401k Plan data: RETIREMENT PLAN OF WAYNESBORO HOSPITAL plan

RETIREMENT PLAN OF WAYNESBORO HOSPITAL 401k Plan overview

Plan Name	RETIREMENT PLAN OF WAYNESBORO HOSPITAL
Plan identification number	003

RETIREMENT PLAN OF WAYNESBORO HOSPITAL Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	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.

401k Sponsoring company profile

WAYNESBORO HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: WAYNESBORO HOSPITAL

Employer identification number (EIN): 231360854

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about WAYNESBORO HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 713759

More information about WAYNESBORO HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RETIREMENT PLAN OF WAYNESBORO 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 2018-01-01
003 2017-01-01 KIMBERLY RZOMP KIMBERLY RZOMP 2018-10-15
003 2016-01-01 KIMBERLY RZOMP KIMBERLY RZOMP 2017-10-12
003 2015-01-01 JEFFERY CARTY JEFFERY CARTY 2016-10-13
003 2014-01-01 KIMBERLY RZOMP KIMBERLY RZOMP 2015-10-13
003 2013-01-01 JEFFERY CARTY JEFFERY CARTY 2014-10-13
003 2012-01-01 KIMBERLY RZOMP KIMBERLY RZOMP 2013-10-14
003 2011-01-01 PATRICK O'DONNELL PATRICK O'DONNELL 2012-10-12
003 2010-01-01 PATRICK O'DONNELL PATRICK O'DONNELL 2011-10-14
003 2009-01-01 PATRICK W O'DONNELL

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2020-01-01
003	2019-01-01
003	2018-01-01
003	2017-01-01	KIMBERLY RZOMP	KIMBERLY RZOMP	2018-10-15
003	2016-01-01	KIMBERLY RZOMP	KIMBERLY RZOMP	2017-10-12
003	2015-01-01	JEFFERY CARTY	JEFFERY CARTY	2016-10-13
003	2014-01-01	KIMBERLY RZOMP	KIMBERLY RZOMP	2015-10-13
003	2013-01-01	JEFFERY CARTY	JEFFERY CARTY	2014-10-13
003	2012-01-01	KIMBERLY RZOMP	KIMBERLY RZOMP	2013-10-14
003	2011-01-01	PATRICK O'DONNELL	PATRICK O'DONNELL	2012-10-12
003	2010-01-01	PATRICK O'DONNELL	PATRICK O'DONNELL	2011-10-14
003	2009-01-01	PATRICK W O'DONNELL

Plan Statistics for RETIREMENT PLAN OF WAYNESBORO HOSPITAL

401k plan membership statisitcs for RETIREMENT PLAN OF WAYNESBORO HOSPITAL

Measure Date Value
2020: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2020 401k membership
Total participants, beginning-of-year 2020-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Number of participants with account balances 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2019 401k membership
Total participants, beginning-of-year 2019-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 83
Number of retired or separated participants receiving benefits 2019-01-01 5
Number of other retired or separated participants entitled to future benefits 2019-01-01 33
Total of all active and inactive participants 2019-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 122
Number of participants with account balances 2019-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2018 401k membership
Total participants, beginning-of-year 2018-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 93
Number of retired or separated participants receiving benefits 2018-01-01 4
Number of other retired or separated participants entitled to future benefits 2018-01-01 33
Total of all active and inactive participants 2018-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 130
Number of participants with account balances 2018-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2017 401k membership
Total participants, beginning-of-year 2017-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 101
Number of retired or separated participants receiving benefits 2017-01-01 4
Number of other retired or separated participants entitled to future benefits 2017-01-01 32
Total of all active and inactive participants 2017-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 138
Number of participants with account balances 2017-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2016 401k membership
Total participants, beginning-of-year 2016-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 106
Number of retired or separated participants receiving benefits 2016-01-01 3
Number of other retired or separated participants entitled to future benefits 2016-01-01 31
Total of all active and inactive participants 2016-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 141
Number of participants with account balances 2016-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2015 401k membership
Total participants, beginning-of-year 2015-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 111
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 33
Total of all active and inactive participants 2015-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 144
Number of participants with account balances 2015-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2014 401k membership
Total participants, beginning-of-year 2014-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 122
Number of retired or separated participants receiving benefits 2014-01-01 3
Number of other retired or separated participants entitled to future benefits 2014-01-01 28
Total of all active and inactive participants 2014-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 154
Number of participants with account balances 2014-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2013 401k membership
Total participants, beginning-of-year 2013-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 136
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 33
Total of all active and inactive participants 2013-01-01 171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 172
Number of participants with account balances 2013-01-01 156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2012 401k membership
Total participants, beginning-of-year 2012-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 146
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 33
Total of all active and inactive participants 2012-01-01 180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 181
Number of participants with account balances 2012-01-01 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2011 401k membership
Total participants, beginning-of-year 2011-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 146
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 38
Total of all active and inactive participants 2011-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 186
Number of participants with account balances 2011-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2010 401k membership
Total participants, beginning-of-year 2010-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 141
Number of retired or separated participants receiving benefits 2010-01-01 3
Number of other retired or separated participants entitled to future benefits 2010-01-01 42
Total of all active and inactive participants 2010-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 186
Number of participants with account balances 2010-01-01 178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 151
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 46
Total of all active and inactive participants 2009-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 199
Number of participants with account balances 2009-01-01 196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2020: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2020 401k membership
Total participants, beginning-of-year	2020-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Number of participants with account balances	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2019 401k membership
Total participants, beginning-of-year	2019-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	83
Number of retired or separated participants receiving benefits	2019-01-01	5
Number of other retired or separated participants entitled to future benefits	2019-01-01	33
Total of all active and inactive participants	2019-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	122
Number of participants with account balances	2019-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2018 401k membership
Total participants, beginning-of-year	2018-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	93
Number of retired or separated participants receiving benefits	2018-01-01	4
Number of other retired or separated participants entitled to future benefits	2018-01-01	33
Total of all active and inactive participants	2018-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	130
Number of participants with account balances	2018-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2017 401k membership
Total participants, beginning-of-year	2017-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	101
Number of retired or separated participants receiving benefits	2017-01-01	4
Number of other retired or separated participants entitled to future benefits	2017-01-01	32
Total of all active and inactive participants	2017-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	138
Number of participants with account balances	2017-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2016 401k membership
Total participants, beginning-of-year	2016-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	106
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	31
Total of all active and inactive participants	2016-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	141
Number of participants with account balances	2016-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2015 401k membership
Total participants, beginning-of-year	2015-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	111
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	33
Total of all active and inactive participants	2015-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	144
Number of participants with account balances	2015-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2014 401k membership
Total participants, beginning-of-year	2014-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	122
Number of retired or separated participants receiving benefits	2014-01-01	3
Number of other retired or separated participants entitled to future benefits	2014-01-01	28
Total of all active and inactive participants	2014-01-01	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	154
Number of participants with account balances	2014-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2013 401k membership
Total participants, beginning-of-year	2013-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	136
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	33
Total of all active and inactive participants	2013-01-01	171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	172
Number of participants with account balances	2013-01-01	156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2012 401k membership
Total participants, beginning-of-year	2012-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	146
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	33
Total of all active and inactive participants	2012-01-01	180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	181
Number of participants with account balances	2012-01-01	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2011 401k membership
Total participants, beginning-of-year	2011-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	146
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	38
Total of all active and inactive participants	2011-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	186
Number of participants with account balances	2011-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2010 401k membership
Total participants, beginning-of-year	2010-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	141
Number of retired or separated participants receiving benefits	2010-01-01	3
Number of other retired or separated participants entitled to future benefits	2010-01-01	42
Total of all active and inactive participants	2010-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	186
Number of participants with account balances	2010-01-01	178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	151
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	46
Total of all active and inactive participants	2009-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	199
Number of participants with account balances	2009-01-01	196
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 OF WAYNESBORO HOSPITAL

Measure	Date	Value
2020 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets from this plan	2020-12-31	$2,144,151
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$139,433
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$455,566
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$455,408
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$0
Value of total assets at end of year	2020-12-31	$0
Value of total assets at beginning of year	2020-12-31	$2,460,284
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$158
Total interest from all sources	2020-12-31	$23,836
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$63,804
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$63,804
Administrative expenses professional fees incurred	2020-12-31	$158
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$5,104
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-316,133
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,460,284
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$583,418
Interest on participant loans	2020-12-31	$220
Interest earned on other investments	2020-12-31	$23,616
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,871,762
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$51,793
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$455,408
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	SMITH ELLIOTT KEARNS & COMPANY
Accountancy firm EIN	2020-12-31	520783935
2019 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$156,405
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$296,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$296,586
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$0
Value of total assets at end of year	2019-12-31	$2,460,284
Value of total assets at beginning of year	2019-12-31	$2,600,540
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$75
Total interest from all sources	2019-12-31	$32,713
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$46,612
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$46,612
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Participant contributions at end of year	2019-12-31	$5,104
Participant contributions at beginning of year	2019-12-31	$2,879
Administrative expenses (other) incurred	2019-12-31	$75
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-140,256
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,460,284
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,600,540
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$583,418
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$566,926
Interest on participant loans	2019-12-31	$245
Interest earned on other investments	2019-12-31	$32,468
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,871,762
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,030,735
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$77,080
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$296,586
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SMITH ELLIOTT KEARNS & COMPANY
Accountancy firm EIN	2019-12-31	520783935
2018 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$5,018
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$541,276
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$525,493
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$0
Value of total assets at end of year	2018-12-31	$2,600,540
Value of total assets at beginning of year	2018-12-31	$3,136,798
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$15,783
Total interest from all sources	2018-12-31	$40,301
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$51,250
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$51,250
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Participant contributions at end of year	2018-12-31	$2,879
Participant contributions at beginning of year	2018-12-31	$7,101
Administrative expenses (other) incurred	2018-12-31	$15,783
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-536,258
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,600,540
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,136,798
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$566,926
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$740,631
Interest on participant loans	2018-12-31	$256
Interest earned on other investments	2018-12-31	$40,045
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$2,030,735
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$2,389,066
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-86,533
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$525,493
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SMITH ELLIOTT KEARNS & COMPANY
Accountancy firm EIN	2018-12-31	520783935
2017 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$218,203
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$500,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$500,144
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$3,136,798
Value of total assets at beginning of year	2017-12-31	$3,418,906
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$167
Total interest from all sources	2017-12-31	$60,415
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$41,138
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$41,138
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$700,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at end of year	2017-12-31	$7,101
Participant contributions at beginning of year	2017-12-31	$5,103
Administrative expenses (other) incurred	2017-12-31	$167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-282,108
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,136,798
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,418,906
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$740,631
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$976,101
Interest on participant loans	2017-12-31	$312
Interest earned on other investments	2017-12-31	$60,103
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$2,389,066
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,437,702
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$116,650
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$500,144
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2017-12-31	251877259
2016 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$137,318
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$416,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$415,993
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$0
Value of total assets at end of year	2016-12-31	$3,418,906
Value of total assets at beginning of year	2016-12-31	$3,697,656
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$75
Total interest from all sources	2016-12-31	$73,554
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$38,983
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$38,983
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$700,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$5,103
Participant contributions at beginning of year	2016-12-31	$813
Administrative expenses (other) incurred	2016-12-31	$75
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	$-278,750
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,418,906
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,697,656
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	$976,101
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,002,712
Interest on participant loans	2016-12-31	$65
Interest earned on other investments	2016-12-31	$73,489
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,437,702
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,694,131
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$24,781
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$415,993
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2016-12-31	251877259
2015 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$71,489
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$224,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$224,571
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$0
Value of total assets at end of year	2015-12-31	$3,697,656
Value of total assets at beginning of year	2015-12-31	$3,850,738
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$0
Total interest from all sources	2015-12-31	$80,088
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$17,815
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$17,815
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$700,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Participant contributions at end of year	2015-12-31	$813
Participant contributions at beginning of year	2015-12-31	$3,398
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	$-153,082
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,697,656
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,850,738
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	$1,002,712
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,114,612
Interest on participant loans	2015-12-31	$115
Interest earned on other investments	2015-12-31	$79,973
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,694,131
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,732,728
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-14,093
Net investment gain/loss from pooled separate accounts	2015-12-31	$-12,321
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$224,571
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	2015-12-31	Yes
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2015-12-31	251877259
2014 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$162,020
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$274,550
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$265,760
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$3,850,738
Value of total assets at beginning of year	2014-12-31	$3,963,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$8,790
Total interest from all sources	2014-12-31	$82,264
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	$700,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Participant contributions at end of year	2014-12-31	$3,398
Participant contributions at beginning of year	2014-12-31	$8,673
Other income not declared elsewhere	2014-12-31	$321
Administrative expenses (other) incurred	2014-12-31	$8,790
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	$-112,530
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,850,738
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,963,268
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	$1,114,612
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,165,014
Interest on participant loans	2014-12-31	$331
Interest earned on other investments	2014-12-31	$81,933
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,732,728
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,789,581
Net investment gain/loss from pooled separate accounts	2014-12-31	$79,435
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$265,760
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2014-12-31	251877259
2013 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$289,218
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$370,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$370,053
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$3,963,268
Value of total assets at beginning of year	2013-12-31	$4,044,253
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$150
Total interest from all sources	2013-12-31	$87,014
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	$700,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Participant contributions at end of year	2013-12-31	$8,673
Participant contributions at beginning of year	2013-12-31	$6,351
Other income not declared elsewhere	2013-12-31	$18
Administrative expenses (other) incurred	2013-12-31	$150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-80,985
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,963,268
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$4,044,253
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	$1,165,014
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,012,872
Interest on participant loans	2013-12-31	$282
Interest earned on other investments	2013-12-31	$86,732
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,789,581
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$3,025,030
Net investment gain/loss from pooled separate accounts	2013-12-31	$202,186
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$370,053
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2013-12-31	251877259
2012 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$229,168
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$238,985
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$234,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$4,044,253
Value of total assets at beginning of year	2012-12-31	$4,054,070
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$4,950
Total interest from all sources	2012-12-31	$91,301
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
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$700,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Participant contributions at end of year	2012-12-31	$6,351
Participant contributions at beginning of year	2012-12-31	$6,117
Administrative expenses (other) incurred	2012-12-31	$4,950
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	$-9,817
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,044,253
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,054,070
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,012,872
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$987,939
Interest on participant loans	2012-12-31	$407
Interest earned on other investments	2012-12-31	$90,894
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$3,025,030
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$3,060,014
Net investment gain/loss from pooled separate accounts	2012-12-31	$137,867
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$234,035
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	Yes
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2012-12-31	251877259
2011 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 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	$53,373
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$179,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$175,239
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$0
Value of total assets at end of year	2011-12-31	$4,054,070
Value of total assets at beginning of year	2011-12-31	$4,180,006
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$4,070
Total interest from all sources	2011-12-31	$92,711
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	$700,000
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	$6,117
Participant contributions at beginning of year	2011-12-31	$17,608
Other income not declared elsewhere	2011-12-31	$263
Administrative expenses (other) incurred	2011-12-31	$4,070
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	$-125,936
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,054,070
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,180,006
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	$987,939
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,041,776
Interest on participant loans	2011-12-31	$705
Interest earned on other investments	2011-12-31	$92,006
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$3,060,014
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$3,120,622
Net investment gain/loss from pooled separate accounts	2011-12-31	$-39,601
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$175,239
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2011-12-31	251877259
2010 : RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$225,985
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$375,021
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$374,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$0
Value of total assets at end of year	2010-12-31	$4,180,006
Value of total assets at beginning of year	2010-12-31	$4,329,042
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$150
Total interest from all sources	2010-12-31	$96,849
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	$700,000
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	$17,608
Participant contributions at beginning of year	2010-12-31	$19,487
Other income not declared elsewhere	2010-12-31	$17
Administrative expenses (other) incurred	2010-12-31	$150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-149,036
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,180,006
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,329,042
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,041,776
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$976,046
Interest on participant loans	2010-12-31	$1,140
Interest earned on other investments	2010-12-31	$95,709
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$3,120,622
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$3,333,509
Net investment gain/loss from pooled separate accounts	2010-12-31	$129,119
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$374,871
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	CHARLES L. STRAUSBAUGH, CPA, P.C.
Accountancy firm EIN	2010-12-31	251877259

Form 5500 Responses for RETIREMENT PLAN OF WAYNESBORO HOSPITAL

2020: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 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
2010: RETIREMENT PLAN OF WAYNESBORO HOSPITAL 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: RETIREMENT PLAN OF WAYNESBORO 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

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664046

Policy instance

Insurance contract or identification number	664046
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664046

Policy instance

Insurance contract or identification number	664046
Number of Individuals Covered	122
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664046

Policy instance

Insurance contract or identification number	664046
Number of Individuals Covered	130
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664046

Policy instance

Insurance contract or identification number	664046
Number of Individuals Covered	138
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664046

Policy instance

Insurance contract or identification number	664046
Number of Individuals Covered	144
Insurance policy start date	2015-12-15
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 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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-15
Total amount of commissions paid to insurance broker	USD $3,287
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 $1,959
Insurance broker organization code?	3
Insurance broker name	USI SECURITIES INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	154
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,612
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 $2,168
Insurance broker organization code?	3
Insurance broker name	NETWORK AGENCY INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	172
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,999
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 $2,460
Insurance broker organization code?	3
Insurance broker name	NETWORK AGENCY INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	181
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $6,150
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
Commission paid to Insurance Broker	USD $2,981
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	SECURITIES SERVICE NETWORK INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	186
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $6,235
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFZ160

Policy instance

Insurance contract or identification number	VFZ160
Number of Individuals Covered	186
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,282
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	WAYNESBORO HOSPITAL
Employer identification number (EIN):	231360854
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	713759