401k Plan data: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN plan

AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan Name	AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN
Plan identification number	002

AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY 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.
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

AMERICAN LUNG ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN LUNG ASSOCIATION

Employer identification number (EIN): 131632524

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

Additional information about AMERICAN LUNG ASSOCIATION

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2017-05-24

Company Identification Number: 132748096

Legal Registered Office Address: 3337 EDGEMONT RD

LAKE OSWEGO
United States of America (USA)
97035

More information about AMERICAN LUNG ASSOCIATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01 LAURA SCOTT 2022-10-14
002 2020-01-01 LAURA SCOTT 2021-10-14
002 2019-01-01 LAURA SCOTT 2020-10-12
002 2019-01-01 LAURA SCOTT 2021-10-14
002 2018-07-01 LAURA SCOTT 2019-10-04 LAURA SCOTT 2019-10-04
002 2018-01-01 LAURA SCOTT 2019-10-04
002 2017-07-01 LAURA SCOTT 2018-10-15 LAURA SCOTT 2018-10-15
002 2017-01-01 LAURA SCOTT 2018-10-11
002 2016-01-01 LAURA SCOTT 2017-10-12
002 2015-01-01 LAURA SCOTT 2016-09-13
002 2014-01-01 LAURA SCOTT 2015-10-06
002 2013-01-01 LAURA SCOTT 2014-10-13
002 2012-01-01 ADRIENNE GLASGOW
002 2012-01-01 LAURA SCOTT
002 2011-01-01 ADRIENNE GLASGOW
002 2010-01-01 ADRIENNE GLASGOW DANIEL GOLDWATER 2011-10-14
002 2009-01-01 ADRIENNE GLASGOW DANIEL GOLDWATER 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01	LAURA SCOTT	2022-10-14
002	2020-01-01	LAURA SCOTT	2021-10-14
002	2019-01-01	LAURA SCOTT	2020-10-12
002	2019-01-01	LAURA SCOTT	2021-10-14
002	2018-07-01	LAURA SCOTT	2019-10-04	LAURA SCOTT	2019-10-04
002	2018-01-01	LAURA SCOTT	2019-10-04
002	2017-07-01	LAURA SCOTT	2018-10-15	LAURA SCOTT	2018-10-15
002	2017-01-01	LAURA SCOTT	2018-10-11
002	2016-01-01	LAURA SCOTT	2017-10-12
002	2015-01-01	LAURA SCOTT	2016-09-13
002	2014-01-01	LAURA SCOTT	2015-10-06
002	2013-01-01	LAURA SCOTT	2014-10-13
002	2012-01-01	ADRIENNE GLASGOW
002	2012-01-01	LAURA SCOTT
002	2011-01-01	ADRIENNE GLASGOW
002	2010-01-01	ADRIENNE GLASGOW		DANIEL GOLDWATER	2011-10-14
002	2009-01-01	ADRIENNE GLASGOW		DANIEL GOLDWATER	2010-10-13

Plan Statistics for AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN

Measure Date Value
2012: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 48
Number of retired or separated participants receiving benefits 2012-01-01 25
Number of other retired or separated participants entitled to future benefits 2012-01-01 50
Total of all active and inactive participants 2012-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 3
Total participants 2012-01-01 126
Number of participants with account balances 2012-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 50
Number of retired or separated participants receiving benefits 2011-01-01 12
Number of other retired or separated participants entitled to future benefits 2011-01-01 95
Total of all active and inactive participants 2011-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 158
Number of participants with account balances 2011-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 48
Number of retired or separated participants receiving benefits 2010-01-01 4
Number of other retired or separated participants entitled to future benefits 2010-01-01 87
Total of all active and inactive participants 2010-01-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 140
Number of participants with account balances 2010-01-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 81
Number of retired or separated participants receiving benefits 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 84
Total of all active and inactive participants 2009-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 170
Number of participants with account balances 2009-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	48
Number of retired or separated participants receiving benefits	2012-01-01	25
Number of other retired or separated participants entitled to future benefits	2012-01-01	50
Total of all active and inactive participants	2012-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	3
Total participants	2012-01-01	126
Number of participants with account balances	2012-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	50
Number of retired or separated participants receiving benefits	2011-01-01	12
Number of other retired or separated participants entitled to future benefits	2011-01-01	95
Total of all active and inactive participants	2011-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	158
Number of participants with account balances	2011-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	48
Number of retired or separated participants receiving benefits	2010-01-01	4
Number of other retired or separated participants entitled to future benefits	2010-01-01	87
Total of all active and inactive participants	2010-01-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	140
Number of participants with account balances	2010-01-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	81
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	84
Total of all active and inactive participants	2009-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	170
Number of participants with account balances	2009-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN

Measure	Date	Value
2012 : AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$275,171
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$566,893
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$766,713
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$765,673
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$4,644,160
Value of total assets at beginning of year	2012-12-31	$5,119,151
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,040
Total interest from all sources	2012-12-31	$13,353
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$44,614
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	$44,614
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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
Other income not declared elsewhere	2012-12-31	$112,304
Administrative expenses (other) incurred	2012-12-31	$1,040
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	$-199,820
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,644,160
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,119,151
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	$3,487,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,905,715
Value of interest in pooled separate accounts at end of year	2012-12-31	$42,976
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$53,451
Interest earned on other investments	2012-12-31	$13,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$761,490
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$796,580
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$796,580
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$21
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$352,417
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$363,405
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$391,897
Net investment gain/loss from pooled separate accounts	2012-12-31	$4,725
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$765,673
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	GRANT THORNTON LLP
Accountancy firm EIN	2012-12-31	366055558
2011 : AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$352,478
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$133,919
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$367,524
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$365,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$229,751
Value of total assets at end of year	2011-12-31	$5,119,151
Value of total assets at beginning of year	2011-12-31	$5,705,234
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,997
Total interest from all sources	2011-12-31	$7,507
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$55,530
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	$55,530
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$229,751
Other income not declared elsewhere	2011-12-31	$7,363
Administrative expenses (other) incurred	2011-12-31	$1,997
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	$-233,605
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,119,151
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$5,705,234
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	$3,905,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,289,858
Value of interest in pooled separate accounts at end of year	2011-12-31	$53,451
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$40,568
Interest earned on other investments	2011-12-31	$7,489
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$796,580
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$933,131
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$933,131
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$18
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$363,405
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$441,677
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-172,136
Net investment gain/loss from pooled separate accounts	2011-12-31	$5,904
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$365,527
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	GRANT THORNTON LLP
Accountancy firm EIN	2011-12-31	366055558
2010 : AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,040,598
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$607,066
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$604,864
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$471,168
Value of total assets at end of year	2010-12-31	$5,705,234
Value of total assets at beginning of year	2010-12-31	$5,271,702
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,202
Total interest from all sources	2010-12-31	$9,271
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$175,445
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	$175,445
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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	$471,168
Other income not declared elsewhere	2010-12-31	$13,248
Administrative expenses (other) incurred	2010-12-31	$2,202
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	$433,532
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$5,705,234
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,271,702
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	$4,289,858
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,683,212
Value of interest in pooled separate accounts at end of year	2010-12-31	$40,568
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$32,916
Interest earned on other investments	2010-12-31	$9,271
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$933,131
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$967,543
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$967,543
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$441,677
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$588,031
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$366,555
Net investment gain/loss from pooled separate accounts	2010-12-31	$4,911
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$604,864
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	GRANT THORNTON LLP
Accountancy firm EIN	2010-12-31	366055558
2009 : AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY 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 AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN

2012: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY 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: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY 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: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
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: AMERICAN LUNG ASSOCIATION 403(B) TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

366950

Policy instance

Insurance contract or identification number	366950
Number of Individuals Covered	27
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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?	Yes
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

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

L9916000

Policy instance

Insurance contract or identification number	L9916000
Number of Individuals Covered	18
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $558
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?	Yes
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 $558
Insurance broker organization code?	3
Insurance broker name	CAMMACK LARHETTE BROKERAGE, INC.

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

366950

Policy instance

Insurance contract or identification number	366950
Number of Individuals Covered	37
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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?	Yes
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

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

L9916000

Policy instance

Insurance contract or identification number	L9916000
Number of Individuals Covered	6
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $563
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

366950

Policy instance

Insurance contract or identification number	366950
Number of Individuals Covered	43
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	Yes
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

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

L9916000

Policy instance

Insurance contract or identification number	L9916000
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $754
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?	Yes
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

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Company Name:	AMERICAN LUNG ASSOCIATION
Employer identification number (EIN):	131632524
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2017-05-24
Company Identification Number:	132748096
Legal Registered Office Address:	3337 EDGEMONT RD LAKE OSWEGO United States of America (USA) 97035