401k Plan data: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. plan

403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 401k Plan overview

Plan Name	403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.
Plan identification number	001

403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

NATIVE AMERICAN COMMUNITY HEALTH CENTER INC has sponsored the creation of one or more 401k plans.

Company Name: NATIVE AMERICAN COMMUNITY HEALTH CENTER INC

Employer identification number (EIN): 942540194

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about NATIVE AMERICAN COMMUNITY HEALTH CENTER INC

Jurisdiction of Incorporation: Arizona Corporation Commission

Incorporation Date:

Company Identification Number: 01177286

More information about NATIVE AMERICAN COMMUNITY HEALTH CENTER INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 CHARLENE WILLIAMS CHARLENE WILLIAMS 2018-10-01
001 2016-01-01 CHARLENE WILLIAMS CHARLENE WILLIAMS 2017-10-09
001 2015-01-01 CHARLENE WILLIAMS 2016-07-07 CHARLENE WILLIAMS 2016-07-07
001 2014-01-01 CHARLENE WILLIAMS 2015-09-28 CHARLENE WILLIAMS 2015-09-28
001 2013-01-01 CHARLENE WILLIAMS 2014-07-23 CHARLENE WILLIAMS 2014-07-23
001 2012-01-01 CHARLENE WILLIAMS 2013-10-14 CHARLENE WILLIAMS 2013-10-14
001 2011-01-01 ANNIE YAZZIE 2012-10-01 ANNIE YAZZIE 2012-10-01
001 2010-01-01 WALTER MURILLO 2011-07-25 WALTER MURILLO 2011-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	CHARLENE WILLIAMS		CHARLENE WILLIAMS	2018-10-01
001	2016-01-01	CHARLENE WILLIAMS		CHARLENE WILLIAMS	2017-10-09
001	2015-01-01	CHARLENE WILLIAMS	2016-07-07	CHARLENE WILLIAMS	2016-07-07
001	2014-01-01	CHARLENE WILLIAMS	2015-09-28	CHARLENE WILLIAMS	2015-09-28
001	2013-01-01	CHARLENE WILLIAMS	2014-07-23	CHARLENE WILLIAMS	2014-07-23
001	2012-01-01	CHARLENE WILLIAMS	2013-10-14	CHARLENE WILLIAMS	2013-10-14
001	2011-01-01	ANNIE YAZZIE	2012-10-01	ANNIE YAZZIE	2012-10-01
001	2010-01-01	WALTER MURILLO	2011-07-25	WALTER MURILLO	2011-07-25

Plan Statistics for 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.

401k plan membership statisitcs for 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.

Measure Date Value
2022: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 164
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 116
Total of all active and inactive participants 2022-01-01 281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 281
Number of participants with account balances 2022-01-01 225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 20
2021: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 251
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 66
Total of all active and inactive participants 2021-01-01 317
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 317
Number of participants with account balances 2021-01-01 250
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6
2020: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 200
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 69
Total of all active and inactive participants 2020-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 269
Number of participants with account balances 2020-01-01 222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 4
2019: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 100
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 69
Total of all active and inactive participants 2019-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 169
Number of participants with account balances 2019-01-01 164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 7
2018: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 88
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 69
Total of all active and inactive participants 2018-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 157
Number of participants with account balances 2018-01-01 152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 13
2017: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 99
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 47
Total of all active and inactive participants 2017-01-01 146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 147
Number of participants with account balances 2017-01-01 142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 85
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 45
Total of all active and inactive participants 2016-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 131
Number of participants with account balances 2016-01-01 127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8

Measure	Date	Value
2022: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	164
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	116
Total of all active and inactive participants	2022-01-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	281
Number of participants with account balances	2022-01-01	225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	20
2021: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	251
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	66
Total of all active and inactive participants	2021-01-01	317
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	317
Number of participants with account balances	2021-01-01	250
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6
2020: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	200
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	69
Total of all active and inactive participants	2020-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	269
Number of participants with account balances	2020-01-01	222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	4
2019: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	100
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	69
Total of all active and inactive participants	2019-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	169
Number of participants with account balances	2019-01-01	164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	7
2018: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	88
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	69
Total of all active and inactive participants	2018-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	157
Number of participants with account balances	2018-01-01	152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	13
2017: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	99
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	47
Total of all active and inactive participants	2017-01-01	146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	147
Number of participants with account balances	2017-01-01	142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	85
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	45
Total of all active and inactive participants	2016-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	131
Number of participants with account balances	2016-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8

Financial Data on 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.

Measure	Date	Value
2022 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-768,584
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$267,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$266,620
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$635,619
Value of total assets at end of year	2022-12-31	$6,761,714
Value of total assets at beginning of year	2022-12-31	$7,797,699
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$781
Total interest from all sources	2022-12-31	$1,509
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$392,243
Participant contributions at end of year	2022-12-31	$108,628
Participant contributions at beginning of year	2022-12-31	$140,555
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$781
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-1,035,985
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$6,761,714
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$7,797,699
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$6,378,480
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$7,385,652
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$1,509
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$274,606
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$271,492
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,405,712
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$243,376
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$266,620
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FESTER & CHAPMAN, PLLC
Accountancy firm EIN	2022-12-31	821455657
2021 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,830,867
Total of all expenses incurred	2021-12-31	$250,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$249,471
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$776,346
Value of total assets at end of year	2021-12-31	$7,797,699
Value of total assets at beginning of year	2021-12-31	$6,217,242
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$939
Total interest from all sources	2021-12-31	$3,808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	No
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$410,005
Participant contributions at end of year	2021-12-31	$140,555
Participant contributions at beginning of year	2021-12-31	$101,653
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$120,188
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$939
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,580,457
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$7,797,699
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,217,242
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$7,385,652
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,856,819
Interest on participant loans	2021-12-31	$0
Interest earned on other investments	2021-12-31	$3,808
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$271,492
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$258,770
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,050,713
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$246,153
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$249,471
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
2020 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,589,852
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$430,224
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$429,666
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$633,522
Value of total assets at end of year	2020-12-31	$6,217,242
Value of total assets at beginning of year	2020-12-31	$5,057,614
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$558
Total interest from all sources	2020-12-31	$3,867
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$300,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$357,435
Participant contributions at end of year	2020-12-31	$101,653
Participant contributions at beginning of year	2020-12-31	$118,452
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$56,429
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,159,628
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,217,242
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$5,057,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,856,819
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,568,191
Interest on participant loans	2020-12-31	$0
Interest earned on other investments	2020-12-31	$3,867
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$258,770
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$370,971
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$952,463
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$219,658
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$429,666
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	FESTER & CHAPMAN, PLLC
Accountancy firm EIN	2020-12-31	821455657
2019 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,462,869
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$525,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$524,432
Expenses. Certain deemed distributions of participant loans	2019-12-31	$956
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$575,052
Value of total assets at end of year	2019-12-31	$5,057,614
Value of total assets at beginning of year	2019-12-31	$4,120,663
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$530
Total interest from all sources	2019-12-31	$7,872
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$300,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$333,558
Participant contributions at end of year	2019-12-31	$118,452
Participant contributions at beginning of year	2019-12-31	$110,599
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$69,218
Other income not declared elsewhere	2019-12-31	$19
Administrative expenses (other) incurred	2019-12-31	$530
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$936,951
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,057,614
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,120,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,568,191
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,720,375
Interest on participant loans	2019-12-31	$0
Interest earned on other investments	2019-12-31	$7,872
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$370,971
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$289,689
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$879,926
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$172,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$524,432
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	FESTER & CHAPMAN
Accountancy firm EIN	2019-12-31	821455657
2018 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$294,339
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$238,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$236,331
Expenses. Certain deemed distributions of participant loans	2018-12-31	$1,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$620,989
Value of total assets at end of year	2018-12-31	$4,120,663
Value of total assets at beginning of year	2018-12-31	$4,064,355
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$451
Total interest from all sources	2018-12-31	$3,852
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
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	$300,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$359,445
Participant contributions at end of year	2018-12-31	$110,599
Participant contributions at beginning of year	2018-12-31	$109,991
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$66,858
Other income not declared elsewhere	2018-12-31	$239
Administrative expenses (other) incurred	2018-12-31	$451
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	$56,308
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,120,663
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,064,355
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	$3,720,375
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,680,815
Interest on participant loans	2018-12-31	$0
Interest earned on other investments	2018-12-31	$3,852
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$289,689
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$273,549
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-330,741
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$194,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$236,331
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	FESTER & CHAPMAN
Accountancy firm EIN	2018-12-31	821455657
2017 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,097,605
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$230,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$230,274
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$579,694
Value of total assets at end of year	2017-12-31	$4,064,355
Value of total assets at beginning of year	2017-12-31	$3,197,496
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$472
Total interest from all sources	2017-12-31	$3,630
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
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	$300,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$346,675
Participant contributions at end of year	2017-12-31	$109,991
Participant contributions at beginning of year	2017-12-31	$99,859
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$29,543
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$472
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	$866,859
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,064,355
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,197,496
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	$3,680,815
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,907,742
Interest on participant loans	2017-12-31	$0
Interest earned on other investments	2017-12-31	$3,630
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$273,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$189,895
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$514,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$203,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$230,274
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	FESTER & CHAPMAN
Accountancy firm EIN	2017-12-31	821455657
2016 : 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 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	$847,932
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$182,676
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$182,174
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$600,278
Value of total assets at end of year	2016-12-31	$3,197,496
Value of total assets at beginning of year	2016-12-31	$2,532,240
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$502
Total interest from all sources	2016-12-31	$2,759
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	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$279,831
Participant contributions at end of year	2016-12-31	$99,859
Participant contributions at beginning of year	2016-12-31	$73,547
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$183,878
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$502
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	$665,256
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,197,496
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,532,240
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	$2,907,742
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,270,694
Interest on participant loans	2016-12-31	$0
Interest earned on other investments	2016-12-31	$2,759
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$189,895
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$187,999
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$244,895
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$136,569
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$182,174
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	FESTER & CHAPMAN
Accountancy firm EIN	2016-12-31	860494040

Form 5500 Responses for 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.

2022: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: 403(B) THRIFT PLAN OF NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777

Policy instance

Insurance contract or identification number	058777
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,675
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 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
Amount paid for insurance broker fees	2675
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777A

Policy instance

Insurance contract or identification number	058777A
Number of Individuals Covered	317
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,970
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 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 $0
Amount paid for insurance broker fees	1970
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777A

Policy instance

Insurance contract or identification number	058777A
Number of Individuals Covered	269
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,970
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 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 $0
Amount paid for insurance broker fees	1970
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777A

Policy instance

Insurance contract or identification number	058777A
Number of Individuals Covered	169
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $538
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 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 $0
Amount paid for insurance broker fees	538
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777A

Policy instance

Insurance contract or identification number	058777A
Number of Individuals Covered	157
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,679
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 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 $0
Amount paid for insurance broker fees	2679
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058777A

Policy instance

Insurance contract or identification number	058777A
Number of Individuals Covered	147
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,911
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 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 $0
Amount paid for insurance broker fees	2911
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	PHOENIX REGIONAL OFFICE

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Company Name:	NATIVE AMERICAN COMMUNITY HEALTH CENTER INC
Employer identification number (EIN):	942540194
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Arizona Corporation Commission
Incorporation Date:
Company Identification Number:	01177286