401k Plan data: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN plan

JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 401k Plan overview

Plan Name	JOHNSON MEMORIAL HOSPITAL 403(B) PLAN
Plan identification number	002

JOHNSON MEMORIAL HOSPITAL 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.

401k Sponsoring company profile

JOHNSON MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: JOHNSON MEMORIAL HOSPITAL

Employer identification number (EIN): 060646696

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about JOHNSON MEMORIAL HOSPITAL

Jurisdiction of Incorporation: Indiana Secretary of State

Incorporation Date:

Company Identification Number: 012021500155

More information about JOHNSON MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHNSON MEMORIAL HOSPITAL 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-01-01 STUART ROSENBERG 2021-06-07
002 2019-01-01 STUART ROSENBERG 2020-04-18
002 2018-01-01 STUART ROSENBERG 2019-04-28
002 2017-01-01 STUART ROSENBERG
002 2016-01-01 STUART ROSENBERG
002 2015-01-01 DONNA MEGLIOLA
002 2014-01-01 DONNA MEGLIOLA
002 2013-01-01 DONNA MEGLIOLA
002 2012-01-01 DONNA MEGLIOLA
002 2011-01-01 DONNA MEGLIOLA
002 2010-01-01 DIANA ROSE
002 2009-01-01 DIANA ROSE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2020-01-01	STUART ROSENBERG	2021-06-07
002	2019-01-01	STUART ROSENBERG	2020-04-18
002	2018-01-01	STUART ROSENBERG	2019-04-28
002	2017-01-01	STUART ROSENBERG
002	2016-01-01	STUART ROSENBERG
002	2015-01-01	DONNA MEGLIOLA
002	2014-01-01	DONNA MEGLIOLA
002	2013-01-01	DONNA MEGLIOLA
002	2012-01-01	DONNA MEGLIOLA
002	2011-01-01	DONNA MEGLIOLA
002	2010-01-01	DIANA ROSE
002	2009-01-01	DIANA ROSE

Plan Statistics for JOHNSON MEMORIAL HOSPITAL 403(B) PLAN

401k plan membership statisitcs for JOHNSON MEMORIAL HOSPITAL 403(B) PLAN

Measure Date Value
2017: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 98
Total of all active and inactive participants 2017-01-01 99
Total participants 2017-01-01 99
Number of participants with account balances 2017-01-01 99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 756
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 112
Total of all active and inactive participants 2016-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 112
Number of participants with account balances 2016-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 719
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 642
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 113
Total of all active and inactive participants 2015-01-01 755
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 756
Number of participants with account balances 2015-01-01 356
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 597
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 598
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 120
Total of all active and inactive participants 2014-01-01 718
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 719
Number of participants with account balances 2014-01-01 365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 691
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 576
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 21
Total of all active and inactive participants 2013-01-01 597
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 597
Number of participants with account balances 2013-01-01 375
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 425
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 632
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 59
Total of all active and inactive participants 2012-01-01 691
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 691
Number of participants with account balances 2012-01-01 600
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 18
2011: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 459
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 412
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 13
Total of all active and inactive participants 2011-01-01 425
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 425
Number of participants with account balances 2011-01-01 400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2
2010: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 468
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 424
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 35
Total of all active and inactive participants 2010-01-01 459
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 459
Number of participants with account balances 2010-01-01 433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 10
2009: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 429
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 448
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 11
Total of all active and inactive participants 2009-01-01 459
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 459
Number of participants with account balances 2009-01-01 380
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 9

Measure	Date	Value
2017: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	98
Total of all active and inactive participants	2017-01-01	99
Total participants	2017-01-01	99
Number of participants with account balances	2017-01-01	99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	756
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	112
Total of all active and inactive participants	2016-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	112
Number of participants with account balances	2016-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	719
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	642
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	113
Total of all active and inactive participants	2015-01-01	755
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	756
Number of participants with account balances	2015-01-01	356
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	597
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	598
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	120
Total of all active and inactive participants	2014-01-01	718
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	719
Number of participants with account balances	2014-01-01	365
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	691
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	576
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	21
Total of all active and inactive participants	2013-01-01	597
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	597
Number of participants with account balances	2013-01-01	375
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	425
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	632
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	59
Total of all active and inactive participants	2012-01-01	691
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	691
Number of participants with account balances	2012-01-01	600
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	18
2011: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	459
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	412
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	13
Total of all active and inactive participants	2011-01-01	425
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	425
Number of participants with account balances	2011-01-01	400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2
2010: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	468
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	424
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	35
Total of all active and inactive participants	2010-01-01	459
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	459
Number of participants with account balances	2010-01-01	433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	10
2009: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	429
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	448
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	11
Total of all active and inactive participants	2009-01-01	459
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	459
Number of participants with account balances	2009-01-01	380
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	9

Financial Data on JOHNSON MEMORIAL HOSPITAL 403(B) PLAN

Measure	Date	Value
2017 : JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 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	$341,992
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$729,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$729,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$2,506,394
Value of total assets at beginning of year	2017-12-31	$2,893,637
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$9,774
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$129,917
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$129,917
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
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	$-387,243
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,506,394
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,893,637
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	$2,012,749
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,170,990
Interest earned on other investments	2017-12-31	$9,774
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$493,645
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$722,647
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$202,301
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	$729,235
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	WHITTLESEY PC
Accountancy firm EIN	2017-12-31	060903326
2016 : JOHNSON MEMORIAL HOSPITAL 403(B) 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	$-379,805
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$10,409,258
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$10,409,258
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$16,296
Value of total assets at end of year	2016-12-31	$2,893,637
Value of total assets at beginning of year	2016-12-31	$13,682,700
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$101,347
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$101,347
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$13,534
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$33,512
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	$-10,789,063
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,893,637
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$13,682,700
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	$2,170,990
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$10,230,259
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$722,647
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$3,411,899
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$-497,448
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	$2,762
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$7,030
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$10,409,258
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	WHITTLESEY & HADLEY, PC
Accountancy firm EIN	2016-12-31	060903326
2015 : JOHNSON MEMORIAL HOSPITAL 403(B) 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	$1,333,373
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,178,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,170,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,369,615
Value of total assets at end of year	2015-12-31	$13,682,700
Value of total assets at beginning of year	2015-12-31	$13,527,487
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,000
Total interest from all sources	2015-12-31	$28,777
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$696,470
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$696,470
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$930,584
Participant contributions at end of year	2015-12-31	$33,512
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$205,189
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	$155,213
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$13,682,700
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$13,527,487
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
Investment advisory and management fees	2015-12-31	$8,000
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$10,230,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$10,120,911
Interest earned on other investments	2015-12-31	$28,777
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,411,899
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$3,406,576
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-761,489
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
Contributions received in cash from employer	2015-12-31	$233,842
Employer contributions (assets) at end of year	2015-12-31	$7,030
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,170,160
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	WHITTLESEY & HADLEY, PC
Accountancy firm EIN	2015-12-31	060903326
2014 : JOHNSON MEMORIAL HOSPITAL 403(B) 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	$2,002,930
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,361,989
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,354,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,323,081
Value of total assets at end of year	2014-12-31	$13,527,487
Value of total assets at beginning of year	2014-12-31	$12,886,546
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$7,250
Total interest from all sources	2014-12-31	$55,097
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$784,113
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$784,113
Administrative expenses professional fees incurred	2014-12-31	$7,250
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$827,221
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$30,425
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$231,159
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
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	$640,941
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$13,527,487
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$12,886,546
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	$10,120,911
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$9,792,865
Interest earned on other investments	2014-12-31	$55,097
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$3,406,576
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$3,050,251
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-159,361
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
Contributions received in cash from employer	2014-12-31	$264,701
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$13,005
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,354,739
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	WHITTLESEY & HADLEY, PC
Accountancy firm EIN	2014-12-31	060903326
2013 : JOHNSON MEMORIAL HOSPITAL 403(B) 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	$40,778
Total income from all sources (including contributions)	2013-12-31	$3,170,742
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$821,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$812,957
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,270,728
Value of total assets at end of year	2013-12-31	$12,886,546
Value of total assets at beginning of year	2013-12-31	$10,577,779
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$8,240
Total interest from all sources	2013-12-31	$48,549
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$710,342
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$710,342
Administrative expenses professional fees incurred	2013-12-31	$8,240
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$938,742
Participant contributions at end of year	2013-12-31	$30,425
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$144,379
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$40,778
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	$2,349,545
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$12,886,546
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$10,537,001
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	$9,792,865
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$7,940,694
Interest earned on other investments	2013-12-31	$48,549
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$3,050,251
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,637,085
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,141,123
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
Contributions received in cash from employer	2013-12-31	$187,607
Employer contributions (assets) at end of year	2013-12-31	$13,005
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$812,957
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	WHITTLESEY & HADLEY, PC
Accountancy firm EIN	2013-12-31	060903326
2012 : JOHNSON MEMORIAL HOSPITAL 403(B) 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	$40,778
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$63,342
Total income from all sources (including contributions)	2012-12-31	$2,427,762
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$841,934
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$829,910
Value of total corrective distributions	2012-12-31	$3,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,401,513
Value of total assets at end of year	2012-12-31	$10,577,779
Value of total assets at beginning of year	2012-12-31	$9,014,515
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$8,085
Total interest from all sources	2012-12-31	$41,019
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$95,900
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$95,900
Administrative expenses professional fees incurred	2012-12-31	$8,085
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$978,460
Participant contributions at beginning of year	2012-12-31	$45,542
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$241,945
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$3,069
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$40,778
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$63,342
Total non interest bearing cash at beginning of year	2012-12-31	$9
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	$1,585,828
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$10,537,001
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$8,951,173
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	$7,940,694
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$6,254,827
Interest earned on other investments	2012-12-31	$41,016
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$532,388
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$532,388
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,637,085
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,164,114
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$889,330
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
Contributions received in cash from employer	2012-12-31	$181,108
Employer contributions (assets) at beginning of year	2012-12-31	$14,566
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$829,910
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	MAHONEY SABOL & COMPANY
Accountancy firm EIN	2012-12-31	061289571
2011 : JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$63,342
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$68,471
Total income from all sources (including contributions)	2011-12-31	$1,210,315
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$779,411
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$759,399
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,389,169
Value of total assets at end of year	2011-12-31	$9,014,515
Value of total assets at beginning of year	2011-12-31	$8,588,740
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$20,012
Total interest from all sources	2011-12-31	$38,337
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$166,238
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$166,238
Administrative expenses professional fees incurred	2011-12-31	$15,553
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$982,688
Participant contributions at end of year	2011-12-31	$45,542
Participant contributions at beginning of year	2011-12-31	$36,262
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$47,127
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$3,069
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$4,709
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$63,342
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$68,471
Administrative expenses (other) incurred	2011-12-31	$4,459
Total non interest bearing cash at end of year	2011-12-31	$9
Total non interest bearing cash at beginning of year	2011-12-31	$11
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$430,904
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,951,173
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,520,269
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$6,254,827
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$6,388,874
Interest earned on other investments	2011-12-31	$38,336
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$532,388
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$65,961
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$65,961
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,164,114
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,064,781
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-383,429
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$359,354
Employer contributions (assets) at end of year	2011-12-31	$14,566
Employer contributions (assets) at beginning of year	2011-12-31	$28,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$759,399
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MAHONEY SABOL & COMPANY, LLP
Accountancy firm EIN	2011-12-31	061289571
2010 : JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$68,471
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$25,440
Total income from all sources (including contributions)	2010-12-31	$2,754,599
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$394,890
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$391,896
Value of total corrective distributions	2010-12-31	$1,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,989,857
Value of total assets at end of year	2010-12-31	$8,588,740
Value of total assets at beginning of year	2010-12-31	$6,186,000
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,534
Total interest from all sources	2010-12-31	$44,042
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$131,091
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$131,091
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,058,151
Participant contributions at end of year	2010-12-31	$36,262
Participant contributions at beginning of year	2010-12-31	$40,546
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$148,929
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$4,709
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$3,728
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$68,471
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$25,440
Total non interest bearing cash at end of year	2010-12-31	$11
Total non interest bearing cash at beginning of year	2010-12-31	$11
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$2,359,709
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,520,269
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$6,160,560
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$6,388,874
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$4,615,819
Interest earned on other investments	2010-12-31	$44,040
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$65,961
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$19,880
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$19,880
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,064,781
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,481,400
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$589,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$782,777
Employer contributions (assets) at end of year	2010-12-31	$28,142
Employer contributions (assets) at beginning of year	2010-12-31	$24,616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$391,896
Contract administrator fees	2010-12-31	$1,534
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MAHONEY SOBOL & COMPANY, LLP
Accountancy firm EIN	2010-12-31	061289571
2009 : JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for JOHNSON MEMORIAL HOSPITAL 403(B) PLAN

2017: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 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	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: JOHNSON MEMORIAL HOSPITAL 403(B) 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 funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: JOHNSON MEMORIAL HOSPITAL 403(B) 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JOHNSON MEMORIAL HOSPITAL 403(B) 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 funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JOHNSON MEMORIAL HOSPITAL 403(B) 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 funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: JOHNSON MEMORIAL HOSPITAL 403(B) 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	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: JOHNSON MEMORIAL HOSPITAL 403(B) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	81
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	318
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	324
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	329
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	355
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	365
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
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	0
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

892579 - 007

Policy instance

Insurance contract or identification number	892579 - 007
Number of Individuals Covered	371
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
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	0
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?	Yes
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

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Company Name:	JOHNSON MEMORIAL HOSPITAL
Employer identification number (EIN):	060646696
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Indiana Secretary of State
Incorporation Date:
Company Identification Number:	012021500155