401k Plan data: HEALTH SERVICES OF CLARION, INC. MATCHING PLAN plan

HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 401k Plan overview

Plan Name	HEALTH SERVICES OF CLARION, INC. MATCHING PLAN
Plan identification number	001

HEALTH SERVICES OF CLARION, INC. MATCHING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

HEALTH SERVICES OF CLARION, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTH SERVICES OF CLARION, INC.

Employer identification number (EIN): 753126134

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH SERVICES OF CLARION, INC. MATCHING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 BROOKE DIVINS 2023-04-04
001 2021-01-01 BROOKE DIVINS 2022-08-29
001 2020-01-01 BROOKE DIVINS 2021-08-27
001 2019-01-01 CONNIE BEICHNER 2020-04-10
001 2018-01-01 CONNIE BEICHNER 2019-04-29
001 2017-01-01 CONNIE BEICHNER 2018-09-13
001 2016-01-01 CONNIE BEICHNER 2017-10-06
001 2015-01-01 CONNIE BEICHNER 2016-09-13
001 2014-01-01 CONNIE BEICHNER 2015-09-14
001 2013-01-01 CONNIE BEICHNER 2014-10-08
001 2012-01-01 CONNIE BEICHNER 2013-04-25
001 2011-01-01 CONNIE BEICHNER
001 2009-01-01 CONNIE BEICHNER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	BROOKE DIVINS	2023-04-04
001	2021-01-01	BROOKE DIVINS	2022-08-29
001	2020-01-01	BROOKE DIVINS	2021-08-27
001	2019-01-01	CONNIE BEICHNER	2020-04-10
001	2018-01-01	CONNIE BEICHNER	2019-04-29
001	2017-01-01	CONNIE BEICHNER	2018-09-13
001	2016-01-01	CONNIE BEICHNER	2017-10-06
001	2015-01-01	CONNIE BEICHNER	2016-09-13
001	2014-01-01	CONNIE BEICHNER	2015-09-14
001	2013-01-01	CONNIE BEICHNER	2014-10-08
001	2012-01-01	CONNIE BEICHNER	2013-04-25
001	2011-01-01	CONNIE BEICHNER
001	2009-01-01	CONNIE BEICHNER

Plan Statistics for HEALTH SERVICES OF CLARION, INC. MATCHING PLAN

401k plan membership statisitcs for HEALTH SERVICES OF CLARION, INC. MATCHING PLAN

Measure Date Value
2011: HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 56
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 34
Total of all active and inactive participants 2011-01-01 90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 90
Number of participants with account balances 2011-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2009: HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 119
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 16
Total of all active and inactive participants 2009-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 135
Number of participants with account balances 2009-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2011: HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	56
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	34
Total of all active and inactive participants	2011-01-01	90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	90
Number of participants with account balances	2011-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2009: HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	119
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	16
Total of all active and inactive participants	2009-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	135
Number of participants with account balances	2009-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on HEALTH SERVICES OF CLARION, INC. MATCHING PLAN

Measure	Date	Value
2011 : HEALTH SERVICES OF CLARION, INC. MATCHING 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	$19,405
Total loss/gain on sale of assets	2011-12-31	$12,286
Total of all expenses incurred	2011-12-31	$105,102
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$98,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$19,999
Value of total assets at end of year	2011-12-31	$661,757
Value of total assets at beginning of year	2011-12-31	$747,454
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,640
Total interest from all sources	2011-12-31	$7,601
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$15,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$75,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Administrative expenses (other) incurred	2011-12-31	$680
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	$-85,697
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$661,757
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$747,454
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
Investment advisory and management fees	2011-12-31	$5,960
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$27,940
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$30,658
Income. Interest from US Government securities	2011-12-31	$5,717
Income. Interest from corporate debt instruments	2011-12-31	$1,868
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$13,742
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$24,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$24,871
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$16
Asset value of US Government securities at end of year	2011-12-31	$125,970
Asset value of US Government securities at beginning of year	2011-12-31	$115,189
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-35,937
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	$19,999
Employer contributions (assets) at end of year	2011-12-31	$19,999
Employer contributions (assets) at beginning of year	2011-12-31	$45,902
Income. Dividends from common stock	2011-12-31	$15,456
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$98,462
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$35,797
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$41,244
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$438,309
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$489,590
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
Aggregate proceeds on sale of assets	2011-12-31	$430,316
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$418,030
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	BKD, LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : HEALTH SERVICES OF CLARION, INC. MATCHING 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	$120,566
Total loss/gain on sale of assets	2010-12-31	$5,460
Total of all expenses incurred	2010-12-31	$14,303
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$8,137
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$45,902
Value of total assets at end of year	2010-12-31	$747,454
Value of total assets at beginning of year	2010-12-31	$641,191
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$6,166
Total interest from all sources	2010-12-31	$6,650
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$11,870
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$65,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Other income not declared elsewhere	2010-12-31	$10
Administrative expenses (other) incurred	2010-12-31	$612
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	$106,263
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$747,454
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$641,191
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
Investment advisory and management fees	2010-12-31	$5,554
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$30,658
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$27,857
Income. Interest from US Government securities	2010-12-31	$4,569
Income. Interest from corporate debt instruments	2010-12-31	$2,039
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$24,871
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$23,157
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$23,157
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$42
Asset value of US Government securities at end of year	2010-12-31	$115,189
Asset value of US Government securities at beginning of year	2010-12-31	$103,843
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$50,674
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$45,902
Employer contributions (assets) at end of year	2010-12-31	$45,902
Employer contributions (assets) at beginning of year	2010-12-31	$41,208
Income. Dividends from common stock	2010-12-31	$11,870
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$8,137
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$41,244
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$37,138
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$489,590
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$407,988
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
Aggregate proceeds on sale of assets	2010-12-31	$255,475
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$250,015
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	BKD, LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : HEALTH SERVICES OF CLARION, INC. MATCHING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for HEALTH SERVICES OF CLARION, INC. MATCHING PLAN

2011: HEALTH SERVICES OF CLARION, INC. MATCHING 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: HEALTH SERVICES OF CLARION, INC. MATCHING 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	HEALTH SERVICES OF CLARION, INC.
Employer identification number (EIN):	753126134
NAIC Classification:	622000
NAIC Description:	Hospitals