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PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 401k Plan overview

Plan NamePENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL
Plan identification number 001

PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily flat dollar (includes dollars per year of service)
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

COBRE VALLEY COMMUNITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:COBRE VALLEY COMMUNITY HOSPITAL
Employer identification number (EIN):860732836
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01PRESTON POLLOCK PRESTON POLLOCK2018-10-12
0012016-01-01PRESTON POLLOCK PRESTON POLLOCK2017-10-16
0012015-01-01ALLAN SCROGGINS
0012015-01-012016-10-18
0012014-01-01NEAL D. JENSEN NEAL D. JENSEN2015-10-15
0012013-01-01JAMES R. CHILDERS
0012012-01-01JAMES R. CHILDERS
0012011-01-01JAMES R. CHILDERS
0012009-01-01JAMES R. CHILDERS

Plan Statistics for PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL

401k plan membership statisitcs for PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL

Measure Date Value
2022: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2022 401k membership
Market value of plan assets2022-12-31626,324
Acturial value of plan assets2022-12-31594,984
Funding target for retired participants and beneficiaries receiving payment2022-12-31419,809
Number of terminated vested participants2022-12-318
Fundng target for terminated vested participants2022-12-3175,219
Active participant vested funding target2022-12-310
Number of active participants2022-12-310
Total funding liabilities for active participants2022-12-310
Total participant count2022-12-3134
Total funding target for all participants2022-12-31495,028
Balance at beginning of prior year after applicable adjustments2022-12-310
Prefunding balance at beginning of prior year after applicable adjustments2022-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2022-12-310
Prefunding balanced used to offset prior years funding requirement2022-12-310
Amount remaining of carryover balance2022-12-310
Amount remaining of prefunding balance2022-12-310
Present value of excess contributions2022-12-3125,597
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2022-12-3126,979
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2022-12-310
Reductions in caryover balances due to elections or deemed elections2022-12-310
Reductions in prefunding balances due to elections or deemed elections2022-12-310
Balance of carryovers at beginning of current year2022-12-310
Balance of prefunding at beginning of current year2022-12-310
Total employer contributions2022-12-310
Total employee contributions2022-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2022-12-310
Contributions made to avoid restrictions adjusted to valuation date2022-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2022-12-310
Unpaid minimum required contributions for all prior years2022-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2022-12-310
Remaining amount of unpaid minimum required contributions2022-12-310
Minimum required contributions for current year target normal cost2022-12-3120,000
Net shortfall amortization installment of oustanding balance2022-12-310
Waiver amortization installment2022-12-310
Total funding amount beforereflecting carryover/prefunding balances2022-12-310
Carryover balance elected to use to offset funding requirement2022-12-310
Prefunding balance elected to use to offset funding requirement2022-12-310
Additional cash requirement2022-12-310
Contributions allocatedtoward minimum required contributions for current year2022-12-310
Unpaid minimum required contributions for current year2022-12-310
Unpaid minimum required contributions for all years2022-12-310
Total participants, beginning-of-year2022-01-0134
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-0125
Number of other retired or separated participants entitled to future benefits2022-01-017
Total of all active and inactive participants2022-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2021 401k membership
Market value of plan assets2021-12-31611,026
Acturial value of plan assets2021-12-31572,815
Funding target for retired participants and beneficiaries receiving payment2021-12-31456,011
Number of terminated vested participants2021-12-318
Fundng target for terminated vested participants2021-12-3168,370
Active participant vested funding target2021-12-310
Number of active participants2021-12-310
Total funding liabilities for active participants2021-12-310
Total participant count2021-12-3135
Total funding target for all participants2021-12-31524,381
Balance at beginning of prior year after applicable adjustments2021-12-310
Prefunding balance at beginning of prior year after applicable adjustments2021-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2021-12-310
Prefunding balanced used to offset prior years funding requirement2021-12-310
Amount remaining of carryover balance2021-12-310
Amount remaining of prefunding balance2021-12-310
Present value of excess contributions2021-12-31807
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2021-12-31848
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2021-12-310
Reductions in caryover balances due to elections or deemed elections2021-12-310
Reductions in prefunding balances due to elections or deemed elections2021-12-310
Balance of carryovers at beginning of current year2021-12-310
Balance of prefunding at beginning of current year2021-12-310
Total employer contributions2021-12-3126,307
Total employee contributions2021-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2021-12-310
Contributions made to avoid restrictions adjusted to valuation date2021-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2021-12-3125,597
Liquidity shortfalls end of Q12021-12-310
Liquidity shortfalls end of Q22021-12-310
Liquidity shortfalls end of Q32021-12-310
Liquidity shortfalls end of Q42021-12-310
Unpaid minimum required contributions for all prior years2021-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2021-12-310
Remaining amount of unpaid minimum required contributions2021-12-310
Minimum required contributions for current year target normal cost2021-12-3120,000
Net shortfall amortization installment of oustanding balance2021-12-310
Waiver amortization installment2021-12-310
Total funding amount beforereflecting carryover/prefunding balances2021-12-310
Carryover balance elected to use to offset funding requirement2021-12-310
Prefunding balance elected to use to offset funding requirement2021-12-310
Additional cash requirement2021-12-310
Contributions allocatedtoward minimum required contributions for current year2021-12-3125,597
Unpaid minimum required contributions for current year2021-12-310
Unpaid minimum required contributions for all years2021-12-310
Total participants, beginning-of-year2021-01-0135
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-0126
Number of other retired or separated participants entitled to future benefits2021-01-018
Total of all active and inactive participants2021-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2020 401k membership
Market value of plan assets2020-12-31593,778
Acturial value of plan assets2020-12-31581,177
Funding target for retired participants and beneficiaries receiving payment2020-12-31522,387
Number of terminated vested participants2020-12-319
Fundng target for terminated vested participants2020-12-3182,073
Active participant vested funding target2020-12-310
Number of active participants2020-12-310
Total funding liabilities for active participants2020-12-310
Total participant count2020-12-3138
Total funding target for all participants2020-12-31604,460
Balance at beginning of prior year after applicable adjustments2020-12-310
Prefunding balance at beginning of prior year after applicable adjustments2020-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2020-12-310
Prefunding balanced used to offset prior years funding requirement2020-12-310
Amount remaining of carryover balance2020-12-310
Amount remaining of prefunding balance2020-12-310
Present value of excess contributions2020-12-315
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2020-12-315
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2020-12-310
Reductions in caryover balances due to elections or deemed elections2020-12-310
Reductions in prefunding balances due to elections or deemed elections2020-12-310
Balance of carryovers at beginning of current year2020-12-310
Balance of prefunding at beginning of current year2020-12-310
Total employer contributions2020-12-3137,006
Total employee contributions2020-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2020-12-310
Contributions made to avoid restrictions adjusted to valuation date2020-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2020-12-3135,881
Liquidity shortfalls end of Q12020-12-310
Liquidity shortfalls end of Q22020-12-310
Liquidity shortfalls end of Q32020-12-310
Liquidity shortfalls end of Q42020-12-310
Unpaid minimum required contributions for all prior years2020-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2020-12-310
Remaining amount of unpaid minimum required contributions2020-12-310
Minimum required contributions for current year target normal cost2020-12-3125,000
Net shortfall amortization installment of oustanding balance2020-12-3123,283
Waiver amortization installment2020-12-310
Total funding amount beforereflecting carryover/prefunding balances2020-12-3135,074
Carryover balance elected to use to offset funding requirement2020-12-310
Prefunding balance elected to use to offset funding requirement2020-12-310
Additional cash requirement2020-12-3135,074
Contributions allocatedtoward minimum required contributions for current year2020-12-3135,881
Unpaid minimum required contributions for current year2020-12-310
Unpaid minimum required contributions for all years2020-12-310
Total participants, beginning-of-year2020-01-0138
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-0127
Number of other retired or separated participants entitled to future benefits2020-01-018
Total of all active and inactive participants2020-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2019 401k membership
Market value of plan assets2019-12-31561,060
Acturial value of plan assets2019-12-31589,652
Funding target for retired participants and beneficiaries receiving payment2019-12-31570,278
Number of terminated vested participants2019-12-3111
Fundng target for terminated vested participants2019-12-3198,182
Active participant vested funding target2019-12-310
Number of active participants2019-12-310
Total funding liabilities for active participants2019-12-310
Total participant count2019-12-3143
Total funding target for all participants2019-12-31668,460
Balance at beginning of prior year after applicable adjustments2019-12-310
Prefunding balance at beginning of prior year after applicable adjustments2019-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2019-12-310
Prefunding balanced used to offset prior years funding requirement2019-12-310
Amount remaining of carryover balance2019-12-310
Amount remaining of prefunding balance2019-12-310
Present value of excess contributions2019-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2019-12-310
Reductions in caryover balances due to elections or deemed elections2019-12-310
Reductions in prefunding balances due to elections or deemed elections2019-12-310
Balance of carryovers at beginning of current year2019-12-310
Balance of prefunding at beginning of current year2019-12-310
Total employer contributions2019-12-3144,225
Total employee contributions2019-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2019-12-310
Contributions made to avoid restrictions adjusted to valuation date2019-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-12-3142,446
Liquidity shortfalls end of Q12019-12-310
Liquidity shortfalls end of Q22019-12-310
Liquidity shortfalls end of Q32019-12-310
Liquidity shortfalls end of Q42019-12-310
Unpaid minimum required contributions for all prior years2019-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-12-310
Remaining amount of unpaid minimum required contributions2019-12-310
Minimum required contributions for current year target normal cost2019-12-3125,000
Net shortfall amortization installment of oustanding balance2019-12-3178,808
Waiver amortization installment2019-12-310
Total funding amount beforereflecting carryover/prefunding balances2019-12-3142,441
Carryover balance elected to use to offset funding requirement2019-12-310
Prefunding balance elected to use to offset funding requirement2019-12-310
Additional cash requirement2019-12-3142,441
Contributions allocatedtoward minimum required contributions for current year2019-12-3142,446
Unpaid minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for all years2019-12-310
Total participants, beginning-of-year2019-01-0143
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-0129
Number of other retired or separated participants entitled to future benefits2019-01-019
Total of all active and inactive participants2019-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2018 401k membership
Market value of plan assets2018-12-31648,890
Acturial value of plan assets2018-12-31648,890
Funding target for retired participants and beneficiaries receiving payment2018-12-31574,364
Number of terminated vested participants2018-12-3112
Fundng target for terminated vested participants2018-12-3197,151
Active participant vested funding target2018-12-310
Number of active participants2018-12-310
Total funding liabilities for active participants2018-12-310
Total participant count2018-12-3145
Total funding target for all participants2018-12-31671,515
Balance at beginning of prior year after applicable adjustments2018-12-310
Prefunding balance at beginning of prior year after applicable adjustments2018-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2018-12-310
Prefunding balanced used to offset prior years funding requirement2018-12-310
Amount remaining of carryover balance2018-12-310
Amount remaining of prefunding balance2018-12-310
Present value of excess contributions2018-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-12-310
Reductions in caryover balances due to elections or deemed elections2018-12-310
Reductions in prefunding balances due to elections or deemed elections2018-12-310
Balance of carryovers at beginning of current year2018-12-310
Balance of prefunding at beginning of current year2018-12-310
Total employer contributions2018-12-3138,791
Total employee contributions2018-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2018-12-310
Contributions made to avoid restrictions adjusted to valuation date2018-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-12-3137,633
Liquidity shortfalls end of Q12018-12-310
Liquidity shortfalls end of Q22018-12-310
Liquidity shortfalls end of Q32018-12-310
Liquidity shortfalls end of Q42018-12-310
Unpaid minimum required contributions for all prior years2018-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-12-310
Remaining amount of unpaid minimum required contributions2018-12-310
Minimum required contributions for current year target normal cost2018-12-3125,000
Net shortfall amortization installment of oustanding balance2018-12-3122,625
Waiver amortization installment2018-12-310
Total funding amount beforereflecting carryover/prefunding balances2018-12-3137,633
Carryover balance elected to use to offset funding requirement2018-12-310
Prefunding balance elected to use to offset funding requirement2018-12-310
Additional cash requirement2018-12-3137,633
Contributions allocatedtoward minimum required contributions for current year2018-12-3137,633
Unpaid minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for all years2018-12-310
Total participants, beginning-of-year2018-01-0145
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-0132
Number of other retired or separated participants entitled to future benefits2018-01-0111
Total of all active and inactive participants2018-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2017 401k membership
Market value of plan assets2017-12-31612,203
Acturial value of plan assets2017-12-31612,203
Funding target for retired participants and beneficiaries receiving payment2017-12-31591,300
Number of terminated vested participants2017-12-3113
Fundng target for terminated vested participants2017-12-3193,673
Active participant vested funding target2017-12-310
Number of active participants2017-12-310
Total funding liabilities for active participants2017-12-310
Total participant count2017-12-3146
Total funding target for all participants2017-12-31684,973
Balance at beginning of prior year after applicable adjustments2017-12-310
Prefunding balance at beginning of prior year after applicable adjustments2017-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2017-12-310
Prefunding balanced used to offset prior years funding requirement2017-12-310
Amount remaining of carryover balance2017-12-310
Amount remaining of prefunding balance2017-12-310
Present value of excess contributions2017-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2017-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2017-12-310
Reductions in caryover balances due to elections or deemed elections2017-12-310
Reductions in prefunding balances due to elections or deemed elections2017-12-310
Balance of carryovers at beginning of current year2017-12-310
Balance of prefunding at beginning of current year2017-12-310
Total employer contributions2017-12-3149,218
Total employee contributions2017-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2017-12-310
Contributions made to avoid restrictions adjusted to valuation date2017-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2017-12-3147,710
Liquidity shortfalls end of Q12017-12-310
Liquidity shortfalls end of Q22017-12-310
Liquidity shortfalls end of Q32017-12-310
Liquidity shortfalls end of Q42017-12-310
Unpaid minimum required contributions for all prior years2017-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2017-12-310
Remaining amount of unpaid minimum required contributions2017-12-310
Minimum required contributions for current year target normal cost2017-12-3125,000
Net shortfall amortization installment of oustanding balance2017-12-3172,770
Waiver amortization installment2017-12-310
Total funding amount beforereflecting carryover/prefunding balances2017-12-3147,710
Carryover balance elected to use to offset funding requirement2017-12-310
Prefunding balance elected to use to offset funding requirement2017-12-310
Additional cash requirement2017-12-3147,710
Contributions allocatedtoward minimum required contributions for current year2017-12-3147,710
Unpaid minimum required contributions for current year2017-12-310
Unpaid minimum required contributions for all years2017-12-310
Total participants, beginning-of-year2017-01-0146
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-0133
Number of other retired or separated participants entitled to future benefits2017-01-0112
Total of all active and inactive participants2017-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2016 401k membership
Market value of plan assets2016-12-31598,498
Acturial value of plan assets2016-12-31598,498
Funding target for retired participants and beneficiaries receiving payment2016-12-31620,411
Number of terminated vested participants2016-12-3113
Fundng target for terminated vested participants2016-12-3185,257
Active participant vested funding target2016-12-310
Number of active participants2016-12-310
Total funding liabilities for active participants2016-12-310
Total participant count2016-12-3147
Total funding target for all participants2016-12-31705,668
Balance at beginning of prior year after applicable adjustments2016-12-31283
Prefunding balance at beginning of prior year after applicable adjustments2016-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2016-12-31283
Prefunding balanced used to offset prior years funding requirement2016-12-310
Amount remaining of carryover balance2016-12-310
Amount remaining of prefunding balance2016-12-310
Present value of excess contributions2016-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2016-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2016-12-310
Reductions in caryover balances due to elections or deemed elections2016-12-310
Reductions in prefunding balances due to elections or deemed elections2016-12-310
Balance of carryovers at beginning of current year2016-12-310
Balance of prefunding at beginning of current year2016-12-310
Total employer contributions2016-12-3168,818
Total employee contributions2016-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2016-12-310
Contributions made to avoid restrictions adjusted to valuation date2016-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2016-12-3166,209
Liquidity shortfalls end of Q12016-12-310
Liquidity shortfalls end of Q22016-12-310
Liquidity shortfalls end of Q32016-12-310
Liquidity shortfalls end of Q42016-12-310
Unpaid minimum required contributions for all prior years2016-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2016-12-310
Remaining amount of unpaid minimum required contributions2016-12-310
Minimum required contributions for current year target normal cost2016-12-3125,000
Net shortfall amortization installment of oustanding balance2016-12-31107,170
Waiver amortization installment2016-12-310
Total funding amount beforereflecting carryover/prefunding balances2016-12-3166,209
Carryover balance elected to use to offset funding requirement2016-12-310
Prefunding balance elected to use to offset funding requirement2016-12-310
Additional cash requirement2016-12-3166,209
Contributions allocatedtoward minimum required contributions for current year2016-12-3166,209
Unpaid minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for all years2016-12-310
Total participants, beginning-of-year2016-01-0147
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-0133
Number of other retired or separated participants entitled to future benefits2016-01-0113
Total of all active and inactive participants2016-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2015 401k membership
Total participants, beginning-of-year2015-01-0149
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-0134
Number of other retired or separated participants entitled to future benefits2015-01-0113
Total of all active and inactive participants2015-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2014 401k membership
Total participants, beginning-of-year2014-01-0150
Total number of active participants reported on line 7a of the Form 55002014-01-0135
Number of retired or separated participants receiving benefits2014-01-0114
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2013 401k membership
Total participants, beginning-of-year2013-01-0154
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-0135
Number of other retired or separated participants entitled to future benefits2013-01-0115
Total of all active and inactive participants2013-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2012 401k membership
Total participants, beginning-of-year2012-01-0155
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-0137
Number of other retired or separated participants entitled to future benefits2012-01-0117
Total of all active and inactive participants2012-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2011 401k membership
Total participants, beginning-of-year2011-01-0157
Total number of active participants reported on line 7a of the Form 55002011-01-010
Number of retired or separated participants receiving benefits2011-01-0137
Number of other retired or separated participants entitled to future benefits2011-01-0118
Total of all active and inactive participants2011-01-0155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2009 401k membership
Total participants, beginning-of-year2009-01-0171
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-0137
Number of other retired or separated participants entitled to future benefits2009-01-0122
Total of all active and inactive participants2009-01-0159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL

Measure Date Value
2022 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2022 401k financial data
Total income from all sources2022-12-31$-89,550
Expenses. Total of all expenses incurred2022-12-31$70,738
Benefits paid (including direct rollovers)2022-12-31$50,159
Total plan assets at end of year2022-12-31$466,036
Total plan assets at beginning of year2022-12-31$626,324
Value of fidelity bond covering the plan2022-12-31$500,000
Other income received2022-12-31$-89,550
Net income (gross income less expenses)2022-12-31$-160,288
Net plan assets at end of year (total assets less liabilities)2022-12-31$466,036
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$626,324
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$20,579
2021 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2021 401k financial data
Total income from all sources2021-12-31$101,589
Expenses. Total of all expenses incurred2021-12-31$78,412
Benefits paid (including direct rollovers)2021-12-31$58,798
Total plan assets at end of year2021-12-31$626,324
Total plan assets at beginning of year2021-12-31$603,147
Value of fidelity bond covering the plan2021-12-31$500,000
Other income received2021-12-31$67,390
Net income (gross income less expenses)2021-12-31$23,177
Net plan assets at end of year (total assets less liabilities)2021-12-31$626,324
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$603,147
Total contributions received or receivable from employer(s)2021-12-31$34,199
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$19,614
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2020 401k financial data
Total income from all sources2020-12-31$109,185
Expenses. Total of all expenses incurred2020-12-31$84,064
Benefits paid (including direct rollovers)2020-12-31$59,930
Total plan assets at end of year2020-12-31$603,147
Total plan assets at beginning of year2020-12-31$578,026
Value of fidelity bond covering the plan2020-12-31$500,000
Other income received2020-12-31$64,073
Net income (gross income less expenses)2020-12-31$25,121
Net plan assets at end of year (total assets less liabilities)2020-12-31$603,147
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$578,026
Total contributions received or receivable from employer(s)2020-12-31$45,112
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$24,134
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2019 401k financial data
Total income from all sources2019-12-31$120,153
Expenses. Total of all expenses incurred2019-12-31$96,733
Benefits paid (including direct rollovers)2019-12-31$71,435
Total plan assets at end of year2019-12-31$578,026
Total plan assets at beginning of year2019-12-31$554,606
Value of fidelity bond covering the plan2019-12-31$500,000
Other income received2019-12-31$77,172
Net income (gross income less expenses)2019-12-31$23,420
Net plan assets at end of year (total assets less liabilities)2019-12-31$578,026
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$554,606
Total contributions received or receivable from employer(s)2019-12-31$42,981
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25,298
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2018 401k financial data
Total income from all sources2018-12-31$7,760
Expenses. Total of all expenses incurred2018-12-31$96,684
Benefits paid (including direct rollovers)2018-12-31$73,036
Total plan assets at end of year2018-12-31$554,606
Total plan assets at beginning of year2018-12-31$643,530
Value of fidelity bond covering the plan2018-12-31$500,000
Other income received2018-12-31$-29,941
Net income (gross income less expenses)2018-12-31$-88,924
Net plan assets at end of year (total assets less liabilities)2018-12-31$554,606
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$643,530
Total contributions received or receivable from employer(s)2018-12-31$37,701
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$23,648
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2017 401k financial data
Total income from all sources2017-12-31$150,202
Expenses. Total of all expenses incurred2017-12-31$102,093
Benefits paid (including direct rollovers)2017-12-31$76,447
Total plan assets at end of year2017-12-31$643,530
Total plan assets at beginning of year2017-12-31$595,421
Value of fidelity bond covering the plan2017-12-31$500,000
Other income received2017-12-31$89,458
Net income (gross income less expenses)2017-12-31$48,109
Net plan assets at end of year (total assets less liabilities)2017-12-31$643,530
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$595,421
Total contributions received or receivable from employer(s)2017-12-31$60,744
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$25,646
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2016 401k financial data
Total income from all sources2016-12-31$124,361
Expenses. Total of all expenses incurred2016-12-31$102,772
Benefits paid (including direct rollovers)2016-12-31$80,452
Total plan assets at end of year2016-12-31$595,421
Total plan assets at beginning of year2016-12-31$573,832
Value of fidelity bond covering the plan2016-12-31$500,000
Other income received2016-12-31$46,238
Net income (gross income less expenses)2016-12-31$21,589
Net plan assets at end of year (total assets less liabilities)2016-12-31$595,421
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$573,832
Total contributions received or receivable from employer(s)2016-12-31$78,123
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$22,320
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2015 401k financial data
Total income from all sources2015-12-31$72,003
Expenses. Total of all expenses incurred2015-12-31$107,532
Benefits paid (including direct rollovers)2015-12-31$87,667
Total plan assets at end of year2015-12-31$573,832
Total plan assets at beginning of year2015-12-31$609,361
Value of fidelity bond covering the plan2015-12-31$500,000
Other income received2015-12-31$4,336
Net income (gross income less expenses)2015-12-31$-35,529
Net plan assets at end of year (total assets less liabilities)2015-12-31$573,832
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$609,361
Total contributions received or receivable from employer(s)2015-12-31$67,667
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$19,865
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2014 401k financial data
Transfers to/from the plan2014-12-31$-49,669
Total income from all sources2014-12-31$141,629
Expenses. Total of all expenses incurred2014-12-31$106,104
Benefits paid (including direct rollovers)2014-12-31$87,059
Total plan assets at end of year2014-12-31$609,361
Total plan assets at beginning of year2014-12-31$623,505
Value of fidelity bond covering the plan2014-12-31$500,000
Other income received2014-12-31$26,538
Net income (gross income less expenses)2014-12-31$35,525
Net plan assets at end of year (total assets less liabilities)2014-12-31$609,361
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$623,505
Total contributions received or receivable from employer(s)2014-12-31$115,091
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$19,045
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2013 401k financial data
Total income from all sources2013-12-31$111,954
Expenses. Total of all expenses incurred2013-12-31$113,544
Benefits paid (including direct rollovers)2013-12-31$100,192
Total plan assets at end of year2013-12-31$623,505
Total plan assets at beginning of year2013-12-31$625,095
Value of fidelity bond covering the plan2013-12-31$500,000
Other income received2013-12-31$38,159
Net income (gross income less expenses)2013-12-31$-1,590
Net plan assets at end of year (total assets less liabilities)2013-12-31$623,505
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$625,095
Total contributions received or receivable from employer(s)2013-12-31$73,795
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$13,352
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2012 401k financial data
Total income from all sources2012-12-31$132,349
Expenses. Total of all expenses incurred2012-12-31$117,779
Benefits paid (including direct rollovers)2012-12-31$100,008
Total plan assets at end of year2012-12-31$625,095
Total plan assets at beginning of year2012-12-31$610,525
Value of fidelity bond covering the plan2012-12-31$500,000
Other income received2012-12-31$68,332
Net income (gross income less expenses)2012-12-31$14,570
Net plan assets at end of year (total assets less liabilities)2012-12-31$625,095
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$610,525
Total contributions received or receivable from employer(s)2012-12-31$64,017
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$17,771
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2011 401k financial data
Total income from all sources2011-12-31$75,612
Expenses. Total of all expenses incurred2011-12-31$159,465
Benefits paid (including direct rollovers)2011-12-31$141,176
Total plan assets at end of year2011-12-31$610,525
Total plan assets at beginning of year2011-12-31$694,378
Value of fidelity bond covering the plan2011-12-31$500,000
Other income received2011-12-31$-29,354
Net income (gross income less expenses)2011-12-31$-83,853
Net plan assets at end of year (total assets less liabilities)2011-12-31$610,525
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$694,378
Total contributions received or receivable from employer(s)2011-12-31$104,966
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$18,289
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2010 401k financial data
Total income from all sources2010-12-31$94,686
Expenses. Total of all expenses incurred2010-12-31$113,629
Benefits paid (including direct rollovers)2010-12-31$99,165
Total plan assets at end of year2010-12-31$694,378
Total plan assets at beginning of year2010-12-31$713,321
Value of fidelity bond covering the plan2010-12-31$500,000
Other income received2010-12-31$81,888
Net income (gross income less expenses)2010-12-31$-18,943
Net plan assets at end of year (total assets less liabilities)2010-12-31$694,378
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$713,321
Total contributions received or receivable from employer(s)2010-12-31$12,798
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$14,464
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL

2022: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: PENSION PLAN FOR DAYS PAY EMPLOYEES COBRE VALLEY COMMUNITY HOSPITAL 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered32
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,023
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,023
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered34
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,516
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,516
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered35
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,729
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,729
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered38
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,211
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,211
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered43
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,462
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,462
Insurance broker organization code?3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered45
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,803
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $1,803
Insurance broker organization code?3
Insurance broker nameDEREK SKAINS
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,011
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,011
Insurance broker organization code?3
Insurance broker nameDEREK SKAINS
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered49
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,062
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,062
Insurance broker organization code?3
Insurance broker nameDEREK SKAINS
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered50
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,544
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,544
Insurance broker organization code?3
Insurance broker nameDEREK SKAINS
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered54
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,584
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,584
Insurance broker organization code?3
Insurance broker nameDEREK SKAINS
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered55
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,527
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number17362
Policy instance 1
Insurance contract or identification number17362
Number of Individuals Covered57
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,178
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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