401k Plan data: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN plan

UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 401k Plan overview

Plan Name	UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN
Plan identification number	501

UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

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

Company Name: UNION HOSPITAL, INC.

Employer identification number (EIN): 350876396

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 WAYNE R HUTSON
501 2016-01-01 WAYNE R HUTSON
501 2015-01-01 WAYNE R HUTSON
501 2014-01-01 WAYNE HUTSON WAYNE HUTSON 2015-07-29
501 2013-01-01 WAYNE R HUTSON WAYNE R HUTSON 2014-08-20
501 2012-01-01 WAYNE HUTSON WAYNE HUTSON 2013-07-31
501 2011-01-01 WAYNE HUTSON WAYNE HUTSON 2012-09-03
501 2010-01-01 WAYNE R HUTSON WAYNE R HUTSON 2011-07-26
501 2009-01-01 WAYNE R HUTSON WAYNE R HUTSON 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	WAYNE R HUTSON
501	2016-01-01	WAYNE R HUTSON
501	2015-01-01	WAYNE R HUTSON
501	2014-01-01	WAYNE HUTSON	WAYNE HUTSON	2015-07-29
501	2013-01-01	WAYNE R HUTSON	WAYNE R HUTSON	2014-08-20
501	2012-01-01	WAYNE HUTSON	WAYNE HUTSON	2013-07-31
501	2011-01-01	WAYNE HUTSON	WAYNE HUTSON	2012-09-03
501	2010-01-01	WAYNE R HUTSON	WAYNE R HUTSON	2011-07-26
501	2009-01-01	WAYNE R HUTSON	WAYNE R HUTSON	2010-10-13

Plan Statistics for UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN

401k plan membership statisitcs for UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN

Measure Date Value
2022: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,306
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,582
Total of all active and inactive participants 2022-01-01 1,582
Total participants 2022-01-01 1,582
2021: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,243
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,296
Number of retired or separated participants receiving benefits 2021-01-01 10
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 1,306
2020: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,270
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,246
Number of retired or separated participants receiving benefits 2020-01-01 14
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 1,260
2019: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,473
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,252
Number of retired or separated participants receiving benefits 2019-01-01 9
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 1,261
2018: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 2,592
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2,672
Number of retired or separated participants receiving benefits 2018-01-01 12
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 2,684
2017: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,251
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,260
Number of retired or separated participants receiving benefits 2017-01-01 8
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 1,268
2016: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,244
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,243
Number of retired or separated participants receiving benefits 2016-01-01 9
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 1,252
2015: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,309
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,228
Number of retired or separated participants receiving benefits 2015-01-01 14
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1,242
2014: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,549
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,328
Number of retired or separated participants receiving benefits 2014-01-01 5
Total of all active and inactive participants 2014-01-01 1,333
2013: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,506
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,549
Total of all active and inactive participants 2013-01-01 1,549
2012: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,680
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,567
Number of retired or separated participants receiving benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 1,568
2011: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,535
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,610
Number of retired or separated participants receiving benefits 2011-01-01 70
Total of all active and inactive participants 2011-01-01 1,680
2010: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,520
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,535
Number of retired or separated participants receiving benefits 2010-01-01 60
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 1,595
2009: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,427
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,524
Number of retired or separated participants receiving benefits 2009-01-01 8
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 1,532
Total participants 2009-01-01 0

Measure	Date	Value
2022: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,306
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,582
Total of all active and inactive participants	2022-01-01	1,582
Total participants	2022-01-01	1,582
2021: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,243
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,296
Number of retired or separated participants receiving benefits	2021-01-01	10
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	1,306
2020: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,270
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,246
Number of retired or separated participants receiving benefits	2020-01-01	14
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	1,260
2019: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,473
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,252
Number of retired or separated participants receiving benefits	2019-01-01	9
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	1,261
2018: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	2,592
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,672
Number of retired or separated participants receiving benefits	2018-01-01	12
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	2,684
2017: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,251
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,260
Number of retired or separated participants receiving benefits	2017-01-01	8
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	1,268
2016: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,244
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,243
Number of retired or separated participants receiving benefits	2016-01-01	9
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	1,252
2015: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,309
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,228
Number of retired or separated participants receiving benefits	2015-01-01	14
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1,242
2014: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,549
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,328
Number of retired or separated participants receiving benefits	2014-01-01	5
Total of all active and inactive participants	2014-01-01	1,333
2013: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,506
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,549
Total of all active and inactive participants	2013-01-01	1,549
2012: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,680
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,567
Number of retired or separated participants receiving benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	1,568
2011: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,535
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,610
Number of retired or separated participants receiving benefits	2011-01-01	70
Total of all active and inactive participants	2011-01-01	1,680
2010: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,520
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,535
Number of retired or separated participants receiving benefits	2010-01-01	60
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	1,595
2009: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,427
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,524
Number of retired or separated participants receiving benefits	2009-01-01	8
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,532
Total participants	2009-01-01	0

Financial Data on UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN

Measure	Date	Value
2020 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$15,199,591
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$15,219,086
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$14,753,015
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$15,199,591
Value of total assets at end of year	2020-12-31	$1,596,414
Value of total assets at beginning of year	2020-12-31	$1,615,909
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$466,071
Total interest from all sources	2020-12-31	$0
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 year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$2,819,410
Administrative expenses (other) incurred	2020-12-31	$466,071
Total non interest bearing cash at end of year	2020-12-31	$1,596,414
Total non interest bearing cash at beginning of year	2020-12-31	$1,615,909
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	$-19,495
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,596,414
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,615,909
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
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$263,289
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
Contributions received in cash from employer	2020-12-31	$12,380,181
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$14,489,726
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	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	BLUE & CO, LLC
Accountancy firm EIN	2020-12-31	351178661
2019 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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	$14,941,896
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$14,793,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$14,306,628
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$14,941,896
Value of total assets at end of year	2019-12-31	$1,615,909
Value of total assets at beginning of year	2019-12-31	$1,467,248
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$486,607
Total interest from all sources	2019-12-31	$0
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 year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$2,781,896
Administrative expenses (other) incurred	2019-12-31	$486,607
Total non interest bearing cash at end of year	2019-12-31	$1,615,909
Total non interest bearing cash at beginning of year	2019-12-31	$1,467,248
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	$148,661
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,615,909
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,467,248
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
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$206,280
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
Contributions received in cash from employer	2019-12-31	$12,160,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$14,100,348
Did the plan have assets held for investment	2019-12-31	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	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	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	BLUE & CO, LLC
Accountancy firm EIN	2019-12-31	351178661
2017 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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	$15,180,579
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$14,898,835
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$14,173,643
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$15,180,579
Value of total assets at end of year	2017-12-31	$1,110,914
Value of total assets at beginning of year	2017-12-31	$829,170
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$725,192
Total interest from all sources	2017-12-31	$0
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 year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$2,281,611
Administrative expenses (other) incurred	2017-12-31	$725,192
Total non interest bearing cash at end of year	2017-12-31	$1,110,914
Total non interest bearing cash at beginning of year	2017-12-31	$829,170
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	$281,744
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,110,914
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$829,170
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
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$207,664
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
Contributions received in cash from employer	2017-12-31	$12,898,968
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$13,965,979
Did the plan have assets held for investment	2017-12-31	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	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	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	BLUE & CO, LLC
Accountancy firm EIN	2017-12-31	351178661
2016 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$13,224,477
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$12,828,590
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$12,134,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$13,224,477
Value of total assets at end of year	2016-12-31	$829,170
Value of total assets at beginning of year	2016-12-31	$433,283
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$693,969
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$2,017,829
Administrative expenses (other) incurred	2016-12-31	$693,969
Total non interest bearing cash at end of year	2016-12-31	$829,170
Total non interest bearing cash at beginning of year	2016-12-31	$433,283
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	$395,887
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$829,170
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$433,283
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
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$178,496
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$11,206,648
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$11,956,125
Did the plan have assets held for investment	2016-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	BLUE & CO, LLC
Accountancy firm EIN	2016-12-31	351178661
2015 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$11,797,774
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$11,518,825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$10,799,277
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$11,797,774
Value of total assets at end of year	2015-12-31	$433,283
Value of total assets at beginning of year	2015-12-31	$154,334
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$719,548
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,934,955
Administrative expenses (other) incurred	2015-12-31	$719,548
Total non interest bearing cash at end of year	2015-12-31	$433,283
Total non interest bearing cash at beginning of year	2015-12-31	$154,334
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	$278,949
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$433,283
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$154,334
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
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$181,187
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
Contributions received in cash from employer	2015-12-31	$9,862,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$10,618,090
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	BLUE & CO, LLC
Accountancy firm EIN	2015-12-31	351178661
2014 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$14,045,192
Total of all expenses incurred	2014-12-31	$14,101,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$13,500,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$14,045,192
Value of total assets at end of year	2014-12-31	$154,334
Value of total assets at beginning of year	2014-12-31	$210,609
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$600,746
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	$4,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$3,111,289
Total non interest bearing cash at end of year	2014-12-31	$154,334
Total non interest bearing cash at beginning of year	2014-12-31	$210,609
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	$-56,275
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$154,334
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$210,609
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$600,746
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$222,437
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
Contributions received in cash from employer	2014-12-31	$10,933,903
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$13,278,284
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	BLUE & CO, LLC
Accountancy firm EIN	2014-12-31	351178661
2013 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$15,846,293
Total of all expenses incurred	2013-12-31	$15,784,670
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$15,040,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$15,846,293
Value of total assets at end of year	2013-12-31	$210,609
Value of total assets at beginning of year	2013-12-31	$148,986
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$744,149
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	$4,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$3,056,899
Administrative expenses (other) incurred	2013-12-31	$744,149
Total non interest bearing cash at end of year	2013-12-31	$210,609
Total non interest bearing cash at beginning of year	2013-12-31	$148,986
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	$61,623
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$210,609
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$148,986
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
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$243,675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$12,789,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$14,796,846
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	BLUE & CO, LLC
Accountancy firm EIN	2013-12-31	351178661
2012 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$16,451,573
Total of all expenses incurred	2012-12-31	$16,432,968
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$15,714,560
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$16,451,573
Value of total assets at end of year	2012-12-31	$148,986
Value of total assets at beginning of year	2012-12-31	$130,381
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$718,408
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$4,000,000
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
Contributions received from participants	2012-12-31	$3,281,967
Administrative expenses (other) incurred	2012-12-31	$718,408
Total non interest bearing cash at end of year	2012-12-31	$148,986
Total non interest bearing cash at beginning of year	2012-12-31	$130,381
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	$18,605
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$148,986
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$130,381
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
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$250,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$13,169,606
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$15,464,445
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	BLUE & CO, LLC
Accountancy firm EIN	2012-12-31	351178661
2011 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2011 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$17,641,949
Total of all expenses incurred	2011-12-31	$17,901,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$17,157,809
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$17,641,949
Value of total assets at end of year	2011-12-31	$130,381
Value of total assets at beginning of year	2011-12-31	$390,258
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$744,017
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	$4,000,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$3,139,100
Total non interest bearing cash at end of year	2011-12-31	$130,381
Total non interest bearing cash at beginning of year	2011-12-31	$390,258
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	$-259,877
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$130,381
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$390,258
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
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$209,491
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$14,502,849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$16,948,318
Contract administrator fees	2011-12-31	$744,017
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	BLUE & CO, LLC
Accountancy firm EIN	2011-12-31	351178661
2010 : UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$16,196,680
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$15,954,718
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$15,380,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$16,196,680
Value of total assets at end of year	2010-12-31	$390,258
Value of total assets at beginning of year	2010-12-31	$148,296
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$573,768
Total interest from all sources	2010-12-31	$0
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	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$2,463,812
Total non interest bearing cash at end of year	2010-12-31	$390,258
Total non interest bearing cash at beginning of year	2010-12-31	$148,296
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	$241,962
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$390,258
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$148,296
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
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$204,138
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$13,732,868
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$15,176,812
Contract administrator fees	2010-12-31	$573,768
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	BLUE & CO, LLC
Accountancy firm EIN	2010-12-31	351178661

Form 5500 Responses for UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN

2022: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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	No
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: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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: UNION HOSPITAL EMPLOYEE HEALTH BENEFITS PLAN 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

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

AF15-0167-22

Policy instance

Insurance contract or identification number	AF15-0167-22
Number of Individuals Covered	3646
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $589,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SIHO (National Association of Insurance Commissioners NAIC id number: 95812 )

Policy contract number

UNHHSP UNNMED

Policy instance

Insurance contract or identification number	UNHHSP UNNMED
Number of Individuals Covered	3070
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	No
Health Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $602,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SIHO (National Association of Insurance Commissioners NAIC id number: 95812 )

Policy contract number

UNNHSP

Policy instance

Insurance contract or identification number	UNNHSP
Number of Individuals Covered	2580
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $429,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SIHO (National Association of Insurance Commissioners NAIC id number: 95812 )

Policy contract number

UNNHSP

Policy instance

Insurance contract or identification number	UNNHSP
Number of Individuals Covered	2559
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $362,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	2641
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $206,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	2672
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $231,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	1260
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $207,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	1393
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	No
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
Welfare Benefit Premiums Paid to Carrier	USD $181,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	GREGORY AND APPEL

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $222,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	GREGORY AND APPEL

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	1549
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $9,218
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $243,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,218
Insurance broker organization code?	3
Insurance broker name	GREGORY AND APPEL

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-12

Policy instance

Insurance contract or identification number	LGS00362-12
Number of Individuals Covered	1595
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $12,496
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $249,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,496
Insurance broker organization code?	3
Insurance broker name	GREGORY AND APPEL

QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-10

Policy instance

Insurance contract or identification number	LGS00362-10
Number of Individuals Covered	1588
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $10,478
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $209,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS00362-10

Policy instance

Insurance contract or identification number	LGS00362-10
Number of Individuals Covered	1613
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $10,207
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $204,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,207
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	GREGORY AND APPEL

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Company Name:	UNION HOSPITAL, INC.
Employer identification number (EIN):	350876396
NAIC Classification:	622000
NAIC Description:	Hospitals