401k Plan data: WILLIAM B KESSLER MEMORIAL HOSPITAL plan

WILLIAM B KESSLER MEMORIAL HOSPITAL 401k Plan overview

Plan Name	WILLIAM B KESSLER MEMORIAL HOSPITAL
Plan identification number	003

WILLIAM B KESSLER MEMORIAL HOSPITAL Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

WILLIAM B KESSLER MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: WILLIAM B KESSLER MEMORIAL HOSPITAL

Employer identification number (EIN): 221739910

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLIAM B KESSLER MEMORIAL HOSPITAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2020-01-01
003 2019-01-01
003 2015-01-01 RONALD SAHLI 2016-10-07 RONALD SAHLI 2016-10-07
003 2014-01-01 RONALD SAHLI 2015-10-14
003 2013-01-01 RONALD SAHLI 2014-10-15 RONALD SAHLI 2014-10-15
003 2012-01-01 RONALD SAHLI 2013-10-15 RONALD SAHLI 2013-10-15
003 2009-01-01
003 2009-01-01 RONALD W. SAHLI
003 2009-01-01 RONALD W. SAHLI
003 2009-01-01 RONALD W. SAHLI
003 2008-01-01 RONALD SAHLI
003 2007-01-01 RONALD SAHLI
003 2006-01-01 RONALD SAHLI

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2020-01-01
003	2019-01-01
003	2015-01-01	RONALD SAHLI	2016-10-07	RONALD SAHLI	2016-10-07
003	2014-01-01	RONALD SAHLI	2015-10-14
003	2013-01-01	RONALD SAHLI	2014-10-15	RONALD SAHLI	2014-10-15
003	2012-01-01	RONALD SAHLI	2013-10-15	RONALD SAHLI	2013-10-15
003	2009-01-01
003	2009-01-01	RONALD W. SAHLI
003	2009-01-01	RONALD W. SAHLI
003	2009-01-01	RONALD W. SAHLI
003	2008-01-01	RONALD SAHLI
003	2007-01-01	RONALD SAHLI
003	2006-01-01	RONALD SAHLI

Plan Statistics for WILLIAM B KESSLER MEMORIAL HOSPITAL

401k plan membership statisitcs for WILLIAM B KESSLER MEMORIAL HOSPITAL

Measure Date Value
2009: WILLIAM B KESSLER MEMORIAL HOSPITAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 0
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 100
Total of all active and inactive participants 2009-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 100
Number of participants with account balances 2009-01-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 155

Measure	Date	Value
2009: WILLIAM B KESSLER MEMORIAL HOSPITAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	0
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	100
Total of all active and inactive participants	2009-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	100
Number of participants with account balances	2009-01-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	155

Financial Data on WILLIAM B KESSLER MEMORIAL HOSPITAL

Measure	Date	Value
2011 : WILLIAM B KESSLER MEMORIAL HOSPITAL 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$3,287
Total of all expenses incurred	2011-12-31	$361,272
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$360,779
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$173
Value of total assets at end of year	2011-12-31	$225,554
Value of total assets at beginning of year	2011-12-31	$583,543
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$493
Total interest from all sources	2011-12-31	$1,338
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Participant contributions at end of year	2011-12-31	$2,528
Participant contributions at beginning of year	2011-12-31	$2,391
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$30,665
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$128,250
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$173
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	$-357,985
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$225,554
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$583,543
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	$158,028
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$368,313
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$1,338
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$34,333
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$84,589
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$1,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$360,779
Contract administrator fees	2011-12-31	$493
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
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
2010 : WILLIAM B KESSLER MEMORIAL HOSPITAL 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$26,456
Total of all expenses incurred	2010-12-31	$322,874
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$322,082
Value of total assets at end of year	2010-12-31	$583,543
Value of total assets at beginning of year	2010-12-31	$879,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$792
Total interest from all sources	2010-12-31	$4,433
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$508
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	$508
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Participant contributions at end of year	2010-12-31	$2,391
Participant contributions at beginning of year	2010-12-31	$12,740
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$128,250
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$299,920
Other income not declared elsewhere	2010-12-31	$3
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	$-296,418
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$583,543
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$879,961
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	$368,313
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$445,861
Interest on participant loans	2010-12-31	$301
Interest earned on other investments	2010-12-31	$4,132
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$84,589
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$121,440
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$21,512
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$322,082
Contract administrator fees	2010-12-31	$792
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
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
2008 : WILLIAM B KESSLER MEMORIAL HOSPITAL 2008 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2008-12-31	$0
2007 : WILLIAM B KESSLER MEMORIAL HOSPITAL 2007 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2007-12-31	$0
2006 : WILLIAM B KESSLER MEMORIAL HOSPITAL 2006 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2006-12-31	$0

Form 5500 Responses for WILLIAM B KESSLER MEMORIAL HOSPITAL

2009: WILLIAM B KESSLER MEMORIAL HOSPITAL 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: WILLIAM B KESSLER MEMORIAL HOSPITAL 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes
2007: WILLIAM B KESSLER MEMORIAL HOSPITAL 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes
2006: WILLIAM B KESSLER MEMORIAL HOSPITAL 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan funding arrangement – Trust	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WILLIAM B KESSLER MEMORIAL HOSPITAL
Employer identification number (EIN):	221739910
NAIC Classification:	622000
NAIC Description:	Hospitals