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NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 401k Plan overview

Plan NameNORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN
Plan identification number 001

NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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.
  • 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

NORTHWEST FLORIDA COMMUNITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:NORTHWEST FLORIDA COMMUNITY HOSPITAL
Employer identification number (EIN):200244662
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about NORTHWEST FLORIDA COMMUNITY HOSPITAL

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2003-09-22
Company Identification Number: P03000104091
Legal Registered Office Address: 5011 SOUTH STATE ROAD 7

DAVIE

33314

More information about NORTHWEST FLORIDA COMMUNITY HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01STEVEN LISENBY2023-10-16 STEVEN LISENBY2023-10-16
0012021-01-01STEVEN LISENBY2022-10-17 STEVEN LISENBY2022-10-17
0012020-01-01STEVEN LISENBY2021-10-15 STEVEN LISENBY2021-10-15
0012019-01-01
0012018-01-01
0012017-01-01MARCEY BLACK MARCEY BLACK2018-10-15
0012016-01-01MARCEY BLACK MARCEY BLACK2017-12-26
0012015-01-01MARCEY BLACK MARCEY BLACK2016-10-15
0012014-01-01MARCEY BLACK MARCEY BLACK2015-10-14
0012013-01-01MARCEY BLACK MARCEY BLACK2014-10-14
0012012-01-01MARCEY BLACK MARCEY BLACK2013-10-11
0012011-01-01MARCEY BLACK MARCEY BLACK2012-10-12
0012010-01-01MARCEY BLACK MARCEY BLACK2011-10-16
0012009-01-01MARCEY BLACK MARCEY BLACK2010-10-13

Plan Statistics for NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN

401k plan membership statisitcs for NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN

Measure Date Value
2022: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01287
Total number of active participants reported on line 7a of the Form 55002022-01-01242
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-0136
Total of all active and inactive participants2022-01-01281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01281
Number of participants with account balances2022-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-013
2021: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01265
Total number of active participants reported on line 7a of the Form 55002021-01-01234
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0131
Total of all active and inactive participants2021-01-01266
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01266
Number of participants with account balances2021-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01273
Total number of active participants reported on line 7a of the Form 55002020-01-01232
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0123
Total of all active and inactive participants2020-01-01255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01255
Number of participants with account balances2020-01-01102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01251
Total number of active participants reported on line 7a of the Form 55002019-01-01235
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0119
Total of all active and inactive participants2019-01-01254
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01254
Number of participants with account balances2019-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01251
Total number of active participants reported on line 7a of the Form 55002018-01-01223
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0121
Total of all active and inactive participants2018-01-01244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01244
Number of participants with account balances2018-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-013
2017: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01193
Total number of active participants reported on line 7a of the Form 55002017-01-01216
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0122
Total of all active and inactive participants2017-01-01238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01238
Number of participants with account balances2017-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-014
2016: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01194
Total number of active participants reported on line 7a of the Form 55002016-01-01163
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0113
Total of all active and inactive participants2016-01-01176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01176
Number of participants with account balances2016-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01202
Total number of active participants reported on line 7a of the Form 55002015-01-01162
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0112
Total of all active and inactive participants2015-01-01174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01174
Number of participants with account balances2015-01-01105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01201
Total number of active participants reported on line 7a of the Form 55002014-01-01156
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0123
Total of all active and inactive participants2014-01-01179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01179
Number of participants with account balances2014-01-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-014
2013: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01190
Total number of active participants reported on line 7a of the Form 55002013-01-01159
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0126
Total of all active and inactive participants2013-01-01185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01185
Number of participants with account balances2013-01-01130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-016
2012: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01198
Total number of active participants reported on line 7a of the Form 55002012-01-01155
Number of other retired or separated participants entitled to future benefits2012-01-0120
Total of all active and inactive participants2012-01-01175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01175
Number of participants with account balances2012-01-01105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0119
2011: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01215
Total number of active participants reported on line 7a of the Form 55002011-01-01183
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0127
Total of all active and inactive participants2011-01-01210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01210
Number of participants with account balances2011-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0117
2010: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01194
Total number of active participants reported on line 7a of the Form 55002010-01-01191
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0121
Total of all active and inactive participants2010-01-01212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01212
Number of participants with account balances2010-01-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-017
2009: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01196
Total number of active participants reported on line 7a of the Form 55002009-01-01186
Number of other retired or separated participants entitled to future benefits2009-01-017
Total of all active and inactive participants2009-01-01193
Total participants2009-01-01193
Number of participants with account balances2009-01-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN

Measure Date Value
2022 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$9,250
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$6,075
Total income from all sources (including contributions)2022-12-31$-229,150
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$211,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$140,864
Value of total corrective distributions2022-12-31$69,233
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$419,896
Value of total assets at end of year2022-12-31$3,103,648
Value of total assets at beginning of year2022-12-31$3,540,745
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,025
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$1,025
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$315,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$355,126
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$5,076
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$9,250
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$6,075
Total non interest bearing cash at end of year2022-12-31$9,250
Total non interest bearing cash at beginning of year2022-12-31$6,075
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-440,272
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,094,398
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,534,670
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,034,704
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$3,484,202
Net investment gain/loss from pooled separate accounts2022-12-31$-649,046
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$59,694
Employer contributions (assets) at end of year2022-12-31$59,694
Employer contributions (assets) at beginning of year2022-12-31$50,468
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$140,864
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CARR, RIGGS, AND INGRAM LLC
Accountancy firm EIN2022-12-31721396621
2021 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$6,075
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,970
Total income from all sources (including contributions)2021-12-31$759,972
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$336,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$269,795
Value of total corrective distributions2021-12-31$62,967
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$330,187
Value of total assets at end of year2021-12-31$3,540,745
Value of total assets at beginning of year2021-12-31$3,114,308
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$3,878
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$3,878
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$315,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$279,719
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$7,555
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$6,075
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$2,970
Total non interest bearing cash at end of year2021-12-31$6,075
Total non interest bearing cash at beginning of year2021-12-31$2,970
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$423,332
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,534,670
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,111,338
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,484,202
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$3,057,312
Net investment gain/loss from pooled separate accounts2021-12-31$429,785
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$50,468
Employer contributions (assets) at end of year2021-12-31$50,468
Employer contributions (assets) at beginning of year2021-12-31$46,471
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$269,795
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31SMITH, DUKES, & BUCKALEW LLP
Accountancy firm EIN2021-12-31630191630
2020 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,970
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,353
Total income from all sources (including contributions)2020-12-31$738,086
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$415,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$378,920
Value of total corrective distributions2020-12-31$36,207
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$305,222
Value of total assets at end of year2020-12-31$3,114,308
Value of total assets at beginning of year2020-12-31$2,790,332
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$600
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$600
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$250,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$248,751
Participant contributions at end of year2020-12-31$7,555
Participant contributions at beginning of year2020-12-31$7,894
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$10,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$2,970
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$1,353
Total non interest bearing cash at end of year2020-12-31$2,970
Total non interest bearing cash at beginning of year2020-12-31$1,353
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$322,359
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,111,338
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,788,979
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$3,057,312
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,735,470
Net investment gain/loss from pooled separate accounts2020-12-31$432,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$46,471
Employer contributions (assets) at end of year2020-12-31$46,471
Employer contributions (assets) at beginning of year2020-12-31$45,615
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$378,920
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31SMITH, DUKES, & BUCKALEW LLP
Accountancy firm EIN2020-12-31630191630
2019 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,353
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,414
Total income from all sources (including contributions)2019-12-31$764,046
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$144,880
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$132,395
Value of total corrective distributions2019-12-31$10,598
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$291,692
Value of total assets at end of year2019-12-31$2,790,332
Value of total assets at beginning of year2019-12-31$2,174,227
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,887
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$1,887
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$250,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$246,077
Participant contributions at end of year2019-12-31$7,894
Participant contributions at beginning of year2019-12-31$8,053
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$1,353
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$4,414
Total non interest bearing cash at end of year2019-12-31$1,353
Total non interest bearing cash at beginning of year2019-12-31$4,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$619,166
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,788,979
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,169,813
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,735,470
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,121,353
Net investment gain/loss from pooled separate accounts2019-12-31$472,354
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$45,615
Employer contributions (assets) at end of year2019-12-31$45,615
Employer contributions (assets) at beginning of year2019-12-31$40,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$132,395
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31SMITH, DUKES, & BUCKALEW LLP
Accountancy firm EIN2019-12-31630191630
2018 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$4,414
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$688
Total income from all sources (including contributions)2018-12-31$114,907
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$83,739
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$66,895
Value of total corrective distributions2018-12-31$11,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$278,011
Value of total assets at end of year2018-12-31$2,174,227
Value of total assets at beginning of year2018-12-31$2,139,333
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$5,528
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$5,528
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$200,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$237,672
Participant contributions at end of year2018-12-31$8,053
Participant contributions at beginning of year2018-12-31$6,327
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$4,414
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$688
Administrative expenses (other) incurred2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$4,482
Total non interest bearing cash at beginning of year2018-12-31$4,811
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$31,168
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,169,813
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,138,645
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,121,353
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,098,285
Net investment gain/loss from pooled separate accounts2018-12-31$-163,104
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$40,339
Employer contributions (assets) at end of year2018-12-31$40,339
Employer contributions (assets) at beginning of year2018-12-31$29,910
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$66,895
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN2018-12-31630191630
2017 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$688
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,653
Total income from all sources (including contributions)2017-12-31$485,025
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$95,685
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$70,343
Value of total corrective distributions2017-12-31$23,601
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$207,609
Value of total assets at end of year2017-12-31$2,139,333
Value of total assets at beginning of year2017-12-31$1,750,958
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,741
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$1,741
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$200,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$176,039
Participant contributions at end of year2017-12-31$6,327
Participant contributions at beginning of year2017-12-31$5,314
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$688
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$1,653
Administrative expenses (other) incurred2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$4,811
Total non interest bearing cash at beginning of year2017-12-31$2,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$389,340
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,138,645
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,749,305
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,098,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,706,595
Interest earned on other investments2017-12-31$0
Net investment gain/loss from pooled separate accounts2017-12-31$277,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$31,570
Employer contributions (assets) at end of year2017-12-31$29,910
Employer contributions (assets) at beginning of year2017-12-31$36,999
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$70,343
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN2017-12-31630191630
2016 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,653
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,904
Total income from all sources (including contributions)2016-12-31$355,740
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$180,418
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$172,520
Value of total corrective distributions2016-12-31$4,862
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$235,298
Value of total assets at end of year2016-12-31$1,750,958
Value of total assets at beginning of year2016-12-31$1,578,887
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$3,036
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$200,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$198,299
Participant contributions at end of year2016-12-31$5,314
Participant contributions at beginning of year2016-12-31$6,065
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$1,653
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$4,904
Administrative expenses (other) incurred2016-12-31$3,036
Total non interest bearing cash at end of year2016-12-31$2,050
Total non interest bearing cash at beginning of year2016-12-31$6,265
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$175,322
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,749,305
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,573,983
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$1,706,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,566,557
Net investment gain/loss from pooled separate accounts2016-12-31$120,442
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$36,999
Employer contributions (assets) at end of year2016-12-31$36,999
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$172,520
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN2016-12-31630191630
2015 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,904
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$292
Total income from all sources (including contributions)2015-12-31$199,369
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$160,722
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$153,879
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$212,373
Value of total assets at end of year2015-12-31$1,578,887
Value of total assets at beginning of year2015-12-31$1,535,628
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$6,843
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$200,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$212,373
Participant contributions at end of year2015-12-31$6,065
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$4,904
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$292
Administrative expenses (other) incurred2015-12-31$6,843
Total non interest bearing cash at end of year2015-12-31$6,265
Total non interest bearing cash at beginning of year2015-12-31$6,179
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$38,647
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,573,983
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,535,336
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,566,557
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,522,741
Net investment gain/loss from pooled separate accounts2015-12-31$-13,004
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$6,708
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$153,879
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2015-12-31630191630
2014 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$292
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$9,339
Total income from all sources (including contributions)2014-12-31$271,416
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$282,882
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$280,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$190,729
Value of total assets at end of year2014-12-31$1,535,628
Value of total assets at beginning of year2014-12-31$1,556,141
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,801
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$2,801
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$150,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$184,021
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$292
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$9,339
Administrative expenses (other) incurred2014-12-31$0
Total non interest bearing cash at end of year2014-12-31$6,179
Total non interest bearing cash at beginning of year2014-12-31$10,250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-11,466
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,535,336
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,546,802
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,522,741
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,545,846
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$80,687
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$6,708
Employer contributions (assets) at end of year2014-12-31$6,708
Employer contributions (assets) at beginning of year2014-12-31$45
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$280,081
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$0
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2014-12-31630191630
2013 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$9,339
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,746
Total income from all sources (including contributions)2013-12-31$379,582
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$125,447
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$115,691
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$158,519
Value of total assets at end of year2013-12-31$1,556,141
Value of total assets at beginning of year2013-12-31$1,299,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$9,756
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$9,756
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$150,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$158,519
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$9,339
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$5,631
Administrative expenses (other) incurred2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$10,250
Total non interest bearing cash at beginning of year2013-12-31$14,138
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$254,135
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,546,802
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,292,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,545,846
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,285,275
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$221,063
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$0
Employer contributions (assets) at end of year2013-12-31$45
Employer contributions (assets) at beginning of year2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$115,691
Liabilities. Value of benefit claims payable at end of year2013-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$1,115
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2013-12-31630191630
2012 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,746
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$4,782
Total income from all sources (including contributions)2012-12-31$320,605
Total of all expenses incurred2012-12-31$318,395
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$310,338
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$162,681
Value of total assets at end of year2012-12-31$1,299,413
Value of total assets at beginning of year2012-12-31$1,295,239
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$8,057
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$8,057
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$150,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$162,681
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$5,631
Total non interest bearing cash at end of year2012-12-31$14,138
Total non interest bearing cash at beginning of year2012-12-31$6,615
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$2,210
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,292,667
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,290,457
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,285,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,240,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$157,924
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$0
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$48,496
Income. Dividends from preferred stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$310,338
Liabilities. Value of benefit claims payable at end of year2012-12-31$1,115
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$4,782
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2012-12-31630191630
2011 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,782
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$9,071
Total income from all sources (including contributions)2011-12-31$218,153
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$70,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$69,195
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$242,732
Value of total assets at end of year2011-12-31$1,295,239
Value of total assets at beginning of year2011-12-31$1,152,195
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,625
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$1,625
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$150,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$194,185
Total non interest bearing cash at end of year2011-12-31$6,615
Total non interest bearing cash at beginning of year2011-12-31$485
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$147,333
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,290,457
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,143,124
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,240,128
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,095,047
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-24,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$48,547
Employer contributions (assets) at end of year2011-12-31$48,496
Employer contributions (assets) at beginning of year2011-12-31$56,663
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$69,195
Contract administrator fees2011-12-31$0
Liabilities. Value of benefit claims payable at end of year2011-12-31$4,782
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$9,071
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2011-12-31630191630
2010 : NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$9,071
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$376,819
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$41,236
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$22,799
Value of total corrective distributions2010-12-31$15,281
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$258,463
Value of total assets at end of year2010-12-31$1,152,195
Value of total assets at beginning of year2010-12-31$807,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$3,156
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$150
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$100,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$166,535
Total non interest bearing cash at end of year2010-12-31$485
Total non interest bearing cash at beginning of year2010-12-31$3
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$335,583
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,143,124
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$807,541
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,095,047
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$806,744
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$118,356
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$91,928
Employer contributions (assets) at end of year2010-12-31$56,663
Employer contributions (assets) at beginning of year2010-12-31$794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$22,799
Contract administrator fees2010-12-31$3,006
Liabilities. Value of benefit claims payable at end of year2010-12-31$9,071
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31SMITH, DUKES & BUCKALEW, LLP
Accountancy firm EIN2010-12-31630191630

Form 5500 Responses for NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN

2022: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: NORTHWEST FLORIDA COMMUNITY HOSPITAL RETIREMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered167
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $11,491
Total amount of fees paid to insurance companyUSD $1,025
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,491
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered148
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,944
Total amount of fees paid to insurance companyUSD $772
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,163
Insurance broker organization code?3
Amount paid for insurance broker fees772
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered131
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,806
Total amount of fees paid to insurance companyUSD $600
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,806
Insurance broker organization code?3
Amount paid for insurance broker fees600
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered124
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,921
Total amount of fees paid to insurance companyUSD $4,947
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,921
Insurance broker organization code?3
Amount paid for insurance broker fees4947
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered130
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,195
Total amount of fees paid to insurance companyUSD $1,802
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,195
Insurance broker organization code?3
Amount paid for insurance broker fees1802
Additional information about fees paid to insurance brokerFEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered134
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,722
Total amount of fees paid to insurance companyUSD $2,704
Commission paid to Insurance BrokerUSD $6,722
Insurance broker organization code?3
Amount paid for insurance broker fees2704
Insurance broker nameSALTMARSH, CLEAVELAND, GUND
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,950
Total amount of fees paid to insurance companyUSD $2,230
Commission paid to Insurance BrokerUSD $4,111
Insurance broker organization code?6
Amount paid for insurance broker fees2230
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATIVE FEES
Insurance broker nameCADERET, GRANT & CO INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered143
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,736
Total amount of fees paid to insurance companyUSD $11,309
Commission paid to Insurance BrokerUSD $4,736
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Insurance broker nameSALTMARSH, CLEAVELAND, GUND
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered162
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,336
Total amount of fees paid to insurance companyUSD $6,881
Commission paid to Insurance BrokerUSD $4,336
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Amount paid for insurance broker fees6881
Insurance broker nameSALTMARSH, CLEAVELAND, GUND
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,276
Total amount of fees paid to insurance companyUSD $2,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,276
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Amount paid for insurance broker fees2452
Insurance broker nameSALTMARSH, CLEAVELAND, GUND
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered163
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,300
Total amount of fees paid to insurance companyUSD $1,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number26279
Policy instance 1
Insurance contract or identification number26279
Number of Individuals Covered143
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,333
Total amount of fees paid to insurance companyUSD $165

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