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CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 401k Plan overview

Plan NameCHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN
Plan identification number 002

CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.

401k Sponsoring company profile

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

Company Name:CHILTON MEMORIAL HOSPITAL
Employer identification number (EIN):221559402
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022015-01-01LYNN TURNER LYNN TURNER2016-08-08
0022014-01-01LYNN TURNER LYNN TURNER2015-10-13
0022013-01-01LYNN TURNER LYNN TURNER2014-10-15
0022012-01-01DEBORAH MEIER
0022011-01-01DEBORAH MEIER
0022010-01-01DEBORAH MEIER

Plan Statistics for CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN

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

Measure Date Value
2015: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,288
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
2014: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,470
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011,288
Total of all active and inactive participants2014-01-011,288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-011,288
Number of participants with account balances2014-01-011,288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,468
Total number of active participants reported on line 7a of the Form 55002013-01-011,409
Number of retired or separated participants receiving benefits2013-01-013
Number of other retired or separated participants entitled to future benefits2013-01-0158
Total of all active and inactive participants2013-01-011,470
Total participants2013-01-011,470
Number of participants with account balances2013-01-011,337
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0174
2012: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,580
Total number of active participants reported on line 7a of the Form 55002012-01-011,393
Number of retired or separated participants receiving benefits2012-01-015
Number of other retired or separated participants entitled to future benefits2012-01-0170
Total of all active and inactive participants2012-01-011,468
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-011,468
Number of participants with account balances2012-01-011,363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0186
2011: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,399
Total number of active participants reported on line 7a of the Form 55002011-01-011,554
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0126
Total of all active and inactive participants2011-01-011,580
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-011,580
Number of participants with account balances2011-01-01530
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0129
2010: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,360
Total number of active participants reported on line 7a of the Form 55002010-01-011,383
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0116
Total of all active and inactive participants2010-01-011,399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-011,399
Number of participants with account balances2010-01-01446
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0154

Financial Data on CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN

Measure Date Value
2015 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2015 401k financial data
Total transfer of assets from this plan2015-10-31$23,085,660
Total income from all sources (including contributions)2015-10-31$235,787
Total of all expenses incurred2015-10-31$1,899,539
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-10-31$1,863,055
Expenses. Certain deemed distributions of participant loans2015-10-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-10-31$0
Value of total assets at end of year2015-10-31$0
Value of total assets at beginning of year2015-10-31$24,749,412
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-10-31$36,484
Total interest from all sources2015-10-31$106,550
Total dividends received (eg from common stock, registered investment company shares)2015-10-31$71,247
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-10-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-10-31$71,247
Administrative expenses professional fees incurred2015-10-31$36,484
Was this plan covered by a fidelity bond2015-10-31Yes
Value of fidelity bond cover2015-10-31$500,000
If this is an individual account plan, was there a blackout period2015-10-31No
Were there any nonexempt tranactions with any party-in-interest2015-10-31No
Participant contributions at end of year2015-10-31$0
Participant contributions at beginning of year2015-10-31$435,101
Assets. Other investments not covered elsewhere at beginning of year2015-10-31$2,769,212
Income. Received or receivable in cash from other sources (including rollovers)2015-10-31$0
Other income not declared elsewhere2015-10-31$-6,585
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-10-31No
Value of net income/loss2015-10-31$-1,663,752
Value of net assets at end of year (total assets less liabilities)2015-10-31$0
Value of net assets at beginning of year (total assets less liabilities)2015-10-31$24,749,412
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-10-31No
Were any leases to which the plan was party in default or uncollectible2015-10-31No
Investment advisory and management fees2015-10-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-10-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-10-31$17,904,617
Interest on participant loans2015-10-31$18,593
Interest earned on other investments2015-10-31$87,957
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-10-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-10-31$3,640,482
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-10-31$64,575
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-10-31Yes
Was there a failure to transmit to the plan any participant contributions2015-10-31No
Has the plan failed to provide any benefit when due under the plan2015-10-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-10-31$1,863,055
Contract administrator fees2015-10-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-10-31No
Did the plan have assets held for investment2015-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-10-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-10-31Yes
Opinion of an independent qualified public accountant for this plan2015-10-31Disclaimer
Accountancy firm name2015-10-31WISS & COMPANY LLP
Accountancy firm EIN2015-10-31221732349
2014 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$1,341,526
Total of all expenses incurred2014-12-31$2,984,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,934,865
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$0
Value of total assets at end of year2014-12-31$24,749,412
Value of total assets at beginning of year2014-12-31$26,392,224
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$49,473
Total interest from all sources2014-12-31$135,245
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$726,702
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$726,702
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$0
Participant contributions at end of year2014-12-31$435,101
Participant contributions at beginning of year2014-12-31$349,817
Assets. Other investments not covered elsewhere at end of year2014-12-31$2,769,212
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$3,092,397
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-1,642,812
Value of net assets at end of year (total assets less liabilities)2014-12-31$24,749,412
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$26,392,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$17,904,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$16,628,798
Interest on participant loans2014-12-31$20,208
Interest earned on other investments2014-12-31$115,037
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$3,640,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$3,865,394
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$479,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$0
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$2,455,818
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,934,865
Contract administrator fees2014-12-31$49,473
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31WISS & COMPANY LLP
Accountancy firm EIN2014-12-31221732349
2013 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$1,991,803
Total unrealized appreciation/depreciation of assets2013-12-31$1,991,803
Total income from all sources (including contributions)2013-12-31$9,667,563
Total of all expenses incurred2013-12-31$1,896,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,858,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$7,175,716
Value of total assets at end of year2013-12-31$26,392,224
Value of total assets at beginning of year2013-12-31$18,621,607
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$38,867
Total interest from all sources2013-12-31$121,588
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$378,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$378,456
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$3,482,790
Participant contributions at end of year2013-12-31$349,817
Participant contributions at beginning of year2013-12-31$231,763
Assets. Other investments not covered elsewhere at end of year2013-12-31$3,092,397
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$3,106,248
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$327,536
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$7,770,617
Value of net assets at end of year (total assets less liabilities)2013-12-31$26,392,224
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$18,621,607
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$16,628,798
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$10,857,988
Interest on participant loans2013-12-31$15,110
Interest earned on other investments2013-12-31$106,478
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$3,865,394
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$3,110,769
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$3,365,390
Employer contributions (assets) at end of year2013-12-31$2,455,818
Employer contributions (assets) at beginning of year2013-12-31$1,314,839
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,858,079
Contract administrator fees2013-12-31$38,867
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31WISS & COMPANY LLP
Accountancy firm EIN2013-12-31221732349
2012 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$0
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Expenses. Interest paid2012-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-12-31$0
Total income from all sources (including contributions)2012-12-31$6,636,947
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,485,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,392,506
Expenses. Certain deemed distributions of participant loans2012-12-31$65,464
Value of total corrective distributions2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$5,172,440
Value of total assets at end of year2012-12-31$18,621,607
Value of total assets at beginning of year2012-12-31$13,469,971
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$27,341
Total income from rents2012-12-31$0
Total interest from all sources2012-12-31$105,284
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$277,324
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$277,324
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$2,900,323
Participant contributions at end of year2012-12-31$231,763
Participant contributions at beginning of year2012-12-31$320,318
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Assets. Other investments not covered elsewhere at end of year2012-12-31$3,106,248
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$2,242,463
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$515,578
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Assets. Loans (other than to participants) at end of year2012-12-31$0
Assets. Loans (other than to participants) at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$0
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Income. Non cash contributions2012-12-31$0
Value of net income/loss2012-12-31$5,151,636
Value of net assets at end of year (total assets less liabilities)2012-12-31$18,621,607
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$13,469,971
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Assets. partnership/joint venture interests at end of year2012-12-31$0
Assets. partnership/joint venture interests at beginning of year2012-12-31$0
Investment advisory and management fees2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$10,857,988
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$8,452,774
Interest on participant loans2012-12-31$13,246
Income. Interest from loans (other than to participants)2012-12-31$0
Interest earned on other investments2012-12-31$92,038
Income. Interest from US Government securities2012-12-31$0
Income. Interest from corporate debt instruments2012-12-31$0
Value of interest in master investment trust accounts at end of year2012-12-31$0
Value of interest in master investment trust accounts at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2012-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$3,110,769
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$2,347,538
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Asset value of US Government securities at end of year2012-12-31$0
Asset value of US Government securities at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$1,081,899
Net investment gain/loss from pooled separate accounts2012-12-31$0
Net investment gain or loss from common/collective trusts2012-12-31$0
Net gain/loss from 103.12 investment entities2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Assets. Value of employer real property at end of year2012-12-31$0
Assets. Value of employer real property at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$1,756,539
Employer contributions (assets) at end of year2012-12-31$1,314,839
Employer contributions (assets) at beginning of year2012-12-31$106,878
Income. Dividends from preferred stock2012-12-31$0
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,392,506
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$0
Contract administrator fees2012-12-31$27,341
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$0
Liabilities. Value of benefit claims payable at end of year2012-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$0
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$0
Aggregate carrying amount (costs) on sale of assets2012-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2012-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31WITHUM SMITH AND BROWN
Accountancy firm EIN2012-12-31222027092
2011 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Expenses. Interest paid2011-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022011-12-31$0
Total income from all sources (including contributions)2011-12-31$3,365,805
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$390,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$367,225
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Value of total corrective distributions2011-12-31$12
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,394,086
Value of total assets at end of year2011-12-31$13,469,971
Value of total assets at beginning of year2011-12-31$10,494,892
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$23,489
Total income from rents2011-12-31$0
Total interest from all sources2011-12-31$80,661
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$261,235
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$261,235
Assets. Real estate other than employer real property at end of year2011-12-31$0
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,429,463
Participant contributions at end of year2011-12-31$320,318
Participant contributions at beginning of year2011-12-31$287,464
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Assets. Other investments not covered elsewhere at end of year2011-12-31$2,242,463
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$844,198
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Assets. Loans (other than to participants) at end of year2011-12-31$0
Assets. Loans (other than to participants) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Other income not declared elsewhere2011-12-31$-92,599
Administrative expenses (other) incurred2011-12-31$0
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Income. Non cash contributions2011-12-31$0
Value of net income/loss2011-12-31$2,975,079
Value of net assets at end of year (total assets less liabilities)2011-12-31$13,469,971
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$10,494,892
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Assets. partnership/joint venture interests at end of year2011-12-31$0
Assets. partnership/joint venture interests at beginning of year2011-12-31$0
Investment advisory and management fees2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$8,452,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$8,146,293
Interest on participant loans2011-12-31$14,853
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$65,808
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Value of interest in master investment trust accounts at end of year2011-12-31$0
Value of interest in master investment trust accounts at beginning of year2011-12-31$0
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2011-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$2,347,538
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$2,047,760
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Asset value of US Government securities at end of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-277,578
Net investment gain/loss from pooled separate accounts2011-12-31$0
Net investment gain or loss from common/collective trusts2011-12-31$0
Net gain/loss from 103.12 investment entities2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Assets. Invements in employer securities at end of year2011-12-31$0
Assets. Invements in employer securities at beginning of year2011-12-31$0
Assets. Value of employer real property at end of year2011-12-31$0
Assets. Value of employer real property at beginning of year2011-12-31$0
Contributions received in cash from employer2011-12-31$120,425
Employer contributions (assets) at end of year2011-12-31$106,878
Employer contributions (assets) at beginning of year2011-12-31$13,375
Income. Dividends from preferred stock2011-12-31$0
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$367,225
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$0
Contract administrator fees2011-12-31$23,489
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$0
Liabilities. Value of benefit claims payable at end of year2011-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$0
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$0
Aggregate carrying amount (costs) on sale of assets2011-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2011-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31WITHUM SMITH AND BROWN
Accountancy firm EIN2011-12-31222027092
2010 : CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$11,198,995
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$704,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$685,955
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$10,309,291
Value of total assets at end of year2010-12-31$10,494,892
Value of total assets at beginning of year2010-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$18,148
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$52,792
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$227,671
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$227,671
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$2,014,765
Participant contributions at end of year2010-12-31$287,464
Participant contributions at beginning of year2010-12-31$0
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$8,281,151
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$1,500
Total non interest bearing cash at end of year2010-12-31$0
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$10,494,892
Value of net assets at end of year (total assets less liabilities)2010-12-31$10,494,892
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$8,146,293
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Interest on participant loans2010-12-31$5,982
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$46,810
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$2,047,760
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Asset value of US Government securities at end of year2010-12-31$0
Asset value of US Government securities at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$609,241
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Assets. Value of employer real property at end of year2010-12-31$0
Assets. Value of employer real property at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$13,375
Employer contributions (assets) at end of year2010-12-31$13,375
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$685,955
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$0
Contract administrator fees2010-12-31$16,648
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Liabilities. Value of benefit claims payable at end of year2010-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31WITHUM SMITH AND BROWN
Accountancy firm EIN2010-12-31222027092

Form 5500 Responses for CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN

2015: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: CHILTON MEMORIAL HOSPITAL 403(B) SAVINGS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Insurance policy start date2015-01-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Number of Individuals Covered179
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,678
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for 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 BrokerUSD $1,678
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Number of Individuals Covered196
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,581
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITY CONTRACT
Commission paid to Insurance BrokerUSD $5,581
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Number of Individuals Covered1363
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,830
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,830
Insurance broker organization code?3
Insurance broker nameMETLIFE SECURITIES INC.
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Number of Individuals Covered530
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,681
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1009861-01
Policy instance 1
Insurance contract or identification number1009861-01
Number of Individuals Covered446
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12,965
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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