401k Plan data: ST. JOSEPH'S HOSPITAL 403(B) PLAN plan

ST. JOSEPH'S HOSPITAL 403(B) PLAN 401k Plan overview

Plan Name	ST. JOSEPH'S HOSPITAL 403(B) PLAN
Plan identification number	002

ST. JOSEPH'S HOSPITAL 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC has sponsored the creation of one or more 401k plans.

Company Name: ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC

Employer identification number (EIN): 550356996

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. JOSEPH'S HOSPITAL 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2018-01-01
002 2017-01-01 ANISSA HITE-DAVIS
002 2016-01-01 ANISSA HITE-DAVIS
002 2015-01-01 ANISSA HITE-DAVIS

Plan Statistics for ST. JOSEPH'S HOSPITAL 403(B) PLAN

401k plan membership statisitcs for ST. JOSEPH'S HOSPITAL 403(B) PLAN

Measure Date Value
2018: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 515
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 478
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 396
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 112
Total of all active and inactive participants 2017-01-01 508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 508
Number of participants with account balances 2017-01-01 448
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 12
2016: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 470
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 410
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 83
Total of all active and inactive participants 2016-01-01 493
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 493
Number of participants with account balances 2016-01-01 412
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 23
2015: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 432
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 410
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 61
Total of all active and inactive participants 2015-01-01 471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 471
Number of participants with account balances 2015-01-01 346
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 6

Measure	Date	Value
2018: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	515
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	478
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	396
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	112
Total of all active and inactive participants	2017-01-01	508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	508
Number of participants with account balances	2017-01-01	448
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	12
2016: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	470
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	410
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	83
Total of all active and inactive participants	2016-01-01	493
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	493
Number of participants with account balances	2016-01-01	412
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	23
2015: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	432
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	410
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	61
Total of all active and inactive participants	2015-01-01	471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	471
Number of participants with account balances	2015-01-01	346
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	6

Financial Data on ST. JOSEPH'S HOSPITAL 403(B) PLAN

Measure	Date	Value
2018 : ST. JOSEPH'S HOSPITAL 403(B) PLAN 2018 401k financial data
Total transfer of assets from this plan	2018-12-31	$4,780,308
Total income from all sources (including contributions)	2018-12-31	$415,648
Total of all expenses incurred	2018-12-31	$588,326
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$579,701
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$712,685
Value of total assets at end of year	2018-12-31	$0
Value of total assets at beginning of year	2018-12-31	$4,952,986
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$8,625
Total interest from all sources	2018-12-31	$191
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$295,200
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$295,200
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$535,883
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$6,153
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-172,678
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,952,986
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,501,610
Interest on participant loans	2018-12-31	$191
Interest earned on other investments	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$287,026
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-592,428
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$176,802
Employer contributions (assets) at beginning of year	2018-12-31	$158,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$579,701
Contract administrator fees	2018-12-31	$8,625
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN	2018-12-31	390859910
2017 : ST. JOSEPH'S HOSPITAL 403(B) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$1,380,290
Total of all expenses incurred	2017-12-31	$136,776
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$131,169
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$711,966
Value of total assets at end of year	2017-12-31	$4,952,986
Value of total assets at beginning of year	2017-12-31	$3,709,472
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,607
Total interest from all sources	2017-12-31	$5,584
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$164,590
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$164,590
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$507,459
Participant contributions at end of year	2017-12-31	$6,153
Participant contributions at beginning of year	2017-12-31	$8,106
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$31,460
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	$1,243,514
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,952,986
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,709,472
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,501,610
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,292,408
Interest on participant loans	2017-12-31	$244
Interest earned on other investments	2017-12-31	$5,340
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$287,026
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$270,184
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$498,150
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	$173,047
Employer contributions (assets) at end of year	2017-12-31	$158,197
Employer contributions (assets) at beginning of year	2017-12-31	$138,774
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$131,169
Contract administrator fees	2017-12-31	$5,607
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN	2017-12-31	390859910
2016 : ST. JOSEPH'S HOSPITAL 403(B) 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	$868,111
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$785,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$781,084
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$630,473
Value of total assets at end of year	2016-12-31	$3,709,472
Value of total assets at beginning of year	2016-12-31	$3,626,644
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,199
Total interest from all sources	2016-12-31	$6,787
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$119,010
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	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$452,630
Participant contributions at end of year	2016-12-31	$8,106
Participant contributions at beginning of year	2016-12-31	$7,192
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$39,069
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	$82,828
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,709,472
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,626,644
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,292,408
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,251,537
Interest on participant loans	2016-12-31	$273
Interest earned on other investments	2016-12-31	$6,514
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$270,184
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$211,906
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$111,841
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	$138,774
Employer contributions (assets) at end of year	2016-12-31	$138,774
Employer contributions (assets) at beginning of year	2016-12-31	$156,009
Income. Dividends from common stock	2016-12-31	$119,010
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$781,084
Contract administrator fees	2016-12-31	$4,199
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2016-12-31	390859910
2015 : ST. JOSEPH'S HOSPITAL 403(B) 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	$829,416
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$226,404
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$216,146
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$844,957
Value of total assets at end of year	2015-12-31	$3,626,644
Value of total assets at beginning of year	2015-12-31	$3,023,632
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$10,258
Total interest from all sources	2015-12-31	$3,960
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$144,274
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$144,274
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$481,706
Participant contributions at end of year	2015-12-31	$7,192
Participant contributions at beginning of year	2015-12-31	$2,392
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$207,242
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	$603,012
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,626,644
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,023,632
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,251,537
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,705,946
Interest on participant loans	2015-12-31	$152
Interest earned on other investments	2015-12-31	$3,808
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$211,906
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$163,543
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-163,775
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	$156,009
Employer contributions (assets) at end of year	2015-12-31	$156,009
Employer contributions (assets) at beginning of year	2015-12-31	$151,751
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$216,146
Contract administrator fees	2015-12-31	$10,258
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2015-12-31	390859910

Form 5500 Responses for ST. JOSEPH'S HOSPITAL 403(B) PLAN

2018: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	This submission is the final filing	Yes
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: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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: ST. JOSEPH'S HOSPITAL 403(B) 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: ST. JOSEPH'S HOSPITAL 403(B) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

68324

Policy instance

Insurance contract or identification number	68324
Number of Individuals Covered	476
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

68324

Policy instance

Insurance contract or identification number	68324
Number of Individuals Covered	448
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

68324

Policy instance

Insurance contract or identification number	68324
Number of Individuals Covered	346
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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

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Company Name:	ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC
Employer identification number (EIN):	550356996
NAIC Classification:	622000
NAIC Description:	Hospitals

Plan id#	Filing Submission Date	Name of Administrator
002	2018-01-01
002	2017-01-01	ANISSA HITE-DAVIS
002	2016-01-01	ANISSA HITE-DAVIS
002	2015-01-01	ANISSA HITE-DAVIS