIL WAGNER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	PETER GERONDEAU	JULIE GROOM	2017-10-13
001	2015-01-01	PETER GERONDEAU
001	2014-01-01	JERONICA GOODWIN
001	2013-01-01	JERONICA GOODWIN
001	2012-01-01	GAIL WAGNER
001	2011-01-01	GAIL WAGNER
001	2009-01-01	GAIL WAGNER
001	2009-01-01	GAIL WAGNER
001	2009-01-01	GAIL WAGNER

Plan Statistics for DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN

401k plan membership statisitcs for DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN

Measure Date Value
2016: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 706
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 547
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 188
Total of all active and inactive participants 2016-01-01 735
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 735
Number of participants with account balances 2016-01-01 320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 702
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 529
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 177
Total of all active and inactive participants 2015-01-01 706
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 706
Number of participants with account balances 2015-01-01 304
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 636
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 520
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 182
Total of all active and inactive participants 2014-01-01 702
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 702
Number of participants with account balances 2014-01-01 280
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 626
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 484
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 152
Total of all active and inactive participants 2013-01-01 636
Total participants 2013-01-01 636
Number of participants with account balances 2013-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 662
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 482
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 144
Total of all active and inactive participants 2012-01-01 626
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 626
Number of participants with account balances 2012-01-01 251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 608
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 472
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 190
Total of all active and inactive participants 2011-01-01 662
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 662
Number of participants with account balances 2011-01-01 267
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 344
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 347
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 3
Total participants 2009-01-01 350
Number of participants with account balances 2009-01-01 274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	706
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	547
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	188
Total of all active and inactive participants	2016-01-01	735
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	735
Number of participants with account balances	2016-01-01	320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	702
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	529
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	177
Total of all active and inactive participants	2015-01-01	706
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	706
Number of participants with account balances	2015-01-01	304
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	636
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	520
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	182
Total of all active and inactive participants	2014-01-01	702
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	702
Number of participants with account balances	2014-01-01	280
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	626
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	484
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	152
Total of all active and inactive participants	2013-01-01	636
Total participants	2013-01-01	636
Number of participants with account balances	2013-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	662
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	482
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	144
Total of all active and inactive participants	2012-01-01	626
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	626
Number of participants with account balances	2012-01-01	251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	608
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	472
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	190
Total of all active and inactive participants	2011-01-01	662
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	662
Number of participants with account balances	2011-01-01	267
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	344
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	347
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	3
Total participants	2009-01-01	350
Number of participants with account balances	2009-01-01	274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN

Measure	Date	Value
2016 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$944,881
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,339,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,333,614
Expenses. Certain deemed distributions of participant loans	2016-12-31	$958
Value of total corrective distributions	2016-12-31	$4,674
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$622,882
Value of total assets at end of year	2016-12-31	$5,802,865
Value of total assets at beginning of year	2016-12-31	$6,197,530
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$300
Total interest from all sources	2016-12-31	$35,419
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	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$539,199
Participant contributions at end of year	2016-12-31	$93,201
Participant contributions at beginning of year	2016-12-31	$109,154
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$33,438
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	$-394,665
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$5,802,865
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$6,197,530
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	$4,524,960
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,880,327
Interest on participant loans	2016-12-31	$33
Interest earned on other investments	2016-12-31	$35,386
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,177,546
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,208,049
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$286,580
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	$50,245
Employer contributions (assets) at end of year	2016-12-31	$7,158
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,333,614
Contract administrator fees	2016-12-31	$300
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	ALEXANDER,ARONSON,FINNING & CO, PC
Accountancy firm EIN	2016-12-31	042571780
2015 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$544,149
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$509,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$505,007
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$3,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$575,587
Value of total assets at end of year	2015-12-31	$6,197,530
Value of total assets at beginning of year	2015-12-31	$6,162,623
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$300
Total interest from all sources	2015-12-31	$35,925
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	$1,000,000
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	$442,264
Participant contributions at end of year	2015-12-31	$109,154
Participant contributions at beginning of year	2015-12-31	$125,666
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$65,224
Other income not declared elsewhere	2015-12-31	$3,263
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	$34,907
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$6,197,530
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$6,162,623
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	$4,880,327
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,791,726
Interest on participant loans	2015-12-31	$35
Interest earned on other investments	2015-12-31	$35,890
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,208,049
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,245,231
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-70,626
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	Yes
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	$68,099
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$505,007
Contract administrator fees	2015-12-31	$300
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	ALEXANDER,ARONSON,FINNING & CO, PC
Accountancy firm EIN	2015-12-31	042571780
2014 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$872,798
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$253,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$249,523
Expenses. Certain deemed distributions of participant loans	2014-12-31	$3,321
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$519,902
Value of total assets at end of year	2014-12-31	$6,162,623
Value of total assets at beginning of year	2014-12-31	$5,543,169
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$500
Total interest from all sources	2014-12-31	$34,903
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	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$425,236
Participant contributions at end of year	2014-12-31	$125,666
Participant contributions at beginning of year	2014-12-31	$121,931
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$43,749
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	$619,454
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$6,162,623
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,543,169
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	$4,791,726
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$4,315,998
Interest on participant loans	2014-12-31	$71
Interest earned on other investments	2014-12-31	$34,832
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,245,231
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,105,240
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$317,993
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	Yes
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	$50,917
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$249,523
Contract administrator fees	2014-12-31	$500
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	ALEXANDER,ARONSON,FINNING & CO, PC
Accountancy firm EIN	2014-12-31	042571780
2013 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$1,368,139
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$880,421
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$880,171
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$509,484
Value of total assets at end of year	2013-12-31	$5,543,169
Value of total assets at beginning of year	2013-12-31	$5,055,451
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$250
Total interest from all sources	2013-12-31	$37,495
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	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$436,482
Participant contributions at end of year	2013-12-31	$121,931
Participant contributions at beginning of year	2013-12-31	$183,324
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$12,811
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	$487,718
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,543,169
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,055,451
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	$4,315,998
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$3,468,543
Interest on participant loans	2013-12-31	$85
Interest earned on other investments	2013-12-31	$37,410
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,105,240
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,403,584
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$821,160
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$60,191
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$880,171
Contract administrator fees	2013-12-31	$250
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	ALEXANDER,ARONSON,FINNING & CO, PC
Accountancy firm EIN	2013-12-31	042571780
2012 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$882,675
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$128,395
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$117,504
Expenses. Certain deemed distributions of participant loans	2012-12-31	$9,369
Value of total corrective distributions	2012-12-31	$1,022
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$441,678
Value of total assets at end of year	2012-12-31	$5,055,451
Value of total assets at beginning of year	2012-12-31	$4,301,171
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$500
Total interest from all sources	2012-12-31	$38,561
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	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$425,473
Participant contributions at end of year	2012-12-31	$183,324
Participant contributions at beginning of year	2012-12-31	$165,708
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$9,189
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	$754,280
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,055,451
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,301,171
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	$3,468,543
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,902,379
Interest on participant loans	2012-12-31	$146
Interest earned on other investments	2012-12-31	$38,415
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,403,584
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,233,084
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$402,436
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	$7,016
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$117,504
Contract administrator fees	2012-12-31	$500
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	ALEXANDER,ARONSON,FINNING & CO, PC
Accountancy firm EIN	2012-12-31	042571780
2011 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$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	$419,287
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$127,810
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$111,805
Expenses. Certain deemed distributions of participant loans	2011-12-31	$6,180
Value of total corrective distributions	2011-12-31	$9,275
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$465,169
Value of total assets at end of year	2011-12-31	$4,301,171
Value of total assets at beginning of year	2011-12-31	$4,009,694
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$550
Total interest from all sources	2011-12-31	$33,369
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	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$395,561
Participant contributions at end of year	2011-12-31	$165,708
Participant contributions at beginning of year	2011-12-31	$157,023
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$9,424
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	$291,477
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,301,171
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,009,694
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	$2,902,379
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,819,563
Interest on participant loans	2011-12-31	$154
Interest earned on other investments	2011-12-31	$33,215
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,233,084
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,033,108
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-79,251
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	$60,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$111,805
Contract administrator fees	2011-12-31	$550
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	ALEXANDER,ARONSON,FINNING & CO. PC
Accountancy firm EIN	2011-12-31	042571780
2010 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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	$912,673
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$260,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$244,720
Expenses. Certain deemed distributions of participant loans	2010-12-31	$2,664
Value of total corrective distributions	2010-12-31	$12,282
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$511,903
Value of total assets at end of year	2010-12-31	$4,009,694
Value of total assets at beginning of year	2010-12-31	$3,357,287
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$600
Total interest from all sources	2010-12-31	$29,494
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	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$372,846
Participant contributions at end of year	2010-12-31	$157,023
Participant contributions at beginning of year	2010-12-31	$135,226
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$48,117
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	$652,407
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,009,694
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,357,287
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	$2,819,563
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,332,041
Interest on participant loans	2010-12-31	$183
Interest earned on other investments	2010-12-31	$29,311
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,033,108
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$890,020
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$371,276
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	$90,940
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$244,720
Contract administrator fees	2010-12-31	$600
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	ALEXANDER,ARONSON,FINNING & CO. PC
Accountancy firm EIN	2010-12-31	042571780
2009 : DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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 DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN

2016: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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: DIMOCK COMMUNITY HEALTH CENTER TAX SHELTERED ANNUITY PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	304
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $847
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $847
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	280
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,002
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,002
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	258
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $963
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $963
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	251
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,240
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,240
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	267
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $879
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

891841+008

Policy instance

Insurance contract or identification number	891841+008
Number of Individuals Covered	273
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $917
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

DIMOCK COMMUNITY FOUNDATION 403(B) PLAN [EIN = 043487827]

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Company Name:	NEW ENGLAND HOSPITAL DBA DIMOCK COMMUNITY HEALTH CENTER
Employer identification number (EIN):	042103609
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers