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CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameCALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN
Plan identification number 012

CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

ASCENSION HEALTHCARE has sponsored the creation of one or more 401k plans.

Company Name:ASCENSION HEALTHCARE
Employer identification number (EIN):311662309
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about ASCENSION HEALTHCARE

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2000-02-14
Company Identification Number: 0013101407
Legal Registered Office Address: 211 E 7TH ST STE 620

AUSTIN
United States of America (USA)
78701

More information about ASCENSION HEALTHCARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0122023-01-01CHRIS BELCHER2024-06-06
0122022-01-01CHRIS BELCHER2023-07-25
0122021-01-01CHRIS BELCHER2022-06-20
0122020-01-01
0122019-01-01
0122018-01-01CHRIS BELCHER
0122017-01-01CHRIS BELCHER

Financial Data on CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN

Measure Date Value
2025 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2025 401k financial data
Total expenses incurred by plan in this plan year2025-06-12359769
Net assets as of the end of the plan year2025-06-125085285
Total assets as of the beginning of the plan year2025-06-124618921
Value of plan covered by a fidelity bond2025-06-1220000000
Value of participant loans at end of plan year2025-06-1222349
Other income to plan in this plan year2025-06-12826133
Plan net income in this plan year2025-06-12466364
Net assets as of the end of the plan year2025-06-125085285
Net assets as of the beginning of the plan year2025-06-124618921
Fees paid to broker by Benefit Provider2025-06-1217697
Expensese paid to adminstrative service provicers from plan in this plan year2025-06-121700
2024 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2024 401k financial data
Total expenses incurred by plan in this plan year2024-06-06138341
Net assets as of the end of the plan year2024-06-064618921
Total assets as of the beginning of the plan year2024-06-063956194
Value of plan covered by a fidelity bond2024-06-0620000000
Value of participant loans at end of plan year2024-06-0625377
Other income to plan in this plan year2024-06-06801068
Plan net income in this plan year2024-06-06662727
Net assets as of the end of the plan year2024-06-064618921
Net assets as of the beginning of the plan year2024-06-063956194
Fees paid to broker by Benefit Provider2024-06-0613115
Expensese paid to adminstrative service provicers from plan in this plan year2024-06-061725
2022 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Total liabilities as of the beginning of the plan year2022-06-200
Total expenses incurred by plan in this plan year2022-06-20603959
Net assets as of the end of the plan year2022-06-205389165
Total assets as of the beginning of the plan year2022-06-205121132
Value of plan covered by a fidelity bond2022-06-2020000000
Value of participant loans at end of plan year2022-06-2011012
Other income to plan in this plan year2022-06-20871992
Plan net income in this plan year2022-06-20268033
Net assets as of the end of the plan year2022-06-205389165
Net assets as of the beginning of the plan year2022-06-205121132
Fees paid to broker by Benefit Provider2022-06-208451
Expensese paid to adminstrative service provicers from plan in this plan year2022-06-202250
2020 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$777,490
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$205,189
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$202,789
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$0
Value of total assets at end of year2020-12-31$5,121,132
Value of total assets at beginning of year2020-12-31$4,548,831
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,400
Total interest from all sources2020-12-31$21,948
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$20,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$572,301
Value of net assets at end of year (total assets less liabilities)2020-12-31$5,121,132
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,548,831
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$4,484,993
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,909,133
Interest earned on other investments2020-12-31$21,948
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$636,139
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$639,698
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$755,542
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$202,789
Contract administrator fees2020-12-31$2,400
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2020-12-31410746749
2019 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$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$910,757
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$928,707
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$925,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$23,699
Value of total assets at end of year2019-12-31$4,548,831
Value of total assets at beginning of year2019-12-31$4,566,781
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,762
Total interest from all sources2019-12-31$25,459
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$20,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$23,699
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-17,950
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,548,831
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,566,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,909,133
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,819,325
Interest earned on other investments2019-12-31$25,459
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$639,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$747,456
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$861,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$925,945
Contract administrator fees2019-12-31$2,762
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2019-12-31410746749
2018 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$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$0
Total income from all sources (including contributions)2018-12-31$-220,301
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$319,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$316,524
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$0
Value of total assets at end of year2018-12-31$4,566,781
Value of total assets at beginning of year2018-12-31$5,106,206
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$2,600
Total interest from all sources2018-12-31$26,127
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$20,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-539,425
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,566,781
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,106,206
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,819,325
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$4,360,297
Interest earned on other investments2018-12-31$26,127
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$747,456
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$745,909
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-246,428
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$316,524
Contract administrator fees2018-12-31$2,600
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2018-12-31410746749
2017 : CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$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$707,849
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$268,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$265,402
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$0
Value of total assets at end of year2017-12-31$5,106,206
Value of total assets at beginning of year2017-12-31$4,666,663
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,904
Total interest from all sources2017-12-31$28,870
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$20,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$439,543
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,106,206
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,666,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$4,360,297
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,820,458
Interest earned on other investments2017-12-31$28,870
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$745,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$846,205
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$678,979
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$265,402
Contract administrator fees2017-12-31$2,904
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2017-12-31410746749

Form 5500 Responses for CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN

2020: CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CALUMET MEDICAL CENTER, INC. 403(B) TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15006
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15006
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15006
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15006
Policy instance 1

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