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THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN 401k Plan overview

Plan NameTHE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN
Plan identification number 001

THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WEST JEFFERSON MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:WEST JEFFERSON MEDICAL CENTER
Employer identification number (EIN):726014898
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-07-01JOANN MAURER

Plan Statistics for THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN

401k plan membership statisitcs for THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN

Measure Date Value
2015: THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01121
Total number of active participants reported on line 7a of the Form 55002015-07-0161
Number of retired or separated participants receiving benefits2015-07-012
Number of other retired or separated participants entitled to future benefits2015-07-0164
Total of all active and inactive participants2015-07-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-011
Total participants2015-07-01128
Number of participants with account balances2015-07-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010

Financial Data on THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN

Measure Date Value
2015 : THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN 2015 401k financial data
Total transfer of assets to this plan2015-12-31$9,371,182
Total income from all sources (including contributions)2015-12-31$299,061
Total of all expenses incurred2015-12-31$61,314
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$60,192
Expenses. Certain deemed distributions of participant loans2015-12-31$1,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$24,462
Value of total assets at end of year2015-12-31$9,608,929
Value of total assets at beginning of year2015-12-31$0
Total interest from all sources2015-12-31$16,195
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$13,849
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$13,849
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$10,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$24,462
Participant contributions at end of year2015-12-31$0
Participant contributions at end of year2015-12-31$2,091
Assets. Other investments not covered elsewhere at end of year2015-12-31$33,996
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$1,219
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$237,747
Value of net assets at end of year (total assets less liabilities)2015-12-31$9,608,929
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$6,327,544
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$0
Value of interest in pooled separate accounts at end of year2015-12-31$1,391,898
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$30
Interest earned on other investments2015-12-31$16,165
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,853,400
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$233,000
Net investment gain/loss from pooled separate accounts2015-12-31$10,336
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$60,192
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No

Form 5500 Responses for THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN

2015: THE WEST JEFFERSON MEDICAL CENTER FIXED ANNUITY RETIREMENT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
2015-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract numberTA068997
Policy instance 1
Insurance contract or identification numberTA068997
Number of Individuals Covered128
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,095
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,095
Insurance broker nameSISUNG SECURITIES CORP

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