401k Plan data: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC plan

TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC
Plan identification number	001

TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

WEST HAWAII COMMUNITY HEALTH CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: WEST HAWAII COMMUNITY HEALTH CENTER, INC.

Employer identification number (EIN): 200495394

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 KATHLEEN BROOKS
001 2016-01-01 KATHLEEN BROOKS
001 2016-01-01
001 2015-01-01 KATHLEEN BROOKS 2016-10-10
001 2014-01-01 KATHLEEN BROOKS 2015-10-05
001 2013-01-01 DIANE PAUTZ 2014-10-14 DIANE PAUTZ 2014-10-14
001 2012-01-01 DIANE PAUTZ 2013-10-03
001 2011-01-01 DIANE PAUTZ 2012-07-19 DIANE PAUTZ 2012-07-19
001 2010-01-01 DIANE PAUTZ 2011-10-17 DIANE PAUTZ 2011-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	KATHLEEN BROOKS
001	2016-01-01	KATHLEEN BROOKS
001	2016-01-01
001	2015-01-01	KATHLEEN BROOKS	2016-10-10
001	2014-01-01	KATHLEEN BROOKS	2015-10-05
001	2013-01-01	DIANE PAUTZ	2014-10-14	DIANE PAUTZ	2014-10-14
001	2012-01-01	DIANE PAUTZ	2013-10-03
001	2011-01-01	DIANE PAUTZ	2012-07-19	DIANE PAUTZ	2012-07-19
001	2010-01-01	DIANE PAUTZ	2011-10-17	DIANE PAUTZ	2011-10-17

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC

Measure Date Value
2022: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2022 401k membership
Total participants, beginning-of-year 2022-01-01 314
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 384
Number of retired or separated participants receiving benefits 2022-01-01 134
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 518
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 518
Number of participants with account balances 2022-01-01 467
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 38
2021: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2021 401k membership
Total participants, beginning-of-year 2021-01-01 275
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 190
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 93
Total of all active and inactive participants 2021-01-01 283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 283
Number of participants with account balances 2021-01-01 268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 22
2020: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2020 401k membership
Total participants, beginning-of-year 2020-01-01 249
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 201
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 75
Total of all active and inactive participants 2020-01-01 276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 276
Number of participants with account balances 2020-01-01 251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2019 401k membership
Total participants, beginning-of-year 2019-01-01 262
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 185
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 62
Total of all active and inactive participants 2019-01-01 247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 247
Number of participants with account balances 2019-01-01 236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 26
2018: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2018 401k membership
Total participants, beginning-of-year 2018-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 169
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 72
Total of all active and inactive participants 2018-01-01 241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 241
Number of participants with account balances 2018-01-01 222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 23
2017: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2017 401k membership
Total participants, beginning-of-year 2017-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 163
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 66
Total of all active and inactive participants 2017-01-01 229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 229
Number of participants with account balances 2017-01-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 26
2016: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2016 401k membership
Total participants, beginning-of-year 2016-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 154
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 43
Total of all active and inactive participants 2016-01-01 197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 197
Number of participants with account balances 2016-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 18

Measure	Date	Value
2022: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2022 401k membership
Total participants, beginning-of-year	2022-01-01	314
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	384
Number of retired or separated participants receiving benefits	2022-01-01	134
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	518
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	518
Number of participants with account balances	2022-01-01	467
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	38
2021: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2021 401k membership
Total participants, beginning-of-year	2021-01-01	275
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	190
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	93
Total of all active and inactive participants	2021-01-01	283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	283
Number of participants with account balances	2021-01-01	268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	22
2020: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2020 401k membership
Total participants, beginning-of-year	2020-01-01	249
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	201
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	75
Total of all active and inactive participants	2020-01-01	276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	276
Number of participants with account balances	2020-01-01	251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2019 401k membership
Total participants, beginning-of-year	2019-01-01	262
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	185
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	62
Total of all active and inactive participants	2019-01-01	247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	247
Number of participants with account balances	2019-01-01	236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	26
2018: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2018 401k membership
Total participants, beginning-of-year	2018-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	169
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	72
Total of all active and inactive participants	2018-01-01	241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	241
Number of participants with account balances	2018-01-01	222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	23
2017: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2017 401k membership
Total participants, beginning-of-year	2017-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	163
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	66
Total of all active and inactive participants	2017-01-01	229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	229
Number of participants with account balances	2017-01-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	26
2016: TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2016 401k membership
Total participants, beginning-of-year	2016-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	154
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	43
Total of all active and inactive participants	2016-01-01	197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	197
Number of participants with account balances	2016-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	18

Financial Data on TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC

Measure	Date	Value
2022 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$663,680
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$339,699
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$279,908
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,726,926
Value of total assets at end of year	2022-12-31	$7,003,093
Value of total assets at beginning of year	2022-12-31	$6,679,112
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$59,791
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$158,726
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,102,258
Participant contributions at end of year	2022-12-31	$167,302
Participant contributions at beginning of year	2022-12-31	$110,506
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$114,063
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$0
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$323,981
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,003,093
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,679,112
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$6,439,142
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$6,072,913
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$6,270
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$152,456
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$396,649
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$495,693
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,221,972
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$510,605
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$279,908
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$59,791
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FORVIS
Accountancy firm EIN	2022-12-31	440160260
2021 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$0
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$0
Total transfer of assets from this plan	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,928,308
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,280,898
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,253,838
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,148,546
Value of total assets at end of year	2021-12-31	$6,679,112
Value of total assets at beginning of year	2021-12-31	$6,031,702
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$27,060
Total income from rents	2021-12-31	$0
Total interest from all sources	2021-12-31	$143,523
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 year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$0
Assets. Real estate other than employer real property at end of year	2021-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$759,671
Participant contributions at end of year	2021-12-31	$110,506
Participant contributions at beginning of year	2021-12-31	$101,691
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$22,157
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$48,605
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$3,167
Administrative expenses (other) incurred	2021-12-31	$0
Liabilities. Value of operating payables at end of year	2021-12-31	$0
Liabilities. Value of operating payables at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$647,410
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,679,112
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,031,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Assets. partnership/joint venture interests at end of year	2021-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2021-12-31	$0
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$6,072,913
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,210,234
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$136,947
Interest on participant loans	2021-12-31	$5,147
Income. Interest from loans (other than to participants)	2021-12-31	$0
Interest earned on other investments	2021-12-31	$138,376
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Value of interest in master investment trust accounts at end of year	2021-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$495,693
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$549,104
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Asset value of US Government securities at end of year	2021-12-31	$0
Asset value of US Government securities at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$633,072
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Net gain/loss from 103.12 investment entities	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Assets. Value of employer real property at end of year	2021-12-31	$0
Assets. Value of employer real property at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$340,270
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$11,569
Income. Dividends from preferred stock	2021-12-31	$0
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,253,838
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$0
Contract administrator fees	2021-12-31	$27,060
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$0
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Aggregate proceeds on sale of assets	2021-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BKD, LLP
Accountancy firm EIN	2021-12-31	440160260
2020 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$0
Total transfer of assets from this plan	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Expenses. Interest paid	2020-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,678,378
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$475,027
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$436,960
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,005,249
Value of total assets at end of year	2020-12-31	$6,031,702
Value of total assets at beginning of year	2020-12-31	$4,828,351
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$38,067
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$9,923
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$64,592
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$64,592
Assets. Real estate other than employer real property at end of year	2020-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2020-12-31	$0
Administrative expenses professional fees incurred	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$639,037
Participant contributions at end of year	2020-12-31	$101,691
Participant contributions at beginning of year	2020-12-31	$79,410
Participant contributions at end of year	2020-12-31	$22,157
Participant contributions at beginning of year	2020-12-31	$57,483
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$77,813
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Assets. Loans (other than to participants) at end of year	2020-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$1,203,351
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,031,702
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,828,351
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Assets. partnership/joint venture interests at end of year	2020-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,210,234
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,028,674
Value of interest in pooled separate accounts at end of year	2020-12-31	$136,947
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$113,159
Interest on participant loans	2020-12-31	$4,141
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$5,782
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Value of interest in master investment trust accounts at end of year	2020-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$549,104
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$527,690
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Asset value of US Government securities at end of year	2020-12-31	$0
Asset value of US Government securities at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$598,614
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Assets. Value of employer real property at end of year	2020-12-31	$0
Assets. Value of employer real property at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$288,399
Employer contributions (assets) at end of year	2020-12-31	$11,569
Employer contributions (assets) at beginning of year	2020-12-31	$21,935
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$436,960
Asset. Corporate debt instrument preferred debt at end of year	2020-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$0
Contract administrator fees	2020-12-31	$38,067
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	BKD, LLP
Accountancy firm EIN	2020-12-31	440160260
2019 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,736,989
Total income from all sources (including contributions)	2019-12-31	$1,736,989
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$260,752
Total of all expenses incurred	2019-12-31	$260,752
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$231,083
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$231,083
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,080,539
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,080,539
Value of total assets at end of year	2019-12-31	$4,828,351
Value of total assets at end of year	2019-12-31	$4,828,351
Value of total assets at beginning of year	2019-12-31	$3,352,114
Value of total assets at beginning of year	2019-12-31	$3,352,114
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,669
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,669
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$12,002
Total interest from all sources	2019-12-31	$12,002
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$65,020
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$65,020
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$65,020
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$65,020
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$450,000
Value of fidelity bond cover	2019-12-31	$450,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$632,187
Contributions received from participants	2019-12-31	$632,187
Participant contributions at end of year	2019-12-31	$79,410
Participant contributions at end of year	2019-12-31	$79,410
Participant contributions at beginning of year	2019-12-31	$51,218
Participant contributions at beginning of year	2019-12-31	$51,218
Participant contributions at end of year	2019-12-31	$57,483
Participant contributions at beginning of year	2019-12-31	$16,904
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$173,735
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$173,735
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,476,237
Value of net income/loss	2019-12-31	$1,476,237
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,828,351
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,828,351
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,352,114
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,352,114
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,028,674
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,028,674
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,669,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,669,617
Value of interest in pooled separate accounts at end of year	2019-12-31	$113,159
Value of interest in pooled separate accounts at end of year	2019-12-31	$113,159
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$90,361
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$90,361
Interest on participant loans	2019-12-31	$3,839
Interest on participant loans	2019-12-31	$3,839
Income. Interest from loans (other than to participants)	2019-12-31	$0
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$8,163
Interest earned on other investments	2019-12-31	$8,163
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$527,690
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$527,690
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$515,113
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$515,113
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$579,428
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$579,428
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$274,617
Contributions received in cash from employer	2019-12-31	$274,617
Employer contributions (assets) at end of year	2019-12-31	$21,935
Employer contributions (assets) at end of year	2019-12-31	$21,935
Employer contributions (assets) at beginning of year	2019-12-31	$8,901
Employer contributions (assets) at beginning of year	2019-12-31	$8,901
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$231,083
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$231,083
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Contract administrator fees	2019-12-31	$29,669
Contract administrator fees	2019-12-31	$29,669
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BKD, LLP
Accountancy firm name	2019-12-31	BKD, LLP
Accountancy firm EIN	2019-12-31	440160260
Accountancy firm EIN	2019-12-31	440160260
2018 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total transfer of assets from this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$687,645
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$896,982
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$872,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$832,594
Value of total assets at end of year	2018-12-31	$3,352,114
Value of total assets at beginning of year	2018-12-31	$3,561,451
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$24,859
Total interest from all sources	2018-12-31	$7,470
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$48,357
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$48,357
Assets. Real estate other than employer real property at end of year	2018-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Administrative expenses professional fees incurred	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$450,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$557,406
Participant contributions at end of year	2018-12-31	$51,218
Participant contributions at beginning of year	2018-12-31	$27,323
Participant contributions at end of year	2018-12-31	$16,904
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$15,349
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$643
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Assets. Loans (other than to participants) at end of year	2018-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-209,337
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,352,114
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,561,451
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Assets. partnership/joint venture interests at end of year	2018-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,669,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,005,714
Value of interest in pooled separate accounts at end of year	2018-12-31	$90,361
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$99,760
Interest on participant loans	2018-12-31	$2,424
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$5,046
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Value of interest in master investment trust accounts at end of year	2018-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$515,113
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$428,654
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Asset value of US Government securities at end of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-191,640
Net investment gain/loss from pooled separate accounts	2018-12-31	$-9,136
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Assets. Value of employer real property at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$259,839
Employer contributions (assets) at end of year	2018-12-31	$8,901
Employer contributions (assets) at beginning of year	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$871,480
Asset. Corporate debt instrument preferred debt at end of year	2018-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$24,859
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BKD, LLP
Accountancy firm EIN	2018-12-31	440160260
2017 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,432,534
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$620,830
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$603,122
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,034,794
Value of total assets at end of year	2017-12-31	$3,561,451
Value of total assets at beginning of year	2017-12-31	$2,749,747
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$17,708
Total interest from all sources	2017-12-31	$5,853
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$45,907
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$45,907
Assets. Real estate other than employer real property at end of year	2017-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$350,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$451,178
Participant contributions at end of year	2017-12-31	$27,323
Participant contributions at beginning of year	2017-12-31	$21,732
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$356,575
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$1,000
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Assets. Loans (other than to participants) at end of year	2017-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$0
Liabilities. Value of operating payables at end of year	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$811,704
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,561,451
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,749,747
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Assets. partnership/joint venture interests at end of year	2017-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$3,005,714
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,200,710
Value of interest in pooled separate accounts at end of year	2017-12-31	$99,760
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$84,056
Interest on participant loans	2017-12-31	$1,067
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$4,786
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Value of interest in master investment trust accounts at end of year	2017-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2017-12-31	$0
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2017-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$428,654
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$440,601
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Asset value of US Government securities at end of year	2017-12-31	$0
Asset value of US Government securities at beginning of year	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$330,016
Net investment gain/loss from pooled separate accounts	2017-12-31	$15,964
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Assets. Invements in employer securities at end of year	2017-12-31	$0
Assets. Invements in employer securities at beginning of year	2017-12-31	$0
Assets. Value of employer real property at end of year	2017-12-31	$0
Assets. Value of employer real property at beginning of year	2017-12-31	$0
Contributions received in cash from employer	2017-12-31	$227,041
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$2,648
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$602,122
Asset. Corporate debt instrument preferred debt at end of year	2017-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$0
Contract administrator fees	2017-12-31	$17,708
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BKD, LLP
Accountancy firm EIN	2017-12-31	440160260
2016 : TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$0
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$756,254
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$179,628
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$171,583
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$560,737
Value of total assets at end of year	2016-12-31	$2,749,747
Value of total assets at beginning of year	2016-12-31	$2,173,121
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$8,045
Total interest from all sources	2016-12-31	$4,749
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$31,081
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$31,081
Assets. Real estate other than employer real property at end of year	2016-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$350,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$363,809
Participant contributions at end of year	2016-12-31	$21,732
Participant contributions at beginning of year	2016-12-31	$21,553
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$12,302
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$4,926
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$576,626
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,749,747
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,173,121
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at end of year	2016-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,200,710
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,781,690
Value of interest in pooled separate accounts at end of year	2016-12-31	$84,056
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$79,317
Interest on participant loans	2016-12-31	$859
Income. Interest from loans (other than to participants)	2016-12-31	$0
Interest earned on other investments	2016-12-31	$3,890
Income. Interest from US Government securities	2016-12-31	$0
Income. Interest from corporate debt instruments	2016-12-31	$0
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$440,601
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$289,792
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$154,922
Net investment gain/loss from pooled separate accounts	2016-12-31	$4,765
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Assets. Invements in employer securities at end of year	2016-12-31	$0
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at end of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$184,626
Employer contributions (assets) at end of year	2016-12-31	$2,648
Employer contributions (assets) at beginning of year	2016-12-31	$769
Income. Dividends from preferred stock	2016-12-31	$0
Income. Dividends from common stock	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$171,583
Asset. Corporate debt instrument preferred debt at end of year	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$3,119
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BKD, LLP
Accountancy firm EIN	2016-12-31	440160260

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF WEST HAWAII COMMUNITY HEALTH CENTER, INC

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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

510618-01

Policy instance

Insurance contract or identification number	510618-01
Number of Individuals Covered	61
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

510618-01

Policy instance

Insurance contract or identification number	510618-01
Number of Individuals Covered	65
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Insurance policy start date	2021-01-01
Insurance policy end date	2021-09-08
Total amount of commissions paid to insurance broker	USD $2,054
Total amount of fees paid to insurance company	USD $205
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2,054
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	264
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,359
Total amount of fees paid to insurance company	USD $239
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,359
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	244
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,535
Total amount of fees paid to insurance company	USD $254
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,535
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS/SERVICE FEES
Insurance broker organization code?	3

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Number of Individuals Covered	9
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Number of Individuals Covered	9
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	259
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $212
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	212
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE

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

Policy contract number

057-317-F-10

Policy instance

Insurance contract or identification number	057-317-F-10
Number of Individuals Covered	9
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	210
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,076
Total amount of fees paid to insurance company	USD $216
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,076
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	CENTRAL ADMINISTRATIVE SERVICES INC

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Company Name:	WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Employer identification number (EIN):	200495394
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists