401k Plan data: ST. LUKE'S HOSPITAL CNA PENSION PLAN plan

ST. LUKE'S HOSPITAL CNA PENSION PLAN 401k Plan overview

Plan Name	ST. LUKE'S HOSPITAL CNA PENSION PLAN
Plan identification number	015

ST. LUKE'S HOSPITAL CNA PENSION PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
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.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SUTTER BAY HOSPITALS has sponsored the creation of one or more 401k plans.

Company Name: SUTTER BAY HOSPITALS

Employer identification number (EIN): 940562680

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about SUTTER BAY HOSPITALS

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0015273

More information about SUTTER BAY HOSPITALS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. LUKE'S HOSPITAL CNA PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
015 2019-01-01
015 2018-01-01
015 2017-01-01 VICTORIA FLEMMING
015 2016-01-01 VICTORIA FLEMMING
015 2015-01-01 VICTORIA FLEMMING
015 2014-01-01 VICTORIA FLEMMING
015 2013-01-01 VICTORIA FLEMMING
015 2012-01-01 VICTORIA FLEMMING

Plan Statistics for ST. LUKE'S HOSPITAL CNA PENSION PLAN

401k plan membership statisitcs for ST. LUKE'S HOSPITAL CNA PENSION PLAN

Measure Date Value
2019: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 52
Number of retired or separated participants receiving benefits 2018-01-01 11
Number of other retired or separated participants entitled to future benefits 2018-01-01 84
Total of all active and inactive participants 2018-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 148
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 72
Number of retired or separated participants receiving benefits 2017-01-01 11
Number of other retired or separated participants entitled to future benefits 2017-01-01 75
Total of all active and inactive participants 2017-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 159
Number of participants with account balances 2017-01-01 159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 87
Number of retired or separated participants receiving benefits 2016-01-01 3
Number of other retired or separated participants entitled to future benefits 2016-01-01 74
Total of all active and inactive participants 2016-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 165
Number of participants with account balances 2016-01-01 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 97
Number of retired or separated participants receiving benefits 2015-01-01 3
Number of other retired or separated participants entitled to future benefits 2015-01-01 72
Total of all active and inactive participants 2015-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 173
Number of participants with account balances 2015-01-01 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 104
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 78
Total of all active and inactive participants 2014-01-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 182
Number of participants with account balances 2014-01-01 182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 106
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 79
Total of all active and inactive participants 2013-01-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 185
Number of participants with account balances 2013-01-01 185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 115
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 76
Total of all active and inactive participants 2012-01-01 191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 191
Number of participants with account balances 2012-01-01 191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2019: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	52
Number of retired or separated participants receiving benefits	2018-01-01	11
Number of other retired or separated participants entitled to future benefits	2018-01-01	84
Total of all active and inactive participants	2018-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	148
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	72
Number of retired or separated participants receiving benefits	2017-01-01	11
Number of other retired or separated participants entitled to future benefits	2017-01-01	75
Total of all active and inactive participants	2017-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	159
Number of participants with account balances	2017-01-01	159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	87
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	74
Total of all active and inactive participants	2016-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	165
Number of participants with account balances	2016-01-01	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	97
Number of retired or separated participants receiving benefits	2015-01-01	3
Number of other retired or separated participants entitled to future benefits	2015-01-01	72
Total of all active and inactive participants	2015-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	173
Number of participants with account balances	2015-01-01	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	104
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	78
Total of all active and inactive participants	2014-01-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	182
Number of participants with account balances	2014-01-01	182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	106
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	79
Total of all active and inactive participants	2013-01-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	185
Number of participants with account balances	2013-01-01	185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	115
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	76
Total of all active and inactive participants	2012-01-01	191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	191
Number of participants with account balances	2012-01-01	191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on ST. LUKE'S HOSPITAL CNA PENSION PLAN

Measure	Date	Value
2019 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2019 401k financial data
Total transfer of assets from this plan	2019-11-30	$1,141,603
Total income from all sources (including contributions)	2019-11-30	$135,359
Total of all expenses incurred	2019-11-30	$107,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-11-30	$107,235
Value of total assets at end of year	2019-11-30	$0
Value of total assets at beginning of year	2019-11-30	$1,113,479
Total interest from all sources	2019-11-30	$13,253
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-11-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-11-30	$0
Was this plan covered by a fidelity bond	2019-11-30	Yes
Value of fidelity bond cover	2019-11-30	$10,000,000
If this is an individual account plan, was there a blackout period	2019-11-30	No
Were there any nonexempt tranactions with any party-in-interest	2019-11-30	No
Participant contributions at end of year	2019-11-30	$0
Participant contributions at beginning of year	2019-11-30	$665
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-11-30	No
Value of net income/loss	2019-11-30	$28,124
Value of net assets at end of year (total assets less liabilities)	2019-11-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-11-30	$1,113,479
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-11-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-11-30	No
Were any leases to which the plan was party in default or uncollectible	2019-11-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-11-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-11-30	$595,261
Interest on participant loans	2019-11-30	$6
Interest earned on other investments	2019-11-30	$13,247
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-11-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-11-30	$517,553
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-11-30	$122,106
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-11-30	No
Was there a failure to transmit to the plan any participant contributions	2019-11-30	No
Has the plan failed to provide any benefit when due under the plan	2019-11-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-11-30	$107,235
Did the plan have assets held for investment	2019-11-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-11-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-11-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-11-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-11-30	Disclaimer
Accountancy firm name	2019-11-30	MOSS ADAMS, LLP
Accountancy firm EIN	2019-11-30	910189318
2018 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$-27,414
Total of all expenses incurred	2018-12-31	$159,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$159,522
Value of total assets at end of year	2018-12-31	$1,113,479
Value of total assets at beginning of year	2018-12-31	$1,300,415
Total interest from all sources	2018-12-31	$16,122
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Funding deficiency by the employer to the plan for this plan year	2018-12-31	$0
Minimum employer required contribution for this plan year	2018-12-31	$0
Amount contributed by the employer to the plan for this plan year	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Participant contributions at end of year	2018-12-31	$665
Participant contributions at beginning of year	2018-12-31	$7,884
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-186,936
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,113,479
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,300,415
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$595,261
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$729,378
Interest on participant loans	2018-12-31	$135
Interest earned on other investments	2018-12-31	$15,987
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$517,553
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$563,153
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-43,536
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$159,522
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2018-12-31	910189318
2017 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$153,044
Total of all expenses incurred	2017-12-31	$87,328
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$87,328
Value of total assets at end of year	2017-12-31	$1,300,415
Value of total assets at beginning of year	2017-12-31	$1,234,699
Total interest from all sources	2017-12-31	$16,869
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Funding deficiency by the employer to the plan for this plan year	2017-12-31	$0
Minimum employer required contribution for this plan year	2017-12-31	$0
Amount contributed by the employer to the plan for this plan year	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at end of year	2017-12-31	$7,884
Participant contributions at beginning of year	2017-12-31	$11,428
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$65,716
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,300,415
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,234,699
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$729,378
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$647,289
Interest on participant loans	2017-12-31	$272
Interest earned on other investments	2017-12-31	$16,597
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$563,153
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$575,982
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$136,175
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$87,328
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2017-12-31	910189318
2016 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$73,324
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$53,906
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$55,813
Expenses. Certain deemed distributions of participant loans	2016-12-31	$-1,907
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$0
Value of total assets at end of year	2016-12-31	$1,234,699
Value of total assets at beginning of year	2016-12-31	$1,215,281
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$17,835
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$11,428
Participant contributions at beginning of year	2016-12-31	$5,740
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$19,418
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,234,699
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,215,281
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$647,289
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$615,581
Interest on participant loans	2016-12-31	$380
Interest earned on other investments	2016-12-31	$17,455
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$575,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$593,960
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$55,489
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$55,813
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2016-12-31	910189318
2015 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$5,668
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$67,052
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$67,052
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$0
Value of total assets at end of year	2015-12-31	$1,215,281
Value of total assets at beginning of year	2015-12-31	$1,276,665
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$0
Total interest from all sources	2015-12-31	$17,933
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Funding deficiency by the employer to the plan for this plan year	2015-12-31	$0
Minimum employer required contribution for this plan year	2015-12-31	$0
Amount contributed by the employer to the plan for this plan year	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Participant contributions at end of year	2015-12-31	$5,740
Participant contributions at beginning of year	2015-12-31	$7,442
Other income not declared elsewhere	2015-12-31	$-3,921
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-61,384
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,215,281
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,276,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$615,581
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$674,077
Interest on participant loans	2015-12-31	$195
Interest earned on other investments	2015-12-31	$17,738
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$593,960
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$595,146
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-8,344
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$67,052
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2015-12-31	910189318
2014 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$41,077
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$53,677
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$48,597
Expenses. Certain deemed distributions of participant loans	2014-12-31	$5,080
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$1,276,665
Value of total assets at beginning of year	2014-12-31	$1,289,265
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$0
Total interest from all sources	2014-12-31	$18,213
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Participant contributions at end of year	2014-12-31	$7,442
Participant contributions at beginning of year	2014-12-31	$10,431
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-12,600
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,276,665
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,289,265
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$674,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$672,175
Interest on participant loans	2014-12-31	$359
Interest earned on other investments	2014-12-31	$17,854
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$595,146
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$606,659
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$22,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$48,597
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2014-12-31	910189318
2013 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$159,283
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$65,104
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$58,261
Expenses. Certain deemed distributions of participant loans	2013-12-31	$6,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$1,289,265
Value of total assets at beginning of year	2013-12-31	$1,195,086
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$18,364
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Participant contributions at end of year	2013-12-31	$10,431
Participant contributions at beginning of year	2013-12-31	$12,005
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$94,179
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,289,265
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,195,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$672,175
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$581,729
Interest on participant loans	2013-12-31	$468
Interest earned on other investments	2013-12-31	$17,896
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$606,659
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$601,352
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$140,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$58,261
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2013-12-31	910189318
2012 : ST. LUKE'S HOSPITAL CNA PENSION PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$69,260
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$7,718
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$8,029
Expenses. Certain deemed distributions of participant loans	2012-12-31	$-311
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$1,195,086
Value of total assets at beginning of year	2012-12-31	$1,133,544
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$17,839
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Participant contributions at end of year	2012-12-31	$12,005
Participant contributions at beginning of year	2012-12-31	$8,628
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$61,542
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,195,086
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,133,544
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$581,729
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$515,318
Interest on participant loans	2012-12-31	$287
Interest earned on other investments	2012-12-31	$17,552
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$601,352
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$609,598
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$51,421
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$8,029
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MOSS ADAMS, LLP
Accountancy firm EIN	2012-12-31	910189318

Form 5500 Responses for ST. LUKE'S HOSPITAL CNA PENSION PLAN

2019: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan is a collectively bargained plan	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: ST. LUKE'S HOSPITAL CNA PENSION PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-11-30
Total amount of commissions paid to insurance broker	USD $133
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $108
Insurance broker organization code?	3

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	159
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $198
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $170
Insurance broker organization code?	3
Insurance broker name	FREEMAN, CARNELL A

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	173
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $165
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $149
Insurance broker organization code?	3
Insurance broker name	CREECH, JOHN D

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	182
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $402
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $345
Insurance broker organization code?	3
Insurance broker name	FREEMAN, CARNELL A.

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	185
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $389
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $339
Insurance broker organization code?	3
Insurance broker name	FREEMAN, CARNELL A.

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

Policy contract number

04867

Policy instance

Insurance contract or identification number	04867
Number of Individuals Covered	191
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $417
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $233
Insurance broker organization code?	3
Insurance broker name	FREEMAN, CARNELL A.

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Company Name:	SUTTER BAY HOSPITALS
Employer identification number (EIN):	940562680
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0015273