401k Plan data: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN plan

CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 401k Plan overview

Plan Name	CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN
Plan identification number	001

CALDWELL MEMORIAL HOSPITAL RETIREMENT 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

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

Company Name: CALDWELL MEMORIAL HOSPITAL

Employer identification number (EIN): 560554202

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01 CHRISTINA GOOD
001 2016-01-01 CHRISTINA GOOD
001 2015-01-01 CHRISTINA GOOD
001 2014-01-01 CHRISTINA GOOD
001 2013-01-01 KIM BEAN
001 2012-01-01 KIM BEAN
001 2011-01-01 KIM BEAN
001 2010-01-01 KIM BEAN
001 2009-01-01 KIM BEAN

Plan Statistics for CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN

401k plan membership statisitcs for CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN

Measure Date Value
2019: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,318
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,226
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 894
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 429
Total of all active and inactive participants 2018-01-01 1,323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,323
Number of participants with account balances 2018-01-01 1,103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,179
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 840
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 375
Total of all active and inactive participants 2017-01-01 1,215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 1,215
Number of participants with account balances 2017-01-01 968
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,168
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 810
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 370
Total of all active and inactive participants 2016-01-01 1,180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1,180
Number of participants with account balances 2016-01-01 867
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,194
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 816
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 361
Total of all active and inactive participants 2015-01-01 1,177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1,177
Number of participants with account balances 2015-01-01 874
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,148
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 569
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 277
Total of all active and inactive participants 2014-01-01 846
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 846
Number of participants with account balances 2014-01-01 846
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,102
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 911
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 257
Total of all active and inactive participants 2013-01-01 1,168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 1,168
Number of participants with account balances 2013-01-01 839
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,082
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 860
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 251
Total of all active and inactive participants 2012-01-01 1,111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1,111
Number of participants with account balances 2012-01-01 819
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,125
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 898
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 251
Total of all active and inactive participants 2011-01-01 1,149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,149
Number of participants with account balances 2011-01-01 816
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,160
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 923
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 238
Total of all active and inactive participants 2010-01-01 1,161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1,161
Number of participants with account balances 2010-01-01 825
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,113
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 962
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 221
Total of all active and inactive participants 2009-01-01 1,183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,183
Number of participants with account balances 2009-01-01 849
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2019: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,318
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,226
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	894
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	429
Total of all active and inactive participants	2018-01-01	1,323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,323
Number of participants with account balances	2018-01-01	1,103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,179
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	840
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	375
Total of all active and inactive participants	2017-01-01	1,215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	1,215
Number of participants with account balances	2017-01-01	968
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,168
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	810
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	370
Total of all active and inactive participants	2016-01-01	1,180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,180
Number of participants with account balances	2016-01-01	867
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,194
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	816
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	361
Total of all active and inactive participants	2015-01-01	1,177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,177
Number of participants with account balances	2015-01-01	874
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,148
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	569
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	277
Total of all active and inactive participants	2014-01-01	846
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	846
Number of participants with account balances	2014-01-01	846
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,102
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	911
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	257
Total of all active and inactive participants	2013-01-01	1,168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	1,168
Number of participants with account balances	2013-01-01	839
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,082
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	860
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	251
Total of all active and inactive participants	2012-01-01	1,111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1,111
Number of participants with account balances	2012-01-01	819
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,125
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	898
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	251
Total of all active and inactive participants	2011-01-01	1,149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,149
Number of participants with account balances	2011-01-01	816
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,160
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	923
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	238
Total of all active and inactive participants	2010-01-01	1,161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,161
Number of participants with account balances	2010-01-01	825
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,113
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	962
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	221
Total of all active and inactive participants	2009-01-01	1,183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,183
Number of participants with account balances	2009-01-01	849
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN

Measure	Date	Value
2019 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2019 401k financial data
Total transfer of assets from this plan	2019-12-31	$35,663,939
Total income from all sources (including contributions)	2019-12-31	$10,077,163
Total of all expenses incurred	2019-12-31	$8,843,489
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$8,712,643
Expenses. Certain deemed distributions of participant loans	2019-12-31	$26,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$4,225,720
Value of total assets at end of year	2019-12-31	$0
Value of total assets at beginning of year	2019-12-31	$34,430,265
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$104,233
Total interest from all sources	2019-12-31	$227,760
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,376,093
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$1,376,093
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$2,347,423
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$631,950
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$857,132
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	$1,233,674
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$34,430,265
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$23,998,668
Interest on participant loans	2019-12-31	$31,288
Interest earned on other investments	2019-12-31	$196,472
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$9,799,647
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$4,247,590
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	$1,021,165
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$8,712,643
Contract administrator fees	2019-12-31	$104,233
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	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2019-12-31	410746749
2018 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$2,482,167
Total of all expenses incurred	2018-12-31	$2,835,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,715,774
Expenses. Certain deemed distributions of participant loans	2018-12-31	$6,417
Value of total corrective distributions	2018-12-31	$12,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$3,779,918
Value of total assets at end of year	2018-12-31	$34,430,265
Value of total assets at beginning of year	2018-12-31	$34,783,957
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$100,981
Total interest from all sources	2018-12-31	$230,403
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,658,286
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	$1,658,286
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
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	$2,081,897
Participant contributions at end of year	2018-12-31	$631,950
Participant contributions at beginning of year	2018-12-31	$456,419
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$775,608
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	$-353,692
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$34,430,265
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$34,783,957
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	$23,998,668
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$23,855,744
Interest on participant loans	2018-12-31	$28,604
Interest earned on other investments	2018-12-31	$201,799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$9,799,647
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$10,471,794
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-3,186,440
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	$922,413
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,715,774
Contract administrator fees	2018-12-31	$100,981
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2018-12-31	410746749
2017 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$7,015,707
Total of all expenses incurred	2017-12-31	$1,696,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,580,994
Value of total corrective distributions	2017-12-31	$26,281
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$3,294,814
Value of total assets at end of year	2017-12-31	$34,783,957
Value of total assets at beginning of year	2017-12-31	$29,464,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$89,386
Total interest from all sources	2017-12-31	$222,396
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,109,558
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	$1,109,558
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
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	$1,795,516
Participant contributions at end of year	2017-12-31	$456,419
Participant contributions at beginning of year	2017-12-31	$359,195
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$634,617
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	$5,319,046
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$34,783,957
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$29,464,911
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	$23,855,744
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$18,900,255
Interest on participant loans	2017-12-31	$16,948
Interest earned on other investments	2017-12-31	$205,448
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$10,471,794
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$10,205,461
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,388,939
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	$864,681
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,580,994
Contract administrator fees	2017-12-31	$89,386
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	CLIFTONLARSONALLEN, LLP
Accountancy firm EIN	2017-12-31	410746749
2016 : CALDWELL MEMORIAL HOSPITAL RETIREMENT 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	$4,689,780
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,473,304
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,371,016
Expenses. Certain deemed distributions of participant loans	2016-12-31	$25,461
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,841,419
Value of total assets at end of year	2016-12-31	$29,464,911
Value of total assets at beginning of year	2016-12-31	$27,248,435
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$76,827
Total interest from all sources	2016-12-31	$227,336
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$869,057
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$869,057
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
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	$1,716,737
Participant contributions at end of year	2016-12-31	$359,195
Participant contributions at beginning of year	2016-12-31	$320,411
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$265,965
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	$2,216,476
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$29,464,911
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$27,248,435
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	$18,900,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$16,620,914
Interest on participant loans	2016-12-31	$12,699
Interest earned on other investments	2016-12-31	$214,637
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$10,205,461
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$10,307,110
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$751,968
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	$858,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,371,016
Contract administrator fees	2016-12-31	$76,827
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	CLIFTONLARSONALLEN, LLP
Accountancy firm EIN	2016-12-31	410746749
2015 : CALDWELL MEMORIAL HOSPITAL RETIREMENT 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	$3,865,889
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,967,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,883,977
Expenses. Certain deemed distributions of participant loans	2015-12-31	$11,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$3,759,859
Value of total assets at end of year	2015-12-31	$27,248,435
Value of total assets at beginning of year	2015-12-31	$26,350,321
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$72,015
Total interest from all sources	2015-12-31	$227,201
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$800,093
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	$800,093
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$1,705,565
Participant contributions at end of year	2015-12-31	$320,411
Participant contributions at beginning of year	2015-12-31	$202,456
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,229,921
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	$898,114
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$27,248,435
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$26,350,321
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	$16,620,914
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$15,865,018
Interest on participant loans	2015-12-31	$9,721
Interest earned on other investments	2015-12-31	$217,480
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$10,307,110
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$10,282,847
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-921,264
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	$824,373
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,883,977
Contract administrator fees	2015-12-31	$72,015
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2015-12-31	410746749
2014 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$4,316,389
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,423,997
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,307,409
Expenses. Certain deemed distributions of participant loans	2014-12-31	$43,774
Value of total corrective distributions	2014-12-31	$2,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,960,106
Value of total assets at end of year	2014-12-31	$26,350,321
Value of total assets at beginning of year	2014-12-31	$24,457,929
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$70,646
Total interest from all sources	2014-12-31	$229,303
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$696,556
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$696,556
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,665,625
Participant contributions at end of year	2014-12-31	$202,456
Participant contributions at beginning of year	2014-12-31	$224,650
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$490,939
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	$1,892,392
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$26,350,321
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$24,457,929
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$15,865,018
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$14,398,852
Interest on participant loans	2014-12-31	$7,483
Interest earned on other investments	2014-12-31	$221,820
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$10,282,847
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$9,834,427
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$430,424
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	$803,542
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,307,409
Contract administrator fees	2014-12-31	$70,646
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2014-12-31	410746749
2013 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$5,463,474
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,600,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,557,735
Expenses. Certain deemed distributions of participant loans	2013-12-31	$-16,200
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$2,638,837
Value of total assets at end of year	2013-12-31	$24,457,929
Value of total assets at beginning of year	2013-12-31	$20,594,907
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$58,917
Total interest from all sources	2013-12-31	$218,544
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$525,877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$525,877
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,630,002
Participant contributions at end of year	2013-12-31	$224,650
Participant contributions at beginning of year	2013-12-31	$195,079
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$217,418
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	$3,863,022
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$24,457,929
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$20,594,907
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$14,398,852
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$11,392,872
Interest on participant loans	2013-12-31	$7,690
Interest earned on other investments	2013-12-31	$210,854
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$9,834,427
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$9,006,956
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$2,080,216
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	$791,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,557,735
Contract administrator fees	2013-12-31	$58,917
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	DIXON HUGHES GOODMAN, PLLC
Accountancy firm EIN	2013-12-31	560747981
2012 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$4,389,117
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,562,305
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,490,588
Expenses. Certain deemed distributions of participant loans	2012-12-31	$9,547
Value of total corrective distributions	2012-12-31	$6,639
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,761,777
Value of total assets at end of year	2012-12-31	$20,594,907
Value of total assets at beginning of year	2012-12-31	$17,768,095
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$55,531
Total interest from all sources	2012-12-31	$231,399
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$349,339
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$349,339
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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	$1,408,395
Participant contributions at end of year	2012-12-31	$195,079
Participant contributions at beginning of year	2012-12-31	$139,878
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$645,338
Administrative expenses (other) incurred	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$2,826,812
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$20,594,907
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$17,768,095
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$11,392,872
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$9,225,914
Interest on participant loans	2012-12-31	$7,006
Interest earned on other investments	2012-12-31	$224,393
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$9,006,956
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$8,402,303
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,046,602
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	$708,044
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,490,588
Contract administrator fees	2012-12-31	$55,531
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2012-12-31	560747981
2011 : CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$2,141,693
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$3,595,109
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,525,384
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,996,583
Value of total assets at end of year	2011-12-31	$17,768,095
Value of total assets at beginning of year	2011-12-31	$19,221,511
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$69,725
Total interest from all sources	2011-12-31	$280,328
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$242,173
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$242,173
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,238,312
Participant contributions at end of year	2011-12-31	$139,878
Participant contributions at beginning of year	2011-12-31	$191,111
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$68,743
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	$-1,453,416
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$17,768,095
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$19,221,511
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$9,225,914
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$11,657,945
Interest on participant loans	2011-12-31	$7,698
Interest earned on other investments	2011-12-31	$272,630
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$8,402,303
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$7,372,455
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-377,391
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	$689,528
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,525,384
Contract administrator fees	2011-12-31	$69,725
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2011-12-31	560747981
2010 : CALDWELL MEMORIAL HOSPITAL RETIREMENT 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	$2,726,767
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,963,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,720,329
Expenses. Certain deemed distributions of participant loans	2010-12-31	$167,001
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,006,531
Value of total assets at end of year	2010-12-31	$19,221,511
Value of total assets at beginning of year	2010-12-31	$18,458,343
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$76,269
Total interest from all sources	2010-12-31	$269,795
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$289,278
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$289,278
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$916,708
Participant contributions at end of year	2010-12-31	$191,111
Participant contributions at beginning of year	2010-12-31	$324,011
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$89,823
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	$763,168
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$19,221,511
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$18,458,343
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$11,657,945
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$11,132,538
Interest on participant loans	2010-12-31	$9,914
Interest earned on other investments	2010-12-31	$259,881
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$7,372,455
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$7,001,794
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,161,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,720,329
Contract administrator fees	2010-12-31	$76,269
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2010-12-31	560747981

Form 5500 Responses for CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN

2019: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	Yes
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: CALDWELL MEMORIAL HOSPITAL RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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: CALDWELL MEMORIAL HOSPITAL RETIREMENT 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

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

Policy contract number

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	1107
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	972
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	877
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
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	874
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
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
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	869
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	850
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	846
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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
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

06744

Policy instance

Insurance contract or identification number	06744
Number of Individuals Covered	858
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

CALDWELL MEMORIAL HOSPITAL, INC. 401K PROFIT SHARING PLAN AND TRUST [EIN = 720878037]

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Company Name:	CALDWELL MEMORIAL HOSPITAL
Employer identification number (EIN):	560554202
NAIC Classification:	622000
NAIC Description:	Hospitals